I hereby certify that all information I furnished/ I will furnish in the application form are true and correct. Should said information furnished therein be found to be false, the Creditor may disapprove the application and/or declare the loan to be due and demandable (in case the loan proceeds have already been released). MCC MONEY SHOPS FINANCE COMPANY INC. and its authorized representative/s are hereby authorized to validate the information provided in the form from our employer, personal references, banks and other such sources.

Person/s identified in the form are hereby authorized to provide information/documents required in connection with the application. I fully understand that loan release shall only be allowed once all requirements of MCC MONEY SHOPS FINANCE COMPANY INC. are complied with.

MCC MONEY SHOPS FINANCE COMPANY INC. is also hereby authorized to fill-up the necessary information required in the Promissory Note and the Disclosure Statement, both of which I have signed/I will sign therein, including the date, amount of the loan granted to me, and the interest rate in accordance with the creditor’s applicable policies and the approved terms and conditions of the loan.

In case of disapproval of the application, I understand that the company is not obliged to disclose the reason/s for such disapproval. In the event of future delinquency, I hereby authorize MCC MONEY SHOPS FINANCE COMPANY INC. to report and/or include my name in the negative listing of any credit bureau or institution.

By agreeing to these terms and conditions, I expressly and absolutely remiss, release and forever discharge MCC MONEY SHOPS FINANCE COMPANY, INC. and the company’s administrators, directors, stockholders, officers, assigns and or any of its employees from any and all claims, suits, actions or causes of action which I, my successors/assigns now have or in the future claim to have against the said company in connection with my rights under the Data Privacy Act of 2012 and its Implementing Rules and Regulations (IRR).