Example Payday Loan Partial Payment Agreement

Do you need an example of a payday loan partial payment agreement; sometimes called a “Delayed Deposit Partial Payment Agreement?” [For this form and all the others you’ll need to successfully make money by lending money in the payday loan, installment and car title loan industry, get our “Bible.”]

Let’s face it. Payday loan lenders, car title loan lenders, installment loan lenders, crowd funding and peer-2-peer lenders  must often take a softer approach. Nothing wrong with this. But, get everything in writing AND spend the time necessary to explain the details to your borrower. Do not gloss over this! Invest the time with your borrower to make it clear what your borrower needs to do and what will occur if they fail to meet their obligation.

DELAYED DEPOSIT SERVICES PARTIAL PAYMENT AGREEMENT (CASH)

 

Licensee Name: __________________________      Customer Name _________________________

Address: ________________________________       Address:_______________________________

________________________________________       _______________________________________

Telephone: ______________________________       Telephone: _____________________________

 

Customer acknowledges:

• I entered into a delayed deposit transaction with Licensee on __________________.
• The check which I wrote in that transaction has been returned unpaid.
• The returned check number is _________.
• The amount of the returned check is $__________.
• Licensee has added a penalty fee of $___________.
• The total amount I owe to Licensee is $_________.
• I wish to make partial payments in order to pay off the full amount I owe to Licensee.

 

Customer and Licensee agree as follows:

• Customer will make payments to Licensee in satisfaction of the above debt in the minimum amount of $______.
• Such payments will be made

___Weekly; ___Bi-weekly; ___Monthly; ___Other (Specify:_________________).

• The payment is due on the _____ day of each ___________; ___Other (Specify:_____________).
• The payments will be made in cash or by money order. Checks cannot be accepted.
• Customer is entitled to a receipt for each payment.
• Customer may pre-pay all or part of the above debt at any time.
• If Customer makes payments according to this schedule, Licensee will not attempt other collection methods available to Licensee and will not re-present the check.
• If Customer fails to make the first payment under this Agreement, Licensee is entitled to re-present the original check for payment. At its option, Licensee may re-present the check electronically within 7 business days of the missed payment date, and may separately electronically debit Customer’s account for the penalty fee.  Licensee may re-present the check more than once.  Customer will receive no additional notification of re-presentment(s) of the check.  Customer may incur costs from the financial institution each time the check is returned unpaid.
• If Customer defaults, in whole or in part, under the Agreement, Licensee may utilize any collection methods available to it under the law. Customer may incur additional costs as a result.
• Licensee will keep a record showing every payment received from Customer. Customer is entitled to a copy of such record during Licensee’s regular business hours, and a copy of this contract.
• Upon successful completion of this contract, the original check will be returned to Customer.

 

____________________________________               __________________________________

Customer Signature                                                    Licensee Representative Signature

 

Date: _______________________________              Date:_____________________________

 

                                                                                                  

                                                                                                          DDS Partial Payments Form/Cash

DELAYED DEPOSIT SERVICES PARTIAL PAYMENT AGREEMENT (ACH)

 

Licensee Name: __________________________      Customer Name _________________________

Address: ________________________________       Address:_______________________________

________________________________________       _______________________________________

Telephone: ______________________________       Telephone: _____________________________

 

Customer acknowledges:

• I entered into a delayed deposit transaction with Licensee on __________________.
• The check which I wrote in that transaction has been returned unpaid.
• The returned check number is _________.
• The amount of the returned check is $__________.
• Licensee has added a penalty fee of $___________.
• The total amount I owe to Licensee is $_________.
• I wish to make partial payments in order to pay off the full amount I owe to Licensee.

[Want this form for your own use? Need it as a PDF or Word document? Email Jer@TrihouseConsulting.com or invest in our “Bible.” Both our payday loan and our car title loan Manuals include a multitude of aldditional forms, docs, check lists and more.]

Customer and Licensee agree as follows:

• In satisfaction of the above debt, Customer authorizes Licensee to electronically debit the account on which the check was written. Licensee will use an Automated Clearing House (ACH) method, which is a nationwide electronic funds transfer system.
• Licensee will electronically debit the account in the amount of $______.
• Licensee will electronically debit such amount:

___ Weekly; ___Bi-weekly; ___Monthly; ___Other (Specify:_________________).

• The electronic debit will occur on the _____ day of each ___________; ___Other (Specify:_____________).
• Customer may pre-pay all, or if electronic debits have been made, the remaining portion of the above debt, in cash at any time. If Customer satisfies the full amount of the debt, this authorization for electronic debiting is immediately revoked.
• If Customer makes payments according to this schedule, Licensee will not attempt other collection methods available to Licensee and will not re-present the check.
• Customer will receive no additional notification of these electronic debits from Licensee. Customer may incur costs from the financial institution if any electronic debit is refused for insufficient funds.
• If Customer defaults, in whole or in part, under the Agreement, or revokes this authorization for electronic debiting by giving written notice to Licensee at the above address, Licensee may utilize any collection methods available to it under the law. Customer may incur additional costs as a result.
• Licensee will keep a record showing every payment received from Customer. Customer is entitled to a copy of such record during Licensee’s regular business hours, and a copy of this contract.
• Upon successful completion of this contract, the original check will be returned to Customer.

 

____________________________________               __________________________________

Customer Signature                                                    Licensee Representative Signature

 

Date: _______________________________              Date:_____________________________