Joyeria Daisy

PERSONAL INFORMATION

First Name*

Last Name*

SSN/ITIN*

Confirm SSN/ITIN*

Mobile Phone*

By providing your phone number you consent to receiving autodialed texts and calls for non-telemarketing purposes.

APPLICANT INFORMATION

Street Address *

Apt#

City *

State *

Zip *

This product is not available in MN,NJ,PR,WI and WY

Email*

APPLICANT IDENTITY VERIFICATION

Date Of Birth *

Id Type *

Id Number *

Id State

Payment Information

Bank Routing Number

Bank Account Number

Bank Name

APPLICANT PRIMARY INCOME

Income Source *

How are you paid? *

Monthly Income *

$

.00

How often are you paid?

Weekly Every Other Week Twice a Month Day of the Month Weekday of the Month

What days of the month are you normally paid? Cannot be fewer than 11 days apart

What day of the month are you normally paid?

You are typically paid:...

Approximate next three paydays:...

I understand that by clicking on the SUBMIT button immediately following this notice, I am providing 'written instructions' to Acima Digital, LLC under the Fair Credit Reporting Act Authorizing Acima Digital, LLC to obtain information from my personal credit profile or other information from Experian/Clarity and other agencies. I authorize Acima Digital, LLC to obtain such information to evaluate the terms of any merchandise lease offer, to confirm my identity, and to avoid fraudulent transactions in my name. I also understand that by clicking "submit" I am agreeing to the Application Terms, Privacy Policy, Terms of Service, and ESIGN disclosure. Additionally, by checking this box I agree to allow Acima Digital, LLC to share my application data with Joyeria Daisy LLC, and with affiliates of Acima Digital, LLC.

I Consent: By checking this box, you agree Acima Digital, LLC ("Acima") and its agents may deliver telemarketing calls and text messages regarding Acima goods, services or offers to you at the telephone number provided on this application using an automated system for the selection or dialing of telephone numbers. You understand that you are not required to consent to marketing calls and text messages in order to obtain goods or services from Acima or open an Acima account. If you do not consent, Acima may still send you text messages regarding important account information, such as transaction details or servicing information. By checking this box you certify that you are authorized to provide this consent.

Joyeria Daisy - Rio Grande City