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Payday Class Actions - Registration Form
Last name
First name
Middle name
Mailing Address
Email Address
Telephone number and area code
(For example: 519-555-1212. If you have an extension such as Extension 1234,
use: 519-555-1212-1234)
Home Phone
Work Phone
Have you ever had a payday loan from
Cash Money?
Yes
No
(a) For each loan you had with Cash Money:
(i) What was the date
of the advance?
(ii) What was the amount of the loan?
(iii) What did you pay to Cash Money, in total?
(b) Do you have a copy of your Cash Money contract(s)?
(If you have your contract (s), please send us a copy)
Yes
No
Have you ever had a payday loan from Unicash?
Yes
No
(a) For each loan you had with Unicash:
(i) What was the date of the advance?
(ii) What was the amount of the loan?
(iii) What did you pay to Unicash, in total?
(b) Do you have a copy of your Unicash
contract(s)?
(If you have your contract (s), please send us a copy)
Yes
No
Have you ever had a payday loan from any other company?
Yes
No
(a) For every other company from which you received a loan:
(i) What is the name of the company?
(ii) What is the address of the company?
(iv) What was the amount of the loan?
(v) What did you pay to the company, in total?
(b) Do you have a copy of your contract(s) with the company?
(If you have your contract (s), please send us a copy)
Yes
No
Our goal is to keep all registrants up-to-date on the status of this class action. Email is one method we use to communicate with Potential Class Members. Copies of all relevant and updated documents, including this Form, will also be posted on our website: www.koskieminsky.com and then by clicking on the "Client Links" link.
You can send your completed form online by pressing submit:
or by regular mail at our address below.
Koskie Minsky, Barristers and Solicitors
20 Queen Street West, Suite 900, Box 52, Toronto, Ontario M5H 3R3
PAYDAY CLASS ACTIONS HOTLINE
1-866-545-9918
paydayclassactions@kmlaw.ca
A representative of the Class Action Team will then be in contact with you.
Copyright © Koskie Minsky LLP, 2008