If you have any questions, or need assistance filling out this application, please give us a call at 800-479-3716.   To receive credit approval, we must receive a verifiable allotment, and your most recent LES as soon as possible.  Before clicking the Submit Application button, please click the Link to MyPay below.  A new window will open up with directions on how to setup your allotment. Allotment Setup Information   Once you have established your allotment, print out a copy, and fax it along with your most recent LES to 925-281-0926.   Please complete all fields in order to process your application in a timely manner.

The FEDERAL EQUAL CREDIT OPPORTUNITY ACT prohibits Creditors from discriminating on the basis of sex or marital status. If married, Applicant(s) understand and represent that each spouse is the agent of the other for contracting and verification unless otherwise specified in writing.<!--symbols[13,10,13,10,]-->--Annual percentage rate for purchases: 19.2% <!--symbols[13,10,]-->--Variable rate: NONE <!--symbols[13,10,]-->--Information: Grace period for repayment of the balance for purchases is 30 Days from billing date <!--symbols[13,10,]-->--Method of computing the balance for purchases is 30 days from billing date ending balance (not including new purchases) <!--symbols[13,10,]-->--Annual Fees: NONE <!--symbols[13,10,]-->--Minimum Finance Charge: $0.50 <!--symbols[13,10,]-->--Transaction Fee for purchases: Cash Advance Fee: None; Over limit Fee: None: <!--symbols[13,10,]-->Late Payment Fee:$10.00 <!--symbols[13,10,13,10,]-->BILLING RIGHTS SUMMARY: <!--symbols[13,10,]-->If you think your bill is wrong, or if you need more information about a transaction on your bill, write us (on a separate sheet) at the address shown on your bill as soon as possible. We must hear from you within 60 days of your first bill on which the error or problem appeared. You can telephone us, but doing so will not preserve your rights. In your letter, you must provide the following information: Your name, account number and the dollar amount of the suspected error. Describe the error and explain why you believe there is an error. If you need more information, describe the item you are unsure about. You do not have to pay the amount in question while we are investigating, but you are still obligated to pay the amounts of your bill that are not in question. <!--symbols[13,10,13,10,]-->While we investigate your question, we cannot report you as delinquent or take any action to collect the amount you question. Special Rule for Purchases: If you have a problem with the quality of goods or services that you financed with us and you have tried in good faith to correct the problem with the merchant, you may not have to pay the remaining amount due on the goods or services. Applicant(s) understand that they can seek financing anywhere and they elect to apply to ROME. If the entire balance is paid within 30 days of each credit extension there will be no finance charge applied. If the Applicant(s) elect to pay less than the entire balance, then they agree to pay a finance charge for all credit extended, computed on the balance stated on each monthly statement of the account at the rate of 1.6% per month (19.2 APR) on the unpaid balance. Such finance charges will only apply to charges that Applicant(s) have authorized and that the rules for billing disputes stated above are fully applicable to all account activity. The term <!--symbols[13,10,]-->finance charge is defined by 12 CFR 226.4 (a) but does not include late charges of $10.00 that Applicant(s) agree to pay if payment is not received within ten (10) days of due date, or bad check charges or penalties subject to California Law. Applicant(s) agree that all payments shall be applied first to any delinquent finance charges, then to any delinquent monthly payments, then to regular monthly payments until the account is current, then to specific revolving purchases, and <!--symbols[13,10,]-->thereafter to the outstanding principal balance. Applicant(s) may issue Standing <!--symbols[13,10,]-->Orders for treatment of credit balances, which will be honored by ROME upon written receipt. Applicant(s) hereby grant ROME a security interest in all goods transferred by the attached Agreement and agree to be bound by all the provisions thereof as well as the provisions of the application and disclosures. In the event of a dispute with any manufacturer, vendor, party to the attached contract or supplier of services thereunder, Applicant(s) agree that they will resolve such disputes with them, under warranty, through their customer service facilities, in writing or otherwise, and that ROME is responsible only for matters required by the Truth in Lending Act, implementing regulations, and applicable State or Federal Law concerning billing rights summarized above. Waiver, condonation or compromise of any breach or default shall not affect ROME's remedies or rights upon subsequent default. Applicant(s) accept responsibility for all taxable and non-taxable costs and Attorney fees incurred by ROME for collection, repossession or suit, and agree that this provision shall be binding on any receiver, court of dissolution or Trustee under 11 U.S.C. Unless ROME is notified by Certified Mail, all notices shall be deemed properly given if deposited, post-paid to the addresses herein, and that this Agreement is severable, and if any part or provision is judicially severed the remainder shall not be affected thereby. For the initial credit for the attached Purchase Agreement, ROME will satisfy Applicant(s) obligation thereunder and authorize shipment of all goods described in the attached Agreement. If Applicant(s) have not received all listed goods within 30 days of purchase, Applicant(s) agree to inform ROME by Certified Mail. After 60 days from extension of credit, unless Applicant(s) have so reported failure of delivery or defective merchandise, ROME will not be responsible thereafter, and Applicant'(s) sole recourse will be with the vendors, manufacturers or carriers. The parties hereto agree that the place of performance, extension of credit, adjustments, revolving credit, and principal place of business of ROME is in Contra Costa County, California. Gwinnett County, Georgia shall be deemed to be the place of exclusive jurisdiction, venue, discovery, and controlling law for resolution of disputes. Applicant(s) agree to pay all costs of collection, repossession, suit, attorney fees for enforcement, intervention, removal of stay, and that the same may be added to Applicant(s), open-end account as incurred. It is understood that ROME may not issue credit without further assurance, and that Applicant(s)' promise to pay by payroll deduction, Electronic Funds Transfer, or other automatic means shall become part of this application and ROME'S reliance thereon shall be deemed both detrimental and prejudicial. Applicant(s) hereby authorize ROME to receive and apply Electronic Funds Transfer, or other automatic payment means, and request forms to initiate the arrangements with the appropriate Bank or Employer, and agree that remittance after any stay shall constitute binding election and preference for which Applicant(s) will hold <!--symbols[13,10,]-->harmless and indemnify ROME. The parties agree that this Agreement shall be binding <!--symbols[13,10,]-->on their heirs, successors and assigns, and that this is the entire Agreement, and that no other representations or promises have been made or relied upon. <!--symbols[13,10,13,10,]-->Applicant(s) want to finance the purchase described in the attached Purchase Agreement and hereby apply for an open-end revolving credit account. The initial amount financed is the price of the purchase and shall be the credit limit for determining eligibility for subsequent charges. Your initial monthly payment will be 3.6% of your first purchase. Applicant(s) agree to make consecutive minimum monthly payments until the account is paid in full and will begin repayment no sooner than forty-five (45) days from the date of this agreement. <!--symbols[13,10,13,10,]-->PRIVACY ACT PROVISION: For determining credit limit, adjusting or increasing credit, issuance of check guarantee or credit cards, billing, collection and credit counseling, Applicant(s) grant continuing permission to ROME to contact Employers, Commanding Officers, References and Credit Bureaus. Applicant(s) hereby grant each of them permission to disclose all relevant credit Data to ROME, and Applicant(s) hereby certify that all information in this application is True and Correct.<!--symbols[13,10,13,10,]-->I will type my full name in the box below and acknowledge and agree to the terms and conditions of this agreement. I will then click the "I agree to the terms" button.

Your authorization is conducted electronically, whereby you acknowledge, by clicking the following box, and typing your full legal name, you have read and agree to these terms.

Enter  your  full legal name ( first, middle, last)

We will contact you within 24 hours by phone or e-mail once you submit this form. IMPORTANT: You will receive a follow-up e-mail within 24 hours. Please check your inbox! If you do not hear from us within one business day, it means the email we sent somehow did not reach you, or we did not receive your application.  If this happens, please send us an email, or give us a call at 800-479-3716. I certify that the information I have provided is true and correct. I authorize Quasarfince.com to verify any information included in this application or in other documents required to obtain the requested purchase. I understand that Quasarfinance.com, Inc. is not a financial institution and may share this information with any lender it does business with to obtain loan approval for this purchase.  I also authorize any party named in this application to provide any and all information requested, such as employment history, credit history, income history, income tax returns, and bank account balances if necessary.