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Your Personal Info



Your Residential Info

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Information required to claim your cash



How would you like to receive your funds?Direct Deposit(Free) – Funds are deposited directly into your account the same day of approval so long your application is approved by 2:30PM EST.

Instant Deposit(+$5.00) – Your funds will be deposited directly into your account within 1 - 2 hours of approval.




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Your Safety Contact

Sharing a safety contact with us is your way of showing us that you intend to use our services with good intentions.


By submitting this form, I confirm that the info I provided is exact and current, and that I have read and accepted the terms and conditions. I accept periodical contact by Captain Cash by email with promotions or updates regarding my account.