Tower Loan Application If married you have the right to apply for credit separately from or jointly with your spouse. Do not furnish information concerning your spouse unless your spouse will be contractually obliged on this account or you are relying on your spouse's income as a basis for repayment of the credit requested. Applying for * Individual Credit Joint Credit Purchaser(s) Married Unmarried Separated Name * First Name Last Name Suffix I (First) II (Second) III (Third) IV (Fourth) JR (Junior) SR (Senior) V (Fifth) VI (Sixth) Home Phone * (###) ### #### Cell Phone (###) ### #### Even though the email field is not required, it is HIGHLY recommended that you fill it out. For example, if the status of your loan changes you will be informed with the email address you provided. Please remember to check your junk or spam email folders for our email. Email * Physical Address Address * Address 1 Address 2 City State/Province Zip/Postal Code Country How long at current address Years * Months * Mailing Address Same as physical address? Yes If yes, leave the below fields blank Address 1 Address 2 City State/Province Zip/Postal Code Country Previous Address Only fill if you have not been at your current address for more than 2 years. Address Address 1 Address 2 City State/Province Zip/Postal Code Country How long were you at the previous address? Years Months Security Info Social Security Number * Date of Birth * MM DD YYYY Residence Info Residence Status * Rent Own Buying Living w/relatives Monthly Payment * Employment and Income Employment Status * Employed Fixed-Income Self Employed Military Unemployed Name of Employer/Business * Phone * (###) ### #### Position How long have you been with this employer? * Years/months Employer Address Address Address 1 Address 2 City State/Province Zip/Postal Code Country Previous Employer Only fill if you have not been with the above employer for more than 2 years Name of Employer/Business How long have you been with this employer? Years/Months Previous Employer Address Address 1 Address 2 City State/Province Zip/Postal Code Country Income Monthly Net Income * Income from alimony, child support or maintenance payments need not be revealed if you choose not to rely upon such income in applying for credit. Other Income Other Income Source Alimony, child support or separate maintenance received under Court Order Written Agreement Oral Bankruptcy Have you had a prior Bankruptcy REFERENCES RELATIVE NOT LIVING WITH YOU Name First Name Last Name Address Address 1 Address 2 City State/Province Zip/Postal Code Country Phone (###) ### #### DISCLOSURES By submitting this Application, Applicant authorizes dealer to gather such information as dealer may require containing statements in this application and agrees that the application shall remain the property of the dealer and / or lender whether credit is granted or not. Applicant agrees and authorizes dealer and Tower Loan to obtain credit reports on Applicant. Applicant hereby certifies that all statements in this application are true and complete and are made for the purpose of obtaining credit. Applicant acknowledges receipt of the Equal Credit Opportunity Act notice. EQUAL CREDIT OPPORTUNITY ACT The federal equal credit opportunity act prohibits creditors from discriminating against creditor applicants on the basis of sex or marital status. The federal agency which administers compliance with this law concerning this type of credit is the Federal Trade Commission, Washington, D.C. 20680 Thank you, you application has been submitted! We will call you to notify you of approval or denial.
