Financing Application

APPLICANT INFORMATION

• Requested Loan Amount If Known
• Finance PlansFinance Plans12 Months Same as Cash60 Months - Low APR120 Months - Low APR

  ShieldRoof does not qualify for our 120 month program.

• First Name
• Middle Name
• Last Name
• Date of Birth
• Social Security #

• Email Address
• Mobile Phone
• Home Phone

• City
• State / Province / Region
• ZIP / Postal Code

Physical Address Required. No P.O. Boxes.

• Please Check What Applies To You:

  • Are you interested in our DefenderRoof?
  • Are you interested in our ShieldRoof?
  • Are you currently working with one of our roof consultants?
  • Are you interested in our SuperRoof?
• How do you rate your credit?

  • Excellent
  • Good
  • Fair
  • Poor

• Employer
• Years on the Job
• Employer Phone

If Applicant is retired, enter "Retired" in the Employer field, enter "0" in the Years on Job field, and use the Co-Applicant's Home phone number.

If Applicant is unemployed, enter "Unemployed" in the Employer field, enter "0" in the Years on job field, and use the Co-Applicant's home phone number.

INCOME

• Applicant's Gross MONTHLY Income ($)

  Examples: Monthly salary (before taxes), alimony, child support, investment income, social security, etc.

• Other Gross MONTHLY Income ($)

  Examples: Co-Applicant and/or spousal income (before taxes), alimony, child support, investment income, social security, etc.

CO-APPLICANT INFORMATION

• First Name
• Middle Name
• Last Name
• Date of Birth
• Social Security #

• Email
• Mobile Phone
• Home Phone

• Employer
• Years on the Job
• Employer Phone

If Applicant is retired, enter "Retired" in the Employer field, enter "0" in the Years on Job field, and use the Co-Applicant's Home phone number.

If Applicant is unemployed, enter "Unemployed" in the Employer field, enter "0" in the Years on job field, and use the Co-Applicant's home phone number.

APPLICANT SIGNATURE

• Applicant Signature

  By typing your name, you certify that the facts stated above are true and correct to the best of your knowledge and that you authorize a credit inquiry by Hippo Roofing.

• Date

CO-APPLICANT SIGNATURE

• Co-Applicant Signature

  By typing your name, you certify that the facts stated above are true and correct to the best of your knowledge and that you authorize a credit inquiry by Hippo Roofing.

• Date