Financing Application

(321) 951-2500

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Applicant Information
Requested Loan Amount If Known
Finance Plans*
ShieldRoof does not qualify for our 120 month program.
Name*
First Middle Last
Date of Birth*
Date Format: MM slash DD slash YYYY
Email*
Mobile Phone*
Home Phone
Applicant Address*
Street Address Address Line 2 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?
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 Allimony, child support or separate maintenance payments need not be revealed if you do not wish to have them considered as a basis for repaying the loan. Married Wisconsin Residents: Combine you and your spouse's information once.
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 If completed below, Applicant and Co-Applicant intend to apply for joint credit.
Add A Co-Applicant?*
Name*
First Middle Last
Date of Birth*
Date Format: MM slash DD slash YYYY
Email*
Mobile Phone*
Home Phone
Years on the Job*
Employer Phone*
Employer*
If Co-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 Co-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 you knowledge.
Date*
Date Format: MM slash DD slash YYYY
Co-Applicant Signature If signed, Applicant and Co-Applicant intend to apply for joint credit.
Co-Applicant Signature
By typing your name, you certify that the facts stated above are true and correct to the best of your knowledge.
Date*
Date Format: MM slash DD slash YYYY
Name
This field is for validation purposes and should be left unchanged.

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ROOFS FROM $99 PER MONTH

Financing Application

Applicant Information

Income Allimony, child support or separate maintenance payments need not be revealed if you do not wish to have them considered as a basis for repaying the loan. Married Wisconsin Residents: Combine you and your spouse's information once.

Co-Applicant Information If completed below, Applicant and Co-Applicant intend to apply for joint credit.

Applicant Signature

Co-Applicant Signature If signed, Applicant and Co-Applicant intend to apply for joint credit.

DefenderRoof®

Get A Metal Roof For The Same Price As Shingles

ShieldRoof®

Want A PERMANENT Roof, But Can’t Get Metal?

Hippo Roofing

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