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Loan Application

Dealer Info
Dealer Info
Dealer Id *
Dealer Name *
Phone *
Loan Info
Loan Info
Merchandise/Service *
Sales Price *
Down Payment *
Days to 1st Payment
Amount Financed
Loan Term *
Same as Cash
Contract Date
Applicant Info
Applicant Info
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 *
Purchaser(s)
Existing Tower Customer
First Name *
MI
Last Name *
Suffix
Home Phone *
Cell Phone
# of Dependents
Physical Address
Physical Address
Address 1 *
Address 2
City *
State *
Zip *
How long at current address?
Years
Months
Mailing Address
Mailing Address
Same as physical address
Address 1 *
Address 2
City *
State *
Zip *
Previous Address
Previous Address
Address 1 *
Address 2
City *
State *
Zip *
How long at previous address? *
Years
Months
Security Info
Security Info
Social Security # *
Date of Birth *
Driver’s License ID
State
Residence Status
Residence Info
Residence Status *
Monthly Payment
Banking Relationship
Banking Relationship
Checking
Savings
Employment And Income
Employment and Income
Employer
Employment Status *
Name of Employer/Business *
Phone *
Position
How long?
Years
Months
Job Start Date
Employer Address
Employer Address
Address 1
Address 2
City
State
Zip
Previous Employer
Previous Employer
Name of Employer/Business *
How long? *
Years
Months
Previous Employer Address
Previous Employer Address
Address 1
Address 2
City
State
Zip
Income
Income
Monthly Net Income *
Other Income
Other Income Source
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.
Alimony, child support or separate maintenance received under
Bankruptcy
Bankruptcy
Prior Bankruptcy?
References
References
Relative Not Living With You
First Name
Last Name
Address 1
Address 2
City
State
Zip
Phone
Disclosures
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
submit

DEALER: PLEASE PRINT AND HAVE APPLICANT/CO-APPLICANT REVIEW AND SIGN BEFORE HITTING THE SUBMIT BUTTON.

Applicant Signature

Co-Applicant Signature