Statement of Oath *

By submitting this application for financial aid, I swear that all information contained within this application is true, accurate, and complete. I understand that this is an application for credit and any information obtained will be used expressly for the purpose of approving credit and funding. Approval is guaranteed with a minimum of 20% down-payment.

ezPay with TW3 Systems Statement of Funding *

I am hereby informed and acknowledge that, if approved, I will be sent offers of funding. Funds will be deposited directly into my checking account once I complete the funding requirements and loan process. I understand that when financing, the following charges will also be included in addition to the standard package price that I choose here. These additional charges include a finance fee of $500 as well as the total of $1800 for Annual Administration Fees for my account. I understand that by including these fees as part of the loan it will help to bring down the total monthly cost I will need to repay. When selecting a loan offer, I understand that I will need to be sure that it will cover the price of my membership enrollment + these additional $2300 in fees. I am hereby informed and acknowledge that these funds are to be used and are being issued expressly for the purpose of completing my enrollment for membership of the TW3 Systems level that I select with this application and agree to complete payment for my membership enrollment within 3 business days from the receipt of funding. I understand that failure to do so will be regarded as an attempt to defraud the bank which comes with strict penalties under law within the United States of America including fines and possible jail time.

First Name *

Last Name *

Social Security Number *

Date of birth *

Mobile Phone *

Email *

Home Address *

City *

State *

Postal code *

Please indicate your current credit rating level *

Do you Own/Rent? *

Own Outright (No Mortgage)

Own, but with a Mortgage

Rent

Having reviewed our membership offers, please choose which Level you are most interested in? (Please choose only one) *

Become an Affiliate (Commission Only - No Cost)

Become a Member (SRT - Sales Rep and Trainer $997 + $150/mo)

Become a Member (PRT - Plus Rep and Trainer $1,497 + $150/mo)

Become a Member (ERT - Elite Rep and Trainer $3,497 + $150/mo)

Are you Currently Employed? *

What is your Monthly Gross Income (before Tax) *

How often do you get paid? *

Weekly

Bi-weekly

Bi-monthly

Monthly

Please enter the amount of Down Payment you are able to place today (if one would be required for funding). *

Driver's License Number *

Upload Copy of Driver's License (FRONT) *

Copy of DL (FRONT)

Upload Copy of Drivers License (BACK) *

Drivers License (BACK)

E-Sign Agreement Acknowledgement *

By checking this box, I hereby consent to the "E-Sign Agreement", the "Credit Authorization Agreement", the "Terms of Service", and "Privacy Policy", and am providing written consent under the FCRA for The Miller Firms, LLC and its partners and their affiliated companies via email and/or at the telephone numbers(s) I have provided above to explore personal financing offers, including contact through automatic dialing systems, artificial or pre-recorded voice messaging, or text message. Consent is not required as a condition to utilize funding option searches through The Miller Firms, LLC and its funding and financial partnerships, and you may choose to be contacted by an individual customer care representative(s) by contacting us through the chat form on the home page of this website.

Agree to be Contacted *

I agree to be contacted by email, phone, and text in regards to this request.