Please Acknowledge the Statement of Oath
By submitting this application for funding, 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.
If approved, you will be sent offers of funding. Funds will be deposited into your checking account once you complete the funding requirements and complete the loan process. You are hereby informed and acknowledge that these funds are to be used, and are being issued expressly for the purpose as outlined by you in this application, and you agree to promptly complete the required payment for stated purpose of these funds within 3 business days from the receipt of funding. 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.
I understand and acknowledge If approved, I will be sent offers of funding. Funds will be deposited into my checking account once I have completed the funding requirements and completed the loan process. I also acknowledge that I am hereby informed that these funds are to be used, and are being issued expressly for the purpose as outlined by me in this application, and I agree to promptly complete the required payment for stated purpose of these funds within 3 business days from the receipt of funding. I understand that failure on my part 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
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Last Name
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Social Security Number
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Date of birth
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Mobile Phone
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Email
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Home Address
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City
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State
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Postal code
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Driver's License Number
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Upload Copy of Driver's License (FRONT)
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Copy of DL (FRONT)
Upload Copy of Drivers License (BACK)
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Drivers License (BACK)
Please indicate your current credit rating level
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Please Choose
450 and lower
451-550
551-570
571-600
601-630
631-650
651-670
671-700
701-720
721-780
781 and higher
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Do you Own or Rent?
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Own Outright (No Mortgage)
Own, but with a Mortgage
Rent
Please select your Highest Education Level Completed
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Highschool Drop Out
Highschool Diploma
Associate's Degree
Bachelor's Degree
Master's Degree
Ph.D
Other Graduate Degree
Are you Currently Employed?
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Please Choose
Employed Full Time
Employed Part-Time
Currently Unemployed
Self Employed
Retired
Not Employed Due to Disability
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What is your Monthly Gross Income (before Tax)
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$
How often do you get paid?
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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).
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$
Purpose for Financing
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Please Select
General Purpose Loan
Purchase of Business Tool Subscription from RocketBusinessTools.com
Purchase of Website Design from WebHostRocket.com
Financing of Contract with Rocket ADA Compliance Services
Financing of On-Line Course from Chris Miller, The Miller Firms, FactorCareers.com, TW3Systems.com, or their Affiliates
Financing of Annual Virtual Coaching Program Subscription from Chris Miller and The Miller Firms
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Please indicate your desired funding.
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Please Select
Webhost Rocket Lifetime 10 Hosting Plan: Maximum $795
WebHost Rocket Web-Design Services: Maximum $15,000
Rocket ADA Standard: Maximum $150
Rocket ADA Monitored: Maximum $450
Rocket ADA Advanced: Maximum $2,500
Rocket ADA Advanced + Monitoring: Maximum $2,800
Rocket Business Tools, Emerging Plan: Maximum $3,124
Rocket Business Tools, Growing Plan: Maximum $4,660
Rocket Business Tools, Established Plan: Maximum $5,908
FactorCareers (Just the Facts) Training Program: Maximum $997
FactorCareers (Basics) Training Program: Maximum $1,997
FactorCareers (Masters) Training Program: Maximum $2,497
TW3 Reseller Membership (12 months) + SRT Package: Maximum $3,297
TW3 Reseller Membership (12 months) + PRT Package: Maximum $3,797
TW3 Reseller Membership (12 months) + ELT Package: Maximum $5,797
TW3 Systems SRT Success Bundle: Maximum $4,301
TW3 Systems PRT Success Bundle: Maximum $4,831
TW3 Systems ELT Success Bundle: Maximum $6,831
TW3 Systems ELT Ultimate Success Bundle: Maximum $8,031
Virtual Coaching Program with Chris Miller: Maximum $5,000
Easy Book Writer Writing Development Course: Maximum $300
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Please Acknowledge E-Sign Agreement
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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 with funding offers
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I agree to be contacted by email, phone, and text in regards to this request.
Submit Application