Membership Application

DriveFree™ > Ditch Later > Membership Application

DriveFree™ Membership Application

Thank you for applying to DriveFree™. Step 1: Please fill in the application below. After you have entered your information, our underwriting team will contact you by phone to help to get started.

Step 1 of 4

Name*
First Last
Phone*
Email*

Social Security Number*
Date of Birth*
Address*
Street Address Address Line 2 City State ZIP Code
How long have you lived at this address?*
- Less than 2 years
- More than 2 years
Previous Address
Street Address Address Line 2 City State ZIP Code
Do you own or rent?*
- Own
- Rent
What is your monthly payment?*

What is your employment status?*
- Employed
- Disability
- Retired
- Self Employed
- Unemployed
Employer Name*
Job Type*
Work Number*
Length of Employment*
Net Monthly Income*

DriveFree™ Subscription*
Price:
Opting-in to DriveFree™ at anytime during your auto loan binds our company, pāyZero® Incorporated to establish your auto loan protection plan. 1. 1:1 payment matching: Which means for every month you pay your auto loan, you establish 1 months of payment protection. (if you paid your loan for 11 months, then you will be eligible for 11 months of payment protection). 2. Payment holidays: Twice a year you don’t have to pay your loan, because DriveFree™ will. 3. Early Payoff: If you make it half way through your loan term without a payment claim, you will be eligible for immediate loan payoff. 4. Financial Empowering: Protection plan improves overall household budget and monthly savings.
Account Number*
Account Type*
Routing Number*
Bank Name*
Cheque Number*