Atlanta Mortgages
On-Line

6920 Main St. 
Atlanta, Ga. 30305
770-484-4835
FAX 770-482-4017

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[Atlanta Mortgages On-Line]


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Purchase  Refinance


2nd Mortgage     Amount 

First Name:          

Spouse First Name:   

Last Name:           

Street Address1:     


Street Address2:     


City/Town:           


State: 


Zip(xxxxx-xxxx):     

       Home Phone (xxx-xxx-xxxx): 

       Work Phone (xxx-xxx-xxxx): 

Spouse Work Phone (xxx-xxx-xxxx): 

        Fax Phone (xxx-xxx-xxxx): 


Email Address:      


Social Security #:  


Spouse SS #:        


Fair Market Value:     


1st Mortgage Balance:  


2nd Mortgage Balance:  

Credit History:

	Excellent  Good  Fair  Poor

If Slow Credit Are Mtgs Current Now? Yes  No

How many times late in last 12 months: 

Self-Employed? Yes  No

Employer:     

How Long:     

Income:       

Income Type:  Salary  Commission

Spouse Self-Employed? Yes  No

Employer:             

How Long:             

Income:               

Income Type:  Salary  Commission

Any Additional Income:   


Own Other Property:      Yes  No

Total Monthly Expenses, less rent: 

 2nd Home

 Rental

Comments

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