3321 Manchester Drive Lilburn, GA 30047 1-800-792-1285 770-979-9422 Fax 770-979-9722 Pgr 404-533-7132

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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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Trinity Home Mortgage
3321 Manchester Drive
Lilburn, GA 30047
1-800-792-1285
770-979-9422
Fax 770-979-9722
Pgr 404-533-7132
A Georgia Residential Mortgage Licensee

A Customer Assistance Program of
the Better Business Bureau™ of Metro Atlanta