North Georgia Mortgage and Financial Services

B-Name:

DOB:

C-Name:

DOB:

Address:

City/State/Zip:

Home Phone:

B-Employer:

Years There:

Inc:

Work #:

Purpose of Loan:

Refinance

Debt Consolidation
Home Improvements
Cash Out
Rate and Term

Purchase

Construction

Home Equity

C-Employer:

Years There:

Inc:

Work #:

First Mortgage

Amount:

Term:

IR: %MP:

Second Mortgage

Amount:

Term:

IR: %MP:

Prepay:

Yes

Taxes:

Insurance:

Taxes Paid Currently:

Yes

Last APPR:

How Much:

Improvements:

Yes

Total Value:

Home Type:

Mobile

Row

Home Improvement Money:

Yes

Include Any Credit Cards:

Yes

Term Interested In:

Any Assets:

Yes

"Buy it ...build it ...add to it ... or fix it up. One of our specialist will partner with you to make your dream a reality!"