Metro Atlanta Mortgage Company, Inc.

Purchasing Form

Is my information safe?

Preferred Loan Officer (if applicable):

Primary Borrower's Contact Information:

First Name: Last Name: Middle Initial:

Current Home Address:

City: State: ZIP:

Home Phone: Cell Phone: Work Phone

() - () - () -

E-Mail:

Work: Personal:

Co-Borrower's Contact Information (if applicable):

First Name: Last Name: Middle Initial:

Current Home Address:

City: State: ZIP:

Home Phone: Cell Phone: Work Phone

() - () - () -

E-Mail:

Work: Personal:

Form Specific Information:

**We can only be as accurate as the information that you provide to us. Please respond to as many of the following questions as possible.**

Primary Borrower's
Gross Annual Income: Minimum Monthly
Payment on Debt: Social Security Number:

$ $ --

Co-Borrower's
Gross Annual Income: Minimum Monthly
Payment on Debt: Social Security Number:

$ $ --

May we pull your credit report?

Yes, I would like Metro Atlanta Mortgage Company, Inc. to pull my credit report for review. No, I will let you know when and if that is necessary.

Who referred you to us?

Have you been looking at properties? Yes No

If so, in what price range? $

Additional Comments: