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Atlas Mortgage Company

Milwaukee Area's Discount Mortgage Leader

Name * Address

City State Zip

Home Phone * Work Phone

E-Mail Address *

My goals are to: * Lower my monthly payment Reduce my interest rate Shorten the term of my mortgage Consolidate bills Take cash out of my peoperty Get pre-approved to purchase a property (Please check all boxes that apply)

If Bankruptcy, When was your discharge date? Employer *

Self Employed? Yes No

Length of Employment Less than 2 years More than 2 years

Annual Pre Tax Income When did you buy this home? What was the purchase price? Current Value of Property? Amount currently owed on property's first mortgage: Current mortgage rate?

Does it have a prepayment penalty?* Yes No

Do you have a second mortgage?* Yes No

Amount currently owed on property’s second mortgage: Current mortgage rate?

Does it have a prepayment penalty? Yes No

Total dollar amount that I owe in credit cards and loans: Monthly payments toward credit cards and loans

Atlas Mortgage Company | 10691 West Parnell Avenue #5 Hales Corners WI 53130 | 414-427-8000 | info@atlaswisconsin.com