QUICK APP
						LOAN OFFICER
					Phone: (404)352-8600    Fax: (404)256-0602
*** Please fill out completely for accurate prequalification ***
BORROWER INFORMATION					CO-BORROWER INFORMATION
Borrower					Co-Borrower
Current Address					Current Address
City/State/Zip					City/State/Zip
Home Phone Number					Home Phone Number
Citizenship	(Please Circle Correct Response Below)				Citizenship	(Please Circle Correct Response Below)
U.S Citizen	Permenant Resident Alien        Foreign National				U.S. Citizen        Permanent Resident Alien        Foreign National
EMPLOYMENT & INCOME INFORMATION
Employer			How Long?		Employer			How Long?
Work Phone Number					Work Phone Number
Gross Monthly Income					Gross Monthly Income
Other Income Source			Amount		Other Income Source			Amount
DEBTS/MONTHLY OBLIGATIONS
Auto Loans		Student Loans			Auto Loans		Student Loans
Credit Cards		Installment Loans			Credit Cards		Installment Loans
EVER FILED BANKRUPTCY?		CH.7 OR CH.13?			EVER FILED BANKRUPTCY?			CH.7 OR CH.13?
DISCHARGE DATE?					DISCHARGE DATE?
SOURCE OF DOWNPAYMENT
Source			Amount		Source			Amount
CREDIT AUTHORIZATION & RELEASE
Authorization is hereby granted to The Piedmont Funding Group to obtain a standard factual data credit report through a credit reporting agency by the Piedmont Funding Group. Authorization is also granted to The Piedmont Funding Group, its affiliates,and the reporting agency to use a photostatic reproduction of this authorization if necessary to obtain information regarding my employment, residence, checking & saving accounts and outstanding credit accounts.
Borrower Signature					Co-Borrower Signature
Social Security Number		Date			Social Security Number		Date
PLEASE COMPLETE AND FAX BACK TO (404) 256-0602 FOR PREQUALIFICATION
FOR OFFICE USE
Property		Unit Number			Sales Price		Earnest Money
Selling Agent					Contract Closing Date