Application Documents

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• Uniform residential loan
   application (PDF document )

• Uniform residential loan
   application in Spanish
   (PDF document )

• Click heree to fill your    application using a word    document

• Word Document Containing:

• AUTHORIZATION TO RELEASE
     INFORMATION
• NOTICE REGARDING APPRAISAL
     REPORTS
• INSURANCE ANTI-COERCION
     LETTER
• BROKER AGREEMENT
• MORTGAGE BROKER FEE
     DISCLOSURE STATEMENT
• DISCLOSURE STATEMENT

Notice

Filling out this form does not lock in rate nor guarantee rate protection of any kind. Loan applications must be confirmed verbally with an Atlantis Mortgage Corporation Loan Officer. Please call us at 954.340.3633 if you have any questions or would like to lock in a rate.

  • Use this form to request mortgage information.
  • Please fill out as much of this form as possible.
  • When finished click on the send button.
  • If you prefer to speak to a loan officer please call 954.340.3633

Please give a phone number so that a loan officer may contact you.

The information you enter on this form will be kept in strict confidence.

PLEASE DO NOT USE DOLLAR SIGNS ($) OR COMMAS ( , ) WHEN ENTERING NUMBERS.


 
Mortgage Type: 1st 2nd Home Equity
Amount Requested: $
Property to be Financed ( if known )  
Address
City
Apt. or Unit#
State
Zip
if refinancing please fill out the
following information and then
continue with Form		  
When did you purchase? yr. mo.
What was the purchase price? $
What do you think it is worth today? $
Do you own other properties? Yes No
If so how many?
Existing Mortgages  
Monthly Mortgage 
Are taxes and insurance included
in your payment? 		Yes
Taxes
Insurance
1st Mortgage 2nd Mortgage

$

$

$

$
If purchase fill out the following information  
When do you expect to purchase? yr. mo.
When will home be completed? yr.   mo.
What is the purchase price,
or how much would you
like to finance?		 $
What is your down payment? $
Do you own other properties? Yes No
If so how many?
Personal Information
Applicant   
First Name
Last Name
Date of Birth
Social Security Number
E-Mail 
Home Phone
Fax
How would you rate your credit?
Are you married to the Co-Applicant?
Best time to contact you?
Co-Applicant  
First Name
Last Name
Date of Birth
Social Security Number
E-Mail 
Home Phone
Fax
How would you rate your credit?
Best time to contact you?
If purchase address is different than the
property address		  
Did you?
How long? yrs.   mo
Address
City
Apt. or Unit#
State
Zip
Current Address
(if less than 2 yrs. at current)
or If Purchase Actual Address.		  
Did you?
How long? yrs.   mo
Address
City
Apt. or Unit#
State
Zip
Employment History  
Applicant    
Employer Name
Gross Monthly Income*

$

Your Position (title)
Self-Employed Yes No
Length with Company yrs. mos.
Phone Number
 Previous Employer  
(if less than 2 yrs. at current)		  
Employer Name
Gross Monthly Income
Your Position
Length of time with Company yrs. mos.
Phone Number
Co-Applicant   
Employer Name
Gross Monthly Income*

$

Your Position (title)
Self-Employed Yes No
Length with Company yrs. mos.
Phone Number
Previous Employer  
(if less than 2 yrs. at current)		  
Employer Name
Gross Monthly Income $
Your Position
Length of time with Company yrs. mos.
Phone Number
Comments


* Before taxes & deductions

By submitting this on-line application, I/We authorize Atlantis Mortgage to check such information as my/our credit, business and employment status and history. Submitting this application does not lock-in rate. Please call us at 954.340.3633 if you have any questions.