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Short Application
Our short application is an easy and fast way to request a mortgage. Please provide the following information.
Personal Information
*First Name:
*Last Name:
Referral Name:
Home Phone:
( ) -
Cell Phone:
( ) -
Work Phone:
( ) - Ext.
Marital Status:
Are you a U.S. citizen?
Date of Birth:
*Social Security or Tax ID #:
- -
*Credit Check Authorization:
Number of Dependents:
Dependent Age(s):
Separate ages by commas.
*Loan Officer:
Current Address
Street Address:
Years at this Address:
 Years     Months
Rent or Own:
Subject Property
Purpose of Loan:
Please Specify  
Property Usage:
Loan Amount:
Purchase Price:
Number of Units:
Year Built:
Subject Property Address:
Monthly Income
Submitting income from alimony, child support, or separate maintenance income is optional if you do not want to use that income for qualification purposes.
Base Income:
Other Income:
Retirement Funds:
Mutual Funds:
Demographic Information
The purpose of collecting this information is to help ensure that all applicants are treated fairly and that the housing needs of communities and neighborhoods are being fulfilled. For residential mortgage lending, Federal law requires that we ask applicants for their demographic information (ethnicity, sex, and race) in order to monitor our compliance with equal credit opportunity, fair housing, and home mortgage disclosure laws. You are not required to provide this information, but are encouraged to do so. You may select one or more designations for "ethnicity" and one or more designations for "Race." The law provides that we may not discriminate on the basis of this information, or on whether you choose to provide it. However, if you choose not to provide the information and you have made this application in person, Federal regulations require us to note your ethnicity, sex, and race on the basis of visual observation or surname.The law also provides that we may not discriminate on the basis of age or marital status information you provide in this application. If you do not wish to provide some or all of this information, please check below.
Ethnicity - Check one or more:

For example: Argentinean, Colombian, Dominican, Nicaraguan, Salvadoran, Spaniard, and so on.

Race - Check one or more:
Enter name of enrolled or principal tribe:

For example: Hmong, Laotian, Thai, Pakistani, Cambodian, and so on.

For example: Fijian, Tongan, and so on.


* Privacy Policy:

Privacy Policy 

Personal & Financial Information
Personal and financial information acquired by Georgia Banking Company is used to process your loan. We do not sell or offer your personal, private information to any 3rd party marketers. We provide your personal private information only to our trusted partners in situations where it is necessary to originate, process, underwrite or close your loan.

Georgia Banking Company Partners
Georgia Banking Com partners with third parties to provide specific services required to originate, process, underwrite & close your loan, including but not limited to the acquisition of appraisals, credit reports, flood & tax certificates, title, underwriting decisions & closing packages.

Registered Users, Account Holders, Clients, Etc.
Georgia Banking Company collects personal information through the course of providing a service to our clients; we will treat all of our clients personal information as private and confidential. Nothing about their accounts, nor their names and address, will be disclosed to anyone, other than bona fide 3rd party partners & in five exceptional cases:

Where we are legally compelled so to do

Where there is a duty to the public to disclose

Where a regulator wishes to see your details to ensure we are complying with regulations

Where disclosure is made at your request and with your consent

The only other situation where we will disclose your personal information is when you have given this information as an integral part of the service we are offering (for instance, where you wish to have your contact details published for a property sales adverts).

You may be contacted by email, telephone or other electronic means during the application process in order to complete your loan.

You may also be contacted in the future to inform you of other product offerings we feel you may be interested in. You may opt-out of any such future correspondence by contacting our customer service department or by replying to emails with 'opt out' in the subject line.

Georgia Banking Company

6190 Powers Ferry Road, Suite 150
Atlanta, GA 30339

Phone: 770.373.6031

Fax: 770.690.8504

Do you have a co-borrower?  
* = Required



Georgia Banking Company NMLS #418473
6190 Powers Ferry Road, Suite 150, Atlanta, GA  30339
Office:  (704) 464-0728
Copyright © 2018 Georgia Banking Company
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