Mortgage Application Form

SSL Certificates 

Please fill in all applicable information, so that we can better serve you.

1. General Information
Please choose one or more of the following:
Pre Approval for Purchase		Refinance Existing Mortgage(s)
Purchase		Consolidate Debts
Additional Money		Other:
What amount of mortgage do you require?		When do you think you will need the mortgage?
		Choose ASAP 1 mo 3 mo 6 mo 1 yr
How did you find out about us?
Choose Refered Previous Client New Client Realtor Other Name

2. Applicant Information
First Name	Middle Initial	Last Name
Birth Date(D/M/Y)	SIN	Marital Status	Dependents
		Choose Single Married Separated Widowed Common Law	Choose 0 1 2 3 4+
Home Phone (include area code)	Work Phone (include area code)	Fax (include area code)	Email
How do you prefer to be contacted?	Choose Email Phone On-site Visit
Co-applicant, please fill out the fields below
First Name	Middle Initial	Last Name
Birth Date(D/M/Y)	SIN	Marital Status	Dependents
		Choose Single Married Separated Widowed Common Law	Choose 0 1 2 3 4+
Home Phone (include area code)	Work Phone (include area code)	Fax (include area code)	Email
How do you prefer to be contacted?	Choose Email Phone On-site Visit

3. Present & Previous Address (past 3 years)
Present Address
Street Address		Years	Tenure
			Choose Rent Own Live with family
City		Province	Postal Code
		Choose AB BC MB NB NL NS NT NU ON PE QC SK YT
Previous Address
Complete the follow if you have been at your present address for less than 3 years.
Street Address		Years	Tenure
			Choose Rent Own Live with family
City		Province	Postal Code
		Choose AB BC MB NB NL NS NT NU ON PE QC SK YT

4. Employment and Income (past 3 years)
APPLICANT
Employer, City, Position		Years	Gross Annual Earning Income/year
			$
			$
Current Employer's Address:
Your Occupation
Are you, the applicant, self-employed?		Yes	No
Other
			$
Employment and Income
CO-APPLICANT
Employer, City, Position		How many years ?	Gross Annual Earning Income/year
			$
			$
Co-applicant Occupation
Is the co-applicant self-employed?		Yes	No
Other
			$
What is the annual gross income for you and your co-applicant?			$

5. Net Worth (Assets)
What Assets Do You and Your Co-Applicant Have?
Description		Value
Savings/Checking:		$
House Value:		$
Stocks/Bonds/Deposits:		$
R.R.S.P.'s:		$
Vehicle Type:
		$
		$
Other Assets:
		$
		$
		$
		$

6. Liabilities (Debts)
Description	Balance	Monthly Payment	Credit Limit
Choose Visa MC Amex Other	$	$	$
Choose Visa MC Amex Other	$	$	$
Choose Visa MC Amex Other	$	$	$
Other
	$	$	$
	$	$	$
Loans, Leases, Mortgages and Others Include Student Loans, Income Tax Owing and Support Payments
	$	$
	$	$
	$	$
	$	$
	$	$

7. Credit Rating
			Years
Where do you do your banking?
How would you rate your Credit?	Choose Poor Average Good Very Good Excellent
If you have declared bankruptcy please answer the following questions
Were you Discharged?	Choose Yes No	If so, then how long ago?
Have you re-established any credit since bankruptcy?	Choose Yes No	If yes, then how long have you had this new credit?

8. Your Present Home & Mortgage...
Rent or own?	Choose Rent Own	Mortage Holder
Rent or Payment	$	Payment Frequency	Choose Weekly Bi-weekly Monthly
Use	Choose Residence Rental Residence and Rental	Type	Choose Fixed Variable Open
Interest Rate	%	Term Remaining	yrs
Balance	Home Value
$	$
Matures When:	Annual Taxes	Condo Fees
	$	$
Is your mortgage OPEN or subject to prepayment penalty?		Choose Yes No Not sure

9. Your New Details...
Enter only if you are purchasing a property now.
Address (enter "unknown" if not known)
Legal Description
Use		Type
Choose Owner Occupied Rental Owner Occupied and Rental		Choose Condo Townhouse Single Family Dwelling
Price		Down Payment
$		$
Down Payment Source		Closing Date

10. Do You Have any Further Comments or Notes?

When refinancing existing mortgages, or applying for a second mortgage, please add any helpful notes, such as address of property and brief description. Please indicate debts to be paid off from new mortgage. If buying, will you be selling your existing home if buying new? What is your estimated sale date?

11. Your Authorization

When I / we submit this application, it is herein agreed and understood that we may use information as may be deemed necessary or reasonable to establish and/or to maintain my/our relationship with prospective lenders. I/we realize that my information will not be sold, in any part whatsoever, to third parties for independent use. However, information disclosure may occur to third parties that assist us in obtaining their mortgage products, or services and support. This includes, but may not limited to, exchanges of information with the credit reporting agencies and financial institutions in accordance with the standard banking industry practice, and/or whenever or wherever so required by law.