Mortgage Application

EXPRESS

All fields except e-mail are optional. More information will usually produce faster results.

APPLICANT:

Mr.Ms. Mrs.

First Name:

Initial:

Surname:

Home Phone:

Work Phone:

E-mail:

Address:

How long:

City:

Prov.

Post. Code:

Date of Birth:
19

S.I.N.

Employer:

How Long:

Occupation:

Gross Ann.Income:

CO-APPLICANT

Mr.Ms.Mrs.

First Name:

Initial:

Surname:

Home Phone:

Work Phone:

Email:

Address:

How long:

City:

Prov.:

Post. Code:

Date of Birth:
19

S.I.N.

Employer:

How Long:

Occupation:

Gross Ann.Income:

Marital status

# of Dependents

If less than 3 years at existing address,
please provide former address and how long in notes section

If less than 3 years on currrent job,
please provide former job details for the past 3 years in notes section

ASSETS

Cash in bank

RRSP's

Stocks/Bonds

Vehicle(s)

Year	Make	Value
Year	Make	Value

Your bank and branch:

BANK LOANS/CREDIT LINES

Bank:

Month.Payment:

Bal.Owing:

Bank:

Month.Payment:

Bal.Owing:

Bank:

Month.Payment:

Bal.Owing:

CREDIT CARDS

Card:

Month.Payment:

Bal.Owing:

Card:

Month.Payment:

Bal.Owing:

Card:

Month.Payment:

Bal.Owing:

I/we presently my/our home and
my/ourpayment isper month

I am/we are applying for a mortgage for

(Renewal is a simple transfer of existing mortgage. Refinance is where you borrow money over and above your existing mortgage balance)

If purchase - maximum purchase price

If renewal - value of present home

If renewal or refinance, existing mortgage is:

with which Bank?

Amount

Rate

Maturity date

The Property I am/we are buying will be

If rental I expect to getper month in rent

Preferred term

Do you have a preference regarding which broker you wish to use?

yes

AMOUNT available as downpayment:

Source of Funds:

Family Gift

Cash in Bank

Other (specify)
Specify other source:

CONTACT ME

betweenand

Contact person:

ADDITIONAL COMMENTS/NOTES:

By submitting the above information, I/we consent to to the receipt and exchange of information about me/us with your affilliates from time to time as you deem appropriate and to the sharing and exchange of reports and information with the credit reporting agencies, credit bureaus, mortgage insurers and/or any other person, corporation, firm or enterprise with whom I/we have or propose to have a financial relationship.

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