General Information

Purpose:                Purchase Refinance Equity Take Out

Type of Property: Free Hold Condo Commercial

Desired Area(s):  

Complete this section if you are seeking financing for the purchase of a home.

Purchase Price:

Down Payment:

1st Time Buyer? Yes No

Realtor's Name  
& Company

Complete this section if you are looking to refinance or obtain additional financing on current home.

Market Value:                 

Annual Property Taxes:

Monthly Strata Fees:     

Existing 1st Mortgage:   To be paid out? Yes No

Existing 2nd Mortgage:  To be paid out? Yes No

Amount Required:          

Personal Information

Applicant Info                                                                        Co-Applicant

*Applicant Name:       Applicant Name:

*Address:                     Address:              

*City:                             City:                       

*Postal Code:               Postal Code:       

*Years at Address:     Yrs at Address: 

If less than 3 years please provide previous address
Prev. Address:             Prev. Address: 

Years at prev.               Years at prev.   
Address                                                                                                Address
*Phone:                          Phone:                 

Date of Birth:                Date of Birth:     
Please use "MM/DD/YY" format

S.I.N.                                 S.I.N.                    

Marital Status:          Commonlaw Divorced Married Single Seperated                             Marital Status:   Commonlaw Divorced Married Single Seperated

# of Dependants:     

*Employeer:                    Employeer:         

*Job Title:                         Job Title:               

*Annual Income:            Annual Income:   

*Years at Job:                 Years at Job:        
If less than 3 years please provide previous employment information
Prev. Employeer:          Prev. Employeer: 

Other income could include P/T, investment or rental income
Other Income:               Other Income:       

Fax #:                         

Email:                        

Please list details of assets - bank accounts, RRSP's, term deposits, GIC's, real estate, vehicles etc.. Account information should include name of bank and approx. balance.  Real estate information should include address and market value.

Type                              Where/Financial Institution                        Amount
Cash in Bank                  

Deposit on property     
being purchased
(if applicable)

Automobile:                    
present value

Value of present            
home (if owned)

Investment/vacation     
properties

Stocks, bonds,                
Mutual funds etc.

RRSP's                             

Other Assets                  

Total                                                                                                        

Please list details of liabilities and monthly obligations - loans, mortgages, credit cards, etc. 
Include name of bank, approx. balance and monthly payments.

Type                   Where/Financial Institution                         Amount
Bank Loans           

Credit Cards        

Owing on               
Automobile

Owing on 1st         
Mortgage

Owing on 2nd        
Mortgage

Mortgage # of       
1st Mortgage

Finance Comp.     
Loan & Other Debt

Alimony/ Child Support                                                              

Other                       

Total                                                                                                

Disclaimer:

I/We warrant and confirm that the information given in the mortgage application form is true and correct and I/we understand that it is being used to determine my/our credit responsibility. You are authorized to obtain any information you may require relative to this application from any sources to which you may apply and each such source is hereby authorized to provide you with such information. You are furthermore authorized to disclose, in response to direct enquiries from any other lender or credit bureau, such information on my loaning account as you consider appropriate, and I agree to indemnify you against and save you harm from any and all claims in damages or otherwise arising from such disclosure on your part. You are also authorized to retain the application whether or not the relative mortgage is approved.