Online Mortgage Application

1. Applicant

First Name
Init
Last Name
S.I.N.
Date of Birth
Dep.
Marital Status
Present Address
City
Province
Postal Code
Length There

Yrs

Mths
Previous Address (if less then 3 years)
City
Province
Postal Code
Length There

Yrs

Mths
Email Address
Home Phone
Cell Phone
Home Fax
Residential Status
Current Employer
Employer Address
Work Phone
Ext
Work Fax
Occupation
Type
Industry
Income
Type
How long with present employer

Yrs

Mths
In current line of business

Yrs

Mths
Previous Employer
Address
Occupation
Years
Income
Other income source
Amount

2. Co-Applicant (If applicable)

First Name
Init
Last Name
S.I.N.
Date of Birth
Marital Status
Present Address
City
Province
Postal Code
Length There

Yrs

Mths
Current Employer
Employer Address
Work Phone
Ext
Work Fax
Occupation
Type
Industry
Income
Type
How long with present employer

Yrs

Mths
In current line of business

Yrs

Mths
Previous Employer
Address
Occupation
Years
Income
Co applicant's other income source
Amount

3. Purchase Details

New Home Address
City
Province
Postal Code
Purchase Price
Downpayment
Downpayment Source
Arrange financing by:
Term
Amortization
Select Payment
Closing Date

Property Type
Property Age
Dwelling Style
Lot Size
Tenure Square Feet
Heating Type Garage Type
Septic & Well Garage Size
Legal Description Occupied by
Property Taxes Property Zoning
Condo Fees

4. Assets

Bank Name
Cash/Savings
Vehicle 1 -Yr/Make/Model/Value
RRSP
Vehicle 2 -Yr/Make/Model/Value
Stocks/Bonds

5. Other Assets Not Included Above (other vehicles, properties etc.)

Other Asset 1 Description
Other Asset 1 Value
Other Asset 2 Description
Other Asset 2 Value

6. Existing Property Details (complete this section if you currently own a home)

Mortgage Lender
Mortgage Number
Home Value
Mortgage Balance
Interest Rate
Monthly Payment
Are Taxes Included
Taxes
Maturity Date
Remaining

7. Second Mortgage Details - if any (this section could include a first mortgage on 2nd home)

Property address (if different from above)
Lender
Mortgage #
Balance
Payment
Interest Rate
Maturity Date

8. Credit Card Balances, Loans, Lines of Credit (please provide a complete list of your creditors and indicate if you will pay it off prior to closing)

Creditor
Balance
Payment
Payoff
Creditor
Balance
Payment
Payoff
1
4
2
5
3
6

9. Other Liabilities Not Included Above

Car Lease 1
Car Lease 2
Support Payments
Alimony
Other

10. Credit Interview And Other Information

1
 Are you applying for any of these special products?
2
 Please estimate your credit history
3
 Are you currently behind on your credit cards and/or loans?
4
 If prior bankruptcy, when was your discharge?
5
 Do you have any unpaid collections?
6
 If you already paid off collections...when was it?
7
 Have you applied for this loan elsewhere in the past 60 days?
8
 Do you require a mortgage insurance?
9
 If you require insurance...are applicants smokers?
10
 Your Lawyer Information - Name,Address,Phone/Fax
11
 Best phone number and time to reach you at

11. Comments

Use this space to let us know why you are requesting this mortgage financing and if you were referred to us by a friend or agent, please include their name below.
I/We confirm that the information given in the application form ais true and correct and I/we understand that it is being used to determine my/our credit responsibility and to evaluate and respond to my/our request for mortgage financing. You are authorized to obtain any information you may require for these purposes from other sources (including, for example, credit bureaus) and each source is hereby authorized to provide you with such information. I/we also understand, acknowledge and agree that the information given in the mortgage application form as well as other information you obtain in relation to my/our credit history may be disclosed to potential lenders, mortgage insurers, other service providers, organizations providing technological or other support services required in relation to this application and other parties with whom I/we propose to have a financial relationship.

I/we further acknowledge and agree that each potential mortgage lender, mortgage insurer or other service provider to whom you provide the mortgage application and/or my/our personal information is permitted to receive such application and information and maintain records relating to me/us and my/our mortgage application and to hold, use, communicate and disclose personal information about me/us, including my/our Social Insurance Number (SIN) if I/we provide it, and collect personal information from me/us, you and from third persons, including credit bureaus, credit reporting and collection agencies, financial institutions, my/our past and present employers, creditors and tenants, my/our spouse or any other person who has information about me/us for the purposes of recording, evaluating and responding to my/our application for mortgage financing or related activities and I/we specifically consent to the release and disclosure of personal information by such persons to and among you and each potential mortgage lender, mortgage insurer or other service provider.

Enter your email address to electronically sign this application (NO webmail addresses ie. Yahoo, Hotmail etc.)