Mortgage Application

PERSONAL INFORMATION

Primary Applicant

Primary Applicant Name*

First Last

Primary Applicant Date of Birth

Primary Applicant Current Age (yrs)

Number of Dependants

Marital Status

Primary Applicant Email*

Primary Applicant Home Phone*

Primary Applicant Work Phone

Primary Applicant Current Address

Street Address City State / Province / Region ZIP / Postal Code

Number of Years & Months

Total number of years and months at current address

Primary Applicant Previous Address

Street Address City State / Province / Region ZIP / Postal Code

Number of Years & Months

Total number of years and months at previous address

Rent

Current Employer

Occupation

Years Employed

Number of years/months employed with current employer

Gross Annual Income

Previous Employer

(If employed for less than 3 years with current employer)

Previous Occupation

Years Employed

Number of years/months employed with previous employer

Gross Annual Income

Other Income:

Please list multiple sources on their own lines.

Is there more than one applicant?

Yes
No

Co-Applicant Information

Co-Applicant Name

First Last

Co-Applicant Date of Birth

Co-Applicant Current Age (yrs)

Number of Dependants

Marital Status

Co-Applicant Email

Co-Applicant Home Phone

Co-Applicant Work Phone

Co-Applicant Current Address

Street Address City State / Province / Region ZIP / Postal Code

Number of Years & Months

Total number of years and months at current address

Co-Applicant Previous Address

Street Address City State / Province / Region ZIP / Postal Code

Number of Years & Months

Total number of years and months at previous address

Rent

Current Employer

Current Occupation

Years Employed

Number of years/months employed with current employer

Gross Annual Income

Previous Employer

(If employed for less than 3 years with current employer)

Previous Occupation

Years Employed

Number of years/months employed with previous employer

Gross Annual Income

ASSETS

Asset Selection

Please select any that may apply and specify their value.

Chequing
Savings
Mutual Funds
RRSP, TFSA, etc.
Real Estate - Residence
Real Estate – Rental Property
Vehicle #1
Vehicle #2

Value of Chequing

Value of Savings

Value of Mutual Funds

Value of RRSP, TFSA, etc.

Value of Real Estate - Residence

Value of Real Estate – Rental

Value of Vehicle #1

Value of Vehicle #2

Additional Assests

Please list any additional assets you might have:

LIABILITIES

Liability Selection:

Please select any that may apply and specify their value and monthly payment.

Credit Card #1
Credit Card #2
Credit Card #3
Lines of credit
Mortgage #1
Mortgage #2
Auto loan #1
Auto Loan #2

Value of Credit Card #1

Payment for Credit Card #1

Value of Credit Card #2

Payment for Credit Card #2

Value of Credit Card #3

Payment for Credit Card #3

Value of Lines of Credit

Payment for Lines of Credit

Value of Mortgage #1

Payment for Mortgage #1

Value of Mortgage #2

Payment for Mortgage #2

Value of Auto Loan #1

Payment for Auto Loan #1

Value of Auto Loan #2

Payment for Auto Loan #2

LIABILITIES

Please list any additional liabilities you might have:

Agreement*

I/We Agree

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.

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PERSONAL INFORMATION

Primary Applicant

Co-Applicant Information

ASSETS

LIABILITIES

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