Primary Applicant
Co-Applicant
Title Mr.Mrs.Ms.Dr.Other
Full Name
Current Address
OwnParentRent
Time Spent at this Address?
Prior Address (If < 3 yrs)
Time at Prior Address
Home #
Cell #
Birth Date
S.I.N
Gender [radio* gender "Male" "Female"]
Dependents
Gender MaleFemale
Marital Status SingleMarriedWidowedSeparatedDivorcedCommon Law
Email
Relationship to Primary Applicant
Employment (if less than 3 years, include previous)
Current Employer Address
Co-Applicant Employer Address
City
Province
Phone
Fax
Income
How Long
Job Title
Previous Employer Address
Types and Amount of Income
Full-time
Self-Employed
Commission
Contract
Part-time w/hrs
Part-time w/o hrs
Rental
Investment
Other
Total
Purpose of Loan
Pre-ApprovalHome PurchaseTransfer of MortgageRefinance/Equity Take
If yes, for what reason:
Sales Price
Down Payment
Date Funds Required
Gift Funds
Bank Account
Sales Proceeds
Borrowed Funds
Sweat Equity
Property Details
Address
Street
Postal Code
Legal Description
Lot
Plan
Type of Heating Electric BaseboardWater HeatingForced AirOther
Zoning ResidentialCommercialFarmOther
Property Type DetachedSemiBungalowRow/TownhouseHigh Rise Apartment
Property Title FreeholdLeaseholdCondominium/Strata
Garage AttachedDetached
Number of Storeys
Insurance Cost / Month
Heating Cost / Month
Hydro Cost / Month
Maintenance Fee / Month
Lot Size
Liveable Space (sq ft)
Current Estimated Value
Age of Property
Property Tax
Date of Purchase
Original Purchase Price
Mortgage Information
Mortgage Type
Original Mtg Amount
Mortgage Balance
Mortgage Payment
Payment Frequency
Maturity Date
Term Type
Remaining Amortization
Rate Type
Interest Rate
Insurer (CMHC)
Mortgage Number
Mortgage Holder 1st2nd3rdOther
FINANCIAL INFORMATION
ASSETS
Name of Institution
Amount
LIABILITIES / LENDERS
Monthly Payments
Balance Owing
Value of Property
Mortgage(s) on home
Cash in Bank
Personal Loan(s)
Deposit on Purchase
Other Loans
Other Real Estates
Car Loan/Leases
Cars
Credit Cards
RRSP (contributed)
Child Support/Alimony
Stocks, Bonds, etc.
Other:
Total Assets:
Total Liabilities:
NET WORTH:
General Information
Are there any suits or judgments against you? YesNo
Have you ever gone through bankruptcy? YesNo
Are any of your assets pledged? YesNo
Are you involved in a marriage separation? YesNo
Are you the endorser or guarantor? YesNo
Comments:
Signature:
Date:
Borrower
I hereby agree that the above information is true and authorize its use for processing my application.
