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Mortgage Application
1. Personal Information
First Name
MI
Last Name
D.O.B.(dd/mm/yy)
S.S.N.
Marital Status
Single
Married
Separated
Divorced
Widowed
Common-Law
Dependents
None
1
2
3
4
5
6
7 or >
Current Address
City
State
Zip code
Years There
< 1
1 year
2 yrs.
3 yrs.
4 yrs.
5 yrs.
6 yrs.
7 yrs.
8 yrs.
9 or >
Previous Address
City
State
Postal code
Years There
< 1
1 year
2 yrs.
3 yrs.
4 yrs.
5 yrs.
6 yrs.
7 yrs.
8 yrs.
9 or >
E-mail Address
Home Phone
Residential Status
Own
Rent
Live with parents
Other
Current Occupation
Current Employer
Work Phone
Gross Yearly Income
$
Years There
< 1
1 year
2 yrs.
3 yrs.
4 yrs.
5 yrs.
6 yrs.
7 yrs.
8 yrs.
9 or >
Current Employer Address
Type of Income
Salary
Hourly
Commission
Self-Employed
Pensioner
Alimony
Support
Other
Previous Occupation
Previous Employer
Gross Yearly Income
$
Years There
< 1
1 year
2 yrs.
3 yrs.
4 yrs.
5 yrs.
6 yrs.
7 yrs.
8 yrs.
9 or >
2. Co-Applicant Information
First Name
MI
Last Name
D.O.B.(dd/mm/yy)
S.I.N.
Relation to Co-Applicant
Spouse
Parent
Relative
Son or Daughter
Brother or Sister
Friend
Other
Current Occupation
Current Employer
Work Phone
Gross Yearly Income
$
Years There
< 1
1 year
2 yrs.
3 yrs.
4 yrs.
5 yrs.
6 yrs.
7 yrs.
8 yrs.
9 or >
Current Employer Address
Type of Income
Salary
Hourly
Commission
Self-Employed
Pensioner
Alimony
Support
Other
Previous Occupation
Previous Employer
Gross Yearly Income
$
Years There
< 1
1 year
2 yrs.
3 yrs.
4 yrs.
5 yrs.
6 yrs.
7 yrs.
8 yrs.
9 or >
3. Details of Mortgage Loan
I am applying for a
first
second
mortgage.
How much of a loan do you need?
$
Monthly property taxes?
$
Current value of your home?
$
Date purchased? (Approx.)
Original purchase price? (Approx.)
$
4. Details of First Mortgage
Mortgage Lender (held by)
Mortgage
None
First
Second
Mortgage Number
$
Balance
$
Rate %
Mthy Paymnt
$
Maturity Date
$
Property Address
5. Details of Second Mortgage
Mortgage
None
First
Second
Mortgage Lender (held by)
Mortgage Number
$
Balance
$
Rate %
Mthy Paymnt
$
Maturity Date
$
Property Address
6. Liabilities
Enter total outstanding balances:
Credit Cards
Loans/Lines of Credit
Enter total monthly payments:
Car Payments
Alimony/Support/Other
7. Assets
Vehicle 1 (Year, Make, Model)
RRSPs
Vehicle 2 (Year, Make, Model)
Stocks/Bonds
Name of your bank(s)
Cash/Savings
8. Property Information
Dwelling Type
Detached
Semi Detached
Townhouse
Duplex
Triplex
High Rise
Property Age
Tenure
Freehold
Condo
Dwelling Style
One Storey
Bi-Level
Two Storey
Split Level
Storey and a half
Three Storey
Square Footage
Garage Size
Single
Double
Triple
None
Heating Type
Gas
Oil
Electric
Hot Water
Fireplace
Space Heater
Wood Stove
Lot Size
Garage Type
Attached
Detached
None
9. Comments
(Provide any additional information which could help us to approve your loan.)
By submitting this online application, we hereby authorize you to obtain a credit report and make any necessary inquiries regarding our mortgage application and to release this information to any lenders who may be interested in providing funds on your behalf.
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