Simple Loan Application
Borrower
Name (Must match ID provided)
*
First Name
Last Name
D.O.B.
*
Month
Day
Year
Address of Collateral Property to this loan
*
Street Address
Unit/Suite No.
City
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Province
Postal Code
How long have you owned this home?
*
Owner Occupied
*
Yes
No
Does collateral property have a first mortgage?
*
Yes
No
Name of first mortgage lender
*
First mortgage balance
*
First mortgage maturity date
*
MM slash DD slash YYYY
First mortgage interest rate
*
First mortgage monthly payment
*
Mailing Address
*
Street Address
Unit/Suite No.
City
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Province
Postal Code
Employment
*
Employed
Business for Self
Retired
Type of Business for Self
*
Employer
*
# of years at current employment
*
Annual Income
*
Marital Status
*
Single
Married/Common Law
Email
*
Phone (Day Time)
*
Phone (Evening)
*
Co-Borrower
A spouse or any other person that shares ownership of the property must be added as a Co-Borrower
Co-Borrower
*
Yes
No
Name (Must match ID provided)
*
First
Last
D.O.B.
*
Month
Day
Year
Employment
*
Employed
Business for Self
Retired
Type of Business for Self
*
Employer
*
# of years at current employment
*
# of years at current employment
*
Annual Income
*
Marital Status
*
Single
Married/Common Law
Email
*
Phone (Day Time)
*
Phone (Evening)
*
Loan Amount Requested
Maximum $100,000
*
Please enter a number from
15000
to
100000
.
Value of assets excluding Collateral Property?
*
$0-$50,000
$50,001-$100,000
$100,000+
Use of Funds
Please tell us what you intend to use the funds for
*
Consolidate credit cards
Renovation of property
Other
Additional Information
Any additional information about the Borrowers, Guarantors, or Property that would assist in the review of the loan application
Phone
This field is for validation purposes and should be left unchanged.