Mortgage Application

Purpose Of Application*
- Refinance (I already own a home and would like a loan)
- Purchase (I bought a home)
- Pre-Approval (I am shopping for a home)
- Renewal/Switch (my current mortgage is close to maturity)
Have You Sumitted An Application With Another Mortgage Broker/Agent In The Past 90 Days?*
- Yes
- No
How Much Would You Like To Borrow?*
Funds Required By*
Month
Day
Year
Do You Have A Real Estate Agent?*
- Yes
- No
Name Of Your Real Estate Agent*
First Last
Name - Applicant*
First Last
Date Of Birth*
Month
Day
Year
Marital Status*
- Single
- Married
- Common Law
- Separated
- Divorced
- Widowed
Number Of Dependants*
SIN - Social Insurance Number*
Home Phone
Cell Phone*
Email*
Credit Rating*
- Excellent
- Reasonable
- Poor
- Don't Know
Current Address*
Street Address City Province Postal Code
Number Of Years At Residence*
Previous Address*
Street Address City Province Postal Code
Number Of Years At Previous Address*
Do You Currently Rent Or Own Your Home?*
- Rent
- Own
When Did You Purchase Your Existing Home?*
Month
Day
Year
What Was The Original Purchase Price Of Your Home?*
Approximate Square Footage Of Your Home*
Annual Property Taxes*
Monthly Rent Amount (Home Only)*
What Do You Plan To Do With Your Existing Home?*
- I/We Have Sold Home
- I/We Are Selling Home
- I/We Are keeping Home
What Is The Approximate Value Of Your Home Today?*
What Was The Selling Price Of Your Home?*
What Is The Anticipated Selling Price Of Your Home?*
Do You Have A Mortgage On Your Home?*
- Yes
- No
First Mortgage Holder (Lender's Name)*
Original Mortgage Amount*
Was The Mortgage Insured With CMHC, Genworth Capital Or Canada Guaranty?*
- Yes
- No
Mortgage Payment*
Payment Frequency*
- Monthly
- Biweekly
- Weekly
Are Your Property Taxes Included In Your Mortgage Payment?*
- Yes
- No
Mortgage Interest Rate*
Rate Type*
- Fixed
- Variable
Term Type*
- Open
- Closed
Mortgage Balance*
Maturity Date*
Month
Day
Year
Is Mortgage Currently In Default?*
- Yes
- No
Amount Of Mortgage Arrears*
Does Property Have A Second Mortgage?*
- Yes
- No
Second Mortgage Holder (Lender's Name)*
Original Mortgage Amount*
Mortgage Payment*
Payment Frequency*
- Monthly
- Biweekly
- Weekly
Mortgage Interest Rate*
Rate Type*
- Fixed
- Variable
Term Type*
- Open
- Closed
Mortgage Balance*
Maturity Date*
Month
Day
Year
Is Mortgage Currently In Default?*
- Yes
- No
Amount Of Mortgage Arrears*
Does Property Have A Third Mortgage?*
- Yes
- No
Third Mortgage Holder (Lender's Name)*
Original Mortgage Amount*
Mortgage Payment*
Payment Frequency*
- Monthly
- Biweekly
- Weekly
Mortgage Interest Rate*
Rate Type*
- Fixed
- Variable
Term Type*
- Open
- Closed
Mortgage Balance*
Maturity Date*
Month
Day
Year
Is Mortgage Currently In Default?*
- Yes
- No
Amount Of Mortgage Arrears*
Does Property Have A Fourth Mortgage?*
- Yes
- No
Employer's Name*
Employer's Phone*
Employer's Address*
Street Address City Province Postal Code
Current Position/ Occupation*
Years At Job*
Years In Industry*
Employment Income (Yearly)*
Income Type*
- Salary
- Salary+Commissions
- Hourly
- Hourly+Commissions
- Self Employed
Occupation Type*
- Manager
- Clerical
- Labourer/Tradesperson
- Retired
- Professional
- Self Employed
Industry Sector*
- Construction
- Government
- Health
- Educaation
- High-Tech
- Retail Sales
- Leisure/Entertainment
- Banking/Finance
- Transportation
- Services
- Farming/Natural Resourses
- Varies
Previous Employer's Name*
Previous Employer's Phone*
Previous Employer's Address*
Street Address City Province Postal Code
(Previous Employment) Position/ Occupation*
(Previous Employment) Years At Job*
(Previous Employment) Years In Industry*
Previous Employment Income (Yearly)*
Previous Employment Income Type*
- Salary
- Salary+Commissions
- Hourly
- Hourly+Commissions
- Self Employed
Previous Employment Occupation Type*
- Manager
- Clerical
- Labourer/Tradesperson
- Retired
- Professional
- Self Employed
Previous Employment Industry Sector*
- Construction
- Government
- Health
- Educaation
- High-Tech
- Retail Sales
- Leisure/Entertainment
- Banking/Finance
- Transportation
- Services
- Farming/Natural Resourses
- Varies
Do You Have Other Source(s) Of Income?*
Please do not include rent from property being mortgaged here. There is a rental income field in the 'Property Being Mortgaged' section of the application.
- Yes
- No
Describe Other Source(s) Of Income*
Income Amount From Other Source(s) (Yearly)*
Are Your Income Taxes In Arrears?*
- Yes
- No
Amount Of Income Tax Arrears*
Have You Ever Filed For Bankruptcy?*
- Yes
- No
Have You Been Discharged?*
- Yes
- No
Date of Discharge*
Month
Day
Year
Do You Have Any Collections Or Judgements Filed Against You?*
- Yes
- No
Total Amount Of Collections And/Or Judgements*
Do You Own Any Other Properties?*
- Yes
- No
Co-Applicant Information (Please select one of the boxes below)*
Please add Co-Applicant if another person is or will be on the Property Title. You may also add a Co-Applicant if you have a Guarantor. Please mention that Co-Applicant is a Guarantor in the Comments section at the end of the application if Co-Applicant is solely a Guarantor and will not be on title.
- Add Co-Applicant
- No Co-Applicant
Name - Co-Applicant*
First Last
Date Of Birth*
Month
Day
Year
Marital Status*
- Single
- Married
- Common Law
- Separated
- Divorced
- Widowed
Relationship To Primary Applicant*
SIN - Social Insurance Number*
Home Phone
Cell Phone*
Email
Credit Rating*
- Excellent
- Reasonable
- Poor
- Don't Know
Current Address
Same As Primary Applicant

Street Address City Province Postal Code
Number Of Years At Residence
Previous Address*
Same As Primary Applicant

Street Address City Province Postal Code
Number Of Years At Previous Residence*
Job Status
- Employed
- Unemployed
Employer's Name
Employer's Address
Street Address City Province Postal Code
Current Position/ Occupation
Years At Job
Years In Industry
Employment Income (Yearly)
Income Type
- Salary
- Salary+Commissions
- Hourly
- Hourly+Commissions
- Self Employed
Occupation Type
- Manager
- Clerical
- Labourer/Tradesperson
- Retired
- Professional
- Self Employed
Industry Sector
- Construction
- Government
- Health
- Educaation
- High-Tech
- Retail Sales
- Leisure/Entertainment
- Banking/Finance
- Transportation
- Services
- Farming/Natural Resourses
- Varies
Previous Employer's Name
Previous Employer's Phone
Previous Employer's Address
Street Address City Province Postal Code
(Previous Employment) Position/Occupation
(Previous Employment) Years At Job
(Previous Employment) Years In Industry
Previous Employment Income (Yearly)
Previous Employment Income Type
- Salary
- Salary+Commissions
- Hourly
- Hourly+Commissions
- Self Employed
Previous Employment Occupation Type
- Manager
- Clerical
- Labourer/Tradesperson
- Retired
- Professional
- Self Employed
Previous Employment Industry Sector
- Construction
- Government
- Health
- Educaation
- High-Tech
- Retail Sales
- Leisure/Entertainment
- Banking/Finance
- Transportation
- Services
- Farming/Natural Resourses
- Varies
Do You Have Other Source(s) Of Income?
Please do not include rent from property being mortgaged here. There is a rental income field in the 'Property Being Mortgaged' section of the application.
- Yes
- No
Describe Other Source(s) Of Income
Income Amount From Other Source(s) (Yearly)
Are Your Income Taxes In Arrears?
- Yes
- No
Amount Of Income Tax Arrears
Have You Ever Filed For Bankruptcy?
- Yes
- No
Have You Been Discharged?
- Yes
- No
Date Of Discharge
Month
Day
Year
Are There Any Collections Or Judgements Filed Against Co-Applicant?
- Yes
- No
Total Amount Of Collections And/Or Judgements
Does Applicant Own Any Other Properties?
- Yes
- No

Vehicle(s) Owned

Please click on "+" button to add row for additional vehicles

Year	Make	Model	Approximate Value	Balance Owing On Vehicle

Total Credit Card Debt*
Total Other Debt (Not Including Mortgage, Credit Card, Auto Loans)*
Comment
- Add Comment
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- I/We declare that the information we have provided is accurate to the best of our knowledge and that all information provide hereafter will be accurate and authentic. I/We hereby irrevocably authorize the company to obtain all forms of personal and/or credit information
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Name
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Step 1 of 3 - Applicant Details