Apply for Your Mortgage

Applicant Name			Title	Association

Date of Birth	Gender	Academic Title	Social Insurance Number
	Select Male Female Other

Present Address and Postal Code		Occupancy	How Long
		Select Own Rent Other

Previous Address (If less than 2 years at present address, please provide full 2 years history)

Email	Cell Number	Home Phone Number

Present Employer	Address	Telephone

Occupation	Employed From	Employed To	Income Type	Monthly Income
			Select Salary Hourly Commission Self-Employed

Previous Employer: Name and Address (If less than 2 years at present employer, please provide full 2 years history)

Occupation	Employed From	Employed To	Income Type	Monthly Income
			Select Salary Hourly Commission Self-Employed

Other sources of Income and Amount			Income Type	Monthly Income
			Select Rental Investment Pension Other

Other sources of Income and Amount			Income Type	Monthly Income
			Select Rental Investment Pension Other

Assets

Cash and Investments
Personal - If married, include assets of both self and spouse
Type	Held at	Name of Financial Institution	Owner	Amount
Select Type TFSA RRSP Chequing Savings Other	Select Bank Other		Select Applicant Co-Applicant Joint
Total

Personal Property
(Vehicles, Automobiles, Recreational vehicles & Equipment, etc.)
Item	Description/Make/Model	Value	Balance Owing on Property	Value less owing (Equity)
1
Total

Real Estate Owned (Including Outside Canada)
Civic Address / Legal Description	Real Estate Type	Mortgage Holder (or no mortgage)	Name of Financial Institution	Owner	Present Value
	Select Type Primary Residence Secondary Residence Investment Property Commercial Property Vacant Land Other	Select No Mortgage Bank Credit Union Private Lender Other		Select Applicant Co-Applicant Joint
Total

Insurance Coverage from All Sources
Source	Coverage Type	Name of Insured	Amount/Coverage
Select Source Employer Private	Select Type Life Disability Critical Illness

Liabilities

Personal Liabilities
Personal - If married, include liabilities of both self and spouse
Liability Type	Lender	Balance Owing	Monthly Payment	Security Values	Life/Disability Coverage
Select Type Line of Credit Credit Card Other	Select Lender Bank Non Bank				No Yes
Total

Land Secured Loans, Including Mortgages and HELOCs
Type	Mortgage or HELOC	Lender	Balance Owing	Monthly Payment	Property Tax	Condo Fees	Maturity Date	Life/Disability
1		Select Bank Not Bank						No Yes
Total

Net Worth
Total Assets
Total Liabilities
Net Worth (Assets - Liabilities)

Additional Comments

Applicant's Signature	Additional Applicant's Signature	Date

Co-Applicant Information

Co-Applicant Name			Title	Association