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EXPRESS APPLICATION

All fields except e-mail are optional. More information will usually produce faster results.

APPLICANT:
    
Mr. Ms. Mrs. First Name:
 		Initial:
Surname:
  
Home Phone:
Work Phone:
 		E-mail:
Address:
 		How long:
 		 
City:
 		Prov.
 		Post. Code:
Date of Birth:
 19 		S.I.N.
 		 
Employer:
 		How Long:
 		Occupation:
Gross Ann.Income:
 		   
CO-APPLICANT
    
Mr. Ms. Mrs. First Name:
Initial:
Surname:
Home Phone:
 		Work Phone:
 		 Email:
Address:
 		How long:
 		 
City:
 		Prov.:
 		Post. Code:
Date of Birth:
 19 		S.I.N.
 		 
Employer:
 		How Long:
 		Occupation:
Gross Ann.Income:
 		   
Marital status
# of Dependents  
If less than 3 years at existing address,
please provide former address and how long in notes section
If less than 3 years on currrent job,
please provide former job details for the past 3 years in notes section
 
ASSETS    
Cash in bank  
RRSP's
Stocks/Bonds  
Vehicle(s)
Year Make Value
Year Make Value
 
Your bank and branch:
 
BANK LOANS/CREDIT LINES    
Bank:
 		Month.Payment:
 		Bal.Owing:
Bank:
 		Month.Payment:
 		Bal.Owing:
Bank:
 		Month.Payment:
 		Bal.Owing:
CREDIT CARDS    
Card:
 		Month.Payment:
 		Bal.Owing:
Card:
 		Month.Payment:
 		Bal.Owing:
Card:
 		Month.Payment:
 		Bal.Owing:
 
I/we presently my/our home and
my/our payment is $ per month
 
I am/we are applying for a mortgage for (Renewal is a simple transfer of existing mortgage. Refinance is where you borrow money over and above your existing mortgage balance)
 
If purchase - maximum purchase price $
 
If renewal - value of present home $
 
If renewal or refinance, existing mortgage is:
with which Bank?
Amount $
Rate
Maturity date
 
The Property I am/we are buying will be
 
If rental I expect to get $ per month in rent
 
Preferred term
 
Do you have a preference regarding which broker you wish to use?
yes  
no
AMOUNT available as downpayment:

Source of Funds: Family Gift Cash in Bank
Other (specify)
Specify other source:
 
CONTACT ME    
between and
Contact person:
 

ADDITIONAL COMMENTS/NOTES:

By submitting the above information, I/we consent to to the receipt and exchange of information about me/us with your affilliates from time to time as you deem appropriate and to the sharing and exchange of reports and information with the credit reporting agencies, credit bureaus, mortgage insurers and/or any other person, corporation, firm or enterprise with whom I/we have or propose to have a financial relationship.

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