Application Applicant Information:

Full Name Present Address Previous Address: (if less than 3 years at current)

MORTGAGE APPLICATION MORTGAGE APPLICATION

S.I.N. Postal Code Date of Birth Dependants Rent/Own Marital Status No. Of Years No. Of Years

$
Rent/Own

$
Home Phone: Bus Phone: Current Employer Home Fax: Bus Fax: Years Gross Annual Income Gross Annual Income Cellular: Email: Occupation Occupation

Previous Employer: (if less than 3 years at current) Years 1 2

Other Income: Source

Years

Income

Occupation

Co-Applicant Information:
Full Name Address S.I.N. Date of Birth Postal Code Yrs Marital Status

Home Phone: Business Phone:

Current Employer

Home Fax: Bus Fax:

Years Gross Annual Income Gross Annual Income

Cellular: Email: Occupation Occupation

Previous Employer: (if less than 3 years at current) Years

1 2 Other Income
Smoker? ____ Yes ____ No

Years

Gross Annual Income

First Time Buyer? _____ Yes

Occupation
____ No

Assets:
Bank: Bank: RRSP: Stocks/Bonds/GIC: Automobile: Automobile: Other Assets: Other Assets: Other Assets: Household Goods: Location: Location: Type: Type: Balance: $ Balance: $ Value: $ Value: $ Value: $ Value: $ Value: $ Value: $ Value: $ Value: $

Liabilities:
Bank Loan/LOC Bank Loan/LOC Bank Loan/LOC Credit Card Credit Card Credit Card Credit Card Other Debt: Other Debt: Type: Type: Type: Type: Balance: $ Balance: $ Balance: $ Balance: $ Balance: $ Balance: $ Balance: $ Balance: $ Balance: $ Payment: $ Payment: $ Payment: $ Payment: $ Payment: $ Payment: $ Payment: $

Current Mortgages/Properties Owned:

Address: Existing Mortgage Bank/Lender: Mortgage Rate: Address: Existing Mortgage Bank/Lender: Mortgage Rate: Address: Existing Mortgage Bank/Lender: Mortgage Rate: % Monthly Payments: $ Rental Income: $ % Monthly Payments: $ Rental Income: $ % Monthly Payments: $ Rental Income: $ Property Value: $ First: Mortgage Balance: $ Property Value: $ First: Mortgage Balance: $ Property Value: $ First: Mortgage Balance: $ Second: Second: Second:

I/We warrant and confirm that the information given in the mortgage application form is true and correct and I/We understand that it is being used to determine my/our credit responsibility. I/We authorize PMO Financial Services to obtain and/or exchange personal information with any personal information agent towards establishing or verifing my financial standing. You are furthermore authorized to disclose, in response to direct enquiries from any other lender or credit bureau, such information on my loaning account as you consider appropriate, and I agree to indemnify you against and save you harm from any and all claims in damages or otherwise arising from such disclosure on your part. You are also authorized to retain the application whether or not the relative mortgage is approved.

Signature: Signature:
Verbal Consent - By Broker

Date: Date: Date:

Notes:

Referral: ___________________________