Untitled Document

Mortgage Application Form

Please fill in all applicable information, so that we can better serve you.

1. General Information
Please choose one or more of the following:
Pre Approval for Purchase Refinance Existing Mortgage(s)
Purchase Consolidate Debts
Additional Money Other:
What amount of mortgage do you require? When do you think you will need the mortgage?
How did you find out about us?  
Name  
2. Applicant Information
First Name Middle Initial Last Name
Birth Date(D/M/Y) SIN Marital Status Dependents
Home Phone
(include area code)
Work Phone
(include area code)
Fax
(include area code)
Email
How do you prefer to be contacted?
Co-applicant, please fill out the fields below
First Name Middle Initial Last Name
Birth Date(D/M/Y) SIN Marital Status Dependents
Home Phone
(include area code)
Work Phone
(include area code)
Fax
(include area code)
Email
How do you prefer to be contacted?
3. Present & Previous Address (past 3 years)
Present Address
Street Address Years Tenure
City Province Postal Code
Previous Address
Complete the follow if you have been at your present address for less than 3 years.
Street Address Years Tenure
City Province Postal Code
4. Employment and Income (past 3 years)
APPLICANT
Employer, City, Position Years Gross Annual Earning
Income/year
$
$
Current Employer's Address:
Your Occupation
Are you, the applicant, self-employed? Yes No
Other
$
Employment and Income
CO-APPLICANT
Employer, City, Position How many years ? Gross Annual Earning
Income/year
$
$
Co-applicant Occupation
Is the co-applicant self-employed? Yes No
Other
$
What is the annual gross income for you and your co-applicant? $
5. Net Worth (Assets)
What Assets Do You and Your Co-Applicant Have?
Description Value
Savings/Checking: $
House Value: $
Stocks/Bonds/Deposits: $
R.R.S.P.'s: $
Vehicle Type:
$
$
Other Assets:
$
$
$
$
Total $
6. Liabilities (Debts)
Description Balance Monthly Payment Credit Limit
$ $ $
$ $ $
$ $ $
Other
$ $ $
$ $ $
Total $ $ $
Loans, Leases, Mortgages and Others
Include Student Loans, Income Tax Owing and Support Payments
$ $
$ $
$ $
$ $
$ $
Total $ $
7. Credit Rating
Years
Where do you do your banking?
How would you rate your Credit?
If you have declared bankruptcy please answer the following questions
Were you Discharged? If so, then how long ago?
Have you re-established any credit since bankruptcy? If yes, then how long have
you had this new credit?
8. Your Present Home & Mortgage...
Rent or own? Mortage Holder
Rent or Payment $ Payment Frequency
Use Type
Interest Rate % Term Remaining yrs
Balance Home Value Equity Loan to Value
$ $ $ %
Matures When: Annual Taxes Condo Fees
$ $
Is your mortgage OPEN or subject to prepayment penalty?
9. Your New Details...
Enter only if you are purchasing a property now.
Address (enter "unknown" if not known)
Legal Description
Use Type
Price Down Payment
$ $
Down Payment Source Closing Date
$ $
In whose name(s) is your property to be registered in?
10. Do You Have any Further Comments or Notes?
When refinancing existing mortgages, or applying for a second mortgage, please add any helpful notes, such as address of property and brief description. Please indicate debts to be paid off from new mortgage.
If buying, will you be selling your existing home if buying new? What is your estimated sale date?
11. Your Authorization
We hereby certify that the information given in my/our application is complete and correct and is given for the purpose of obtaining the financing applied for. In connection with this application I/We hereby authorize the obtaining and exchange information regarding my/our credit history form any recognized credit agency, chartered bank, or others. I/We hereby acknowledge that I/We have been advised that Mortgage Life, Health or Disability Insurance may be available to me/us for this mortgage/loan and take sole responsibility to investigate and secure such coverage if desired. By sending your application you acknowledge and accept the above statements.

About Mike Toporowsky AMP

Mortgage industry experience ... since early 1981

Contact Info

  • Box 3868, Spruce Grove, Alberta
  • 780-940-0604
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