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What Type Of Mortgage Are You Interested In?

First Mortgage Second Mortgage

What Is The Mortgage Loan Amount Required?

$

What Mortgage Term Do You Require?

6 Month Open 3 Year Closed 6 Month Closed 4 Year Closed 1 Year Open 5 Year Closed 1 Year Closed 7 Year Closed 2 Year Closed 10 Year Closed

What Do You Estimate The Property Value To Be

$

What Community Is The Property In?

How Will You Use The Property?

Principal Residence Vacation or Second Home Rental / Investment Property

What Type Of Property Is It?

Single Family Residence Semi - Detached Condo - Town House Condo - High Rise

What Will You Do With The Mortgage Funds?

Purchase Purchase A Property That Has Been Identified Purchase A Property That Has Not Been Identified Refinance Refinance My First Mortgage At The Current Loan Balance Refinance My First Mortgage And Take Cash Out Of The Property To Refinance My First And Second Mortgage

Are You Able To Document Proof Of Your Income?

Yes No

Personal Information Section

E-Mail:

First Name:
Initial:
Last Name:
Social Ins Number:
Birth Date:	MM/DD/YY
Dependents:
Marital Status:	M - Married S - Single D - Divorced P - Seperated W - Widowed C - Commonlaw
Unit:
Number:
Street Name:	Avenue Boulevard Circle Cresent Drive Gate Road Street
City:
Province:
Postal Code:
Res. Phone:
# Of Years:
Res. Status:	O - Own R - Rent P- Live With Parents T - Other
Rent $
Previous Address:	Avenue Boulevard Circle Cresent Drive Gate Road Street
# Of Years:
Res. Status:	O - Own R - Rent P- Live With Parents T - Other
Employment
Current Employer:
Address:
Bus. Phone:	Ext.
Contact time:	Days Evenings Doesn't matter
Contact location:	Work Home Either
Occupation:
# Of Years:
Line Of Business:
Gross Income:	Type: S - Salary/Hour C - Commision E - Self Employed P - Pension A - Alimony O - Other
Fax No:
Previous Employer:
Address:
Occupation:
# Of Years:
Gross Income:	Type: S - Salary/Hour C - Commision E - Self Employed P - Pension A - Alimony O - Other

What DO You Own?

Cash:	$
Principal Residence:	$
Rental Property:	$
RRSP:	$
Stocks/Bonds/Mutuals:	$
Automobiles:	$

What DO You Owe?

Credit Cards:	$
Mortgage #1:	$
Mortgage #2:	$
Loans:	$
Lines Of Credit:	$
Automobiles:	$