Application Form

WHO REFERRED YOU TO DROP MY RATE?
Name of Company

 Representative
 
PURPOSE OF NEW MORTGAGE
Pre-Approval Purchase Refinance Consolidate Debt
 
WHO YOU ARE
Full Name Birth Date
yyyy-mm-dd		 S.I.N. Marital Status Dependents
Applicant  (required) (required)  
coappplicant
 
HOW TO CONTACT YOU
Home Phone Work Phone Fax Number Email Address
Applicant  (required) (required)   (required)
coappplicant
 
WHERE YOU LIVE – (3 Year History)
Street Address City, Province, PC, Country How Long (Yrs) Status
Present
Previous
Previous
 
WHERE YOU WORK – (3 Year History)
Employer Address Position How Long (Yrs) Income/Year
Applicant
Coappplicant
YOUR NET WORTH
ASSETS
Description Value
Savings
Checking
Bonds
R.R.S.P.’s
OUTSTANDING DEBTS
Description Balance Monthly Payment
Vehicle Type Loans
Life
Insurance (csv)
Other Asset
Other Asset
 
YOUR PRESENT HOME
LandLord/Mortgage
Holder		 Monthly
Payment		 Mortgage
Balance		 Home
Value
 
NEW PROPERTY INFORMATION
Property Address Property
Type		 Purchase
Price		 Down Payment /
Equity		 Closing Date
yyyy-mm-dd
 
LEGAL INFORMATION
Solicitor’s Firm Solicitor’s Name
Address City, Province, PC Phone Number Fax Number
 
BANKING INFORMATION
Institution Branch Type of Accounts
Currently a Co-Signer on another loan? 

Yes 

No 
Have you Declared Bankruptcy within the past 7 Years?

Yes 

No 
Reason For Bankruptcy Amount Date Discharged
yyyy-mm-dd
ADDITIONAL COMMENTS REGARDING YOUR MORTGAGE APPLICATION
APPLICATION 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 TMG The Mortgage Group Ontario Inc. FSCO Registration #10315,to obtain and exchange information regarding my/our credit history from 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.

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