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General Mortgage Information:

Purpose of Mortgage:Choose One-------------------Pre-Approval for purchasePurchaseTransfer of MortgageRefinanceDebt ConsolidationEquity Take OutNot Applicable

Purchase Price/Estimated Value of Property:

Mortgage Amount Required:

Down Payment Amount (Purchase Only):

Down Payment Source (Purchase Only):

Proposed Closing Date:

How Did You Hear About Accessible-Mortgages?Choose One-------------------InternetRadioNewspaperWord of MouthOther

Personal Information:

First Name:*

Last Name:*

Date of Birth:*

Marital Status:*Choose One-------------------SingleMarriedCommon-LawSeparatedDivorced

Number of Dependents:

Social Insurance Number:

Home Phone Number:*

Work Phone Number:*

Email Address:*

Fax Number:

Preferred Method of Contact:Choose One-------------------Home PhoneWork PhoneEmailNot Applicable

Personal Information (Co-Applicant):

First Name:

Last Name:

Date of Birth:

Marital Status:Choose One-------------------SingleMarriedCommon-LawSeparatedDivorced

Number of Dependents:

Social Insurance Number:

Home Phone Number:

Work Phone Number:

Email Address:

Fax Number:

Preferred Method of Contact:Choose One-------------------Home PhoneWork PhoneEmailNot Applicable

Current Address (Three Year History):

Street Address:*

City:*

Province:

Postal Code:*

How Long at this Address:* Years

Own or Rent:OwnRent

Monthly Rent:

Mortgage Payment:

Mortgage Amount:

Mortgage Holder:

Payment Frequency:Choose One-------------------MonthlyBiweeklyWeeklyNot Applicable

Interest Rate:

Maturity Date:

Previous Address (If Present Less Than Three Years):

Street Address:

City:

Province:

Postal Code:

How Long at this Address: Years

Own or Rent:OwnRent

Monthly Rent:

Mortgage Payment:

Mortgage Amount:

Mortgage Holder:

Payment Frequency:Choose One-------------------MonthlyBiweeklyWeeklyNot Applicable

Interest Rate:

Maturity Date:

Current Employment Information (Three Year History):

Name of Employer:*

Occupation:*

How Long with this Employer:* Years

Income:*

Pay Rate:*Choose One-------------------HourlySalaryNot Applicable

CO-Applicant

Name of Employer:

Occupation:

How Long with this Employer: Years

Income:

Pay Rate:Choose One-------------------HourlySalaryNot Applicable

Previous Employment Information (If Current Less Than Three Years):

Name of Employer:

Occupation:

How Long with this Employer: Years

Income:

Pay Rate:Choose One-------------------HourlySalaryNot Applicable

CO-Applicant

Name of Employer:

Occupation:

How Long with this Employer: Years

Income:

Pay Rate:Choose One-------------------HourlySalaryNot Applicable

Self Employment Information:

Are You or the CO-Applicant Self Employed?SelfCO-ApplicantNot Applicable

Assets (Include Self and CO-Applicant):

Bank Accounts:

Current Value of Home:

Stocks/Bonds/Term Deposits:

R.R.S.P.:

Vehicle

Model:

Year:

Current Value:

Other:

Other:

Other:

Liabilities (Include Self and CO-Applicant):

Credit Card:Choose One-------------------Master CardVisaAmerican ExpressOtherNot Applicable

Monthly Payment:

Balance:

Credit Card:Choose One-------------------Master CardVisaAmerican ExpressOtherNot Applicable

Monthly Payment:

Balance:

Other Debt:Choose One-------------------LoanLeaseOther MortgageNo Applicable

Lender:

Purpose:

Monthly Payment:

Balance:

Other Debt:Choose One-------------------LoanLeaseOther MortgageNo Applicable

Lender:

Purpose:

Monthly Payment:

Balance:

New Home Details (If Purchasing a Property or Applying for Pre-Approval on a Purchase):

Address:

City:

Province:

Postal Code:

Annual Taxes:

Occupancy:Choose One-------------------Owner OccupiedRentalOwner Occupied / RentalNo Applicable

Ownership:Choose One-------------------FreeholdCondominiumNo Applicable

Property Type:Choose One-------------------1 Story2 StorySplit LevelTownhouseTownhouse CondoApartment CondoSemidetachedDuplexTriplexFourplexOtherNot Applicable

Exterior:Choose One-------------------Metal SidingVinyl SidingBrick SidingStuccoOtherNot Applicable

Water Supply:Choose One-------------------MuncipalWellOtherNot Applicable

Paved Road:YesNo

Sewer Type:Choose One-------------------Sewer ConnectedSeptic InstalledOtherNot Applicable

Year Built:

Garage:Choose One-------------------Surface parkingUnderground ParkingCar PortSingle DetachedSingle AttachedDouble DetachedDouble AttachedNoneNot Applicable

Basement:Choose One-------------------FullPartialCrawlspaceNoneNot Applicable

 Choose One-------------------Fully FinishedPartially FinishedUnfinishedNot Applicable

Fireplace:YesNo

Bedrooms:

Bathrooms:

Half Bathrooms:

Square Footage:

Condominiums Only

Square Footage:

Apartment or Townhouse:ApartmentTownhouse

Heat Included:YesNo

Hydro Included:YesNo

Annual Condo Fees:

Feedback: 

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 any debts to be paid off with funds from the new mortgage.

If buying, will you be selling your existing home? What is your estimated sale date?

Authorization: 

I/we hereby certify that the information 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 authorize Accessible-Mortgages to obtain and exchange credit information regarding my/our credit history from any recognized credit agency, chartered bank or other institution.

I/we hereby acknowledge that I/we have been advised that mortgage life 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 this application, I/we acknowledge and accept the above statements.

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