Mortgage Application

    Referral:

    If other please specify:

    Applicant Information:

    Purpose of Loan

    If other please specify:

    Full Name

    S.I.N.

    Dependants

    Marital Status

    Birthdate

    Month

    Day

    Year

    Present Address

    City

    Postal Code

    Rent/Own($)

    No. of Years

    Previous Address if less than 3 years

    Home Phone:

    Cellular:

    Bus Phone:

    Email:

    Current Employer

    Occupation

    Employer Phone #

    Years

    Gross Annual Income

    Income type

    Employer Address

    Employer Postal Code

    Previous employment if less than 3 years

    Other Income: Source

    Years

    Income

    Occupation

    Self-Employed

    Gross Business Income $

    Net Business Income $

    Purchases

    Desired Purchase Price $

    First Time Buyer?

    Down Payment

    Down Payment Source

    Co-Applicant Information:

    Full Name

    S.I.N.

    Dependants

    Marital Status

    Birthdate

    Month

    Day

    Year

    Present Address

    Postal Code

    Rent/Own($)

    No. of Years

    Home Phone:

    Cellular:

    Bus Phone:

    Email:

    Current Employer

    Years

    Gross Annual Income

    Occupation

    Employer Address

    Other Income: Source

    Years

    Income

    Occupation

    First Time Buyer?

    Assets:

    Bank:

    Type:

    Balance: $

    RRSP:

    Value: $

    Stocks/Bonds/GIC:

    Value: $

    Automobile (year/make/model):

    Value: $

    Automobile (year/make/model):

    Value: $

    Other Assets:

    Value: $

    Do you have Life Insurance? If yes, Policy Coverage $:

    Do you have Disability Insurance?

    Current Mortgages/Properties Owned:

    Address:

    City:

    Property Value: $

    Existing Mortgage Bank/Lender:

    Mortgage Balance: $

    Monthly Payments: $

    Mortgage Rate: %

    Mortgage Renewal Date:

    Rental Income: $

    Property Tax: $

    Condo Fees: $

    Second Mortgage Balance: $

    Monthly Payments: $

    Mortgage Rate: %

    Mortgage Renewal Date:

    Property Tax: $

    Condo Fees: $

    Additional Properties:

    Type:

    Address:

    Property Value: $

    Rental Income: $

    How May We Contact You?

    I would prefer to be contacted by:

    Do you provide permission to be contacted via E-mail

    Comments

    Please detail the purpose of your new mortgage request

    Submit Your Mortgage Application

    I, (First Name), (Last Name) and (Co-Applicant First Name), (Co-Applicant Last Name) understand approval is subject to satisfactory home appraisal, verification of employment and credit report. I realize that DLC National (Harmony Mortgage Group) will base mortgage pre-approval on the information I have supplied on this form, so I verify that it is complete and correct. I consent to DLC National (Harmony Mortgage Group) obtaining credit information about me at any time.
    To indicate your acceptance of the terms explained above, please click Apply.