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Mortgage Application
Our Services
Mortgage Application
Refinance
Insurance Products
Reverse Mortgage
Our Team
News
Contact
Mortgage Application
Referral:
---
Tammy
Carie
Dustin
Lance
Jessica
Facebook
Instagram
Google (or other search engine)
Other
If other please specify:
Desired Purchase Price $
Applicant Information:
Purpose of Loan
---
Pre-approved Mortgage Loan
Mortgage Loan for New Home
Second Mortgage
Refinance/Consolidate
Transfer/Switch
Construction
Inter Alia Mortgage
Other
If other please specify:
Full Name
S.I.N.
Dependants
Marital Status
Birthdate
Month
---
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sept
Oct
Nov
Dec
Day
Year
Present Address
City
Postal Code
Rent/Own($)
No. of Years
Previous Address if less than 3 years
Home Phone:
Cellular:
Bus Phone:
Email:
Current Employer
Occupation
Employer Phone #
Years
Gross Annual Income
Income type
---
salary
hourly
Employer Address
Employer Postal Code
Previous employment if less than 3 years
Other Income: Source
Years
Income
Occupation
First Time Buyer?
---
Yes
No
Down Payment
Down Payment Source
---
own resources
family gift
RSP
Co-Applicant Information:
Full Name
S.I.N.
Dependants
Marital Status
Birthdate
Month
---
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sept
Oct
Nov
Dec
Day
Year
Present Address
Postal Code
Rent/Own($)
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?
---
Yes
No
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?
---
Yes
No
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:
---
Rental
Second Residence
Vacation Property
Address:
Property Value: $
Rental Income: $
How May We Contact You?
I would prefer to be contacted by:
---
E-mail
Telephone
No preference
Do you provide permission to be contacted via E-mail
---
Yes
No
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.