Mortgage Application

    Referral:
    If other please specify:
    Desired Purchase Price $

    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
    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.