Note: * Indicates Required Field Loan Information: Purpose: New Mortgage Transfer Re-Finance Construction Mortgage If other: Type of Property: Residential Commercial Down Payment: Purchase Price: Mortgage Term: 3 Year 4 Year 5 Year Variable Applicant Info: Mr. Mrs. Miss * First Name: *Last Name: *Date of Birth: (mm/dd/yyyy) Marital Status: Married Single Widow/Widower *SIN: Children Applicant Address: *Address: *City: *Province: *Postal Code: *Phone: Co-Applicant Info: First Name: Last Name: Date of Birth:  (mm/dd/yyyy) Marital Status: Married Single Widdow/Widower *SIN:     Co-Applicant Address: Address: City: Province: Postal Code: Phone:     Applicant Employer Info: *Employer: *Occupation/Position: Phone: *Time of Employment: Co-Applicant Employer Info: Employer: Occupation/Position: Phone: Time of Employment: Gross Annual Income Applicant Co-Applicant $ $ Assests Cash: Savings & Chequings $ Guaranteed Investment Services $ Term Deposits: $ Bonds: $ Stock, Mutual Funds Current Value $ RRSPs: $ Vehicle 1 Make: Model: Current Value: $          Loan Value: $ Vehicle 2 Make: Model: Current Value: $          Loan Value: $ Real Estate - Property 1 Address: City: Province: Postal Code: Current Value: $       Mortgage Amount: $   Name Of Lender:       Real Estate - Property 2 Address: City: Province: Postal Code: Current Value: $     Mortgage Amount: $   Name Of Lender:       Other Liabilities Current Loans: Income Tax Payable: Credit Cards: Line of Credit: Other Loans:  *Amount of Loan Required: $  Comments: I/we request a loan and state that the informatin given in this personal credit application and statement is true and correct. I/We consent to the interested Lenders to obtain the necessary credit reports on me/us. In the event event of a default by me/us in respect of this loan, by chosing "I AGREE" below, I/we agree to pay the Lender applicable default charges outlined in the Lender's fee schedule at the time. I Agree Note: * Indicates Required Field