Application

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Please fill out this application and submit it to me for approval.
Please fill in this form completely, if sections or fields are missed, this could slow down the approval process.

   * email address is required

What Do You Need? (Optional)

Completing this form will allow us to quickly process your mortgage application. All information will remain strictly confidential. There is no obligation or commitment by submitting this form and will be used to verify your credit rating.

I want to consolidate all my debt.
I want to purchase my first home with at least 5% down.
I want to lower my monthly mortgage payments and lock into a better rate.
I am currently selling my existing home and looking to mortgage a new home.
I am buying an investment property in Panorama.
I am buying an investment property in another resort location.
I want to buy a home with zero money down.
Other, please explain:
GENERAL INFORMATION
Borrower’s Information

First Name
Middle Initial
Last Name
D.O.B.
S.I.N.
Marital Status
Dependents
Current Address
City
Province
Postal Code
Years There
Previous Address
City
Province
Postal code
Years There
E-mail *
Home Phone
Cell Phone
Living As
Employment Information
Current Occupation
Current Employer
Work Phone
Ext.
Gross Yearly Income
Years There
Employer Address
Basis for Income
Previous Occupation
Previous Employer
Gross Yearly Income
Years There
  Self Employment Information
Self Employed? Yes   No
Business Name
Business Type
Business Gross Revenue
Business Net Income
Business Bank Name
Business Accountant
Co-Borrower’s Information

First Name
Middle Initial
Last Name
D.O.B.
S.I.N.
Relation to Applicant
Dependents
Current Address
City
Province
Postal Code
Years There
Previous Address
City
Province
Postal code
Years There
E-mail
Home Phone
Cell Phone
Living As
Employment Information
Current Occupation
Current Employer
Work Phone
Ext.
Gross Yearly Income
Years There
Employer Address
Basis for Income
Previous Occupation
Previous Employer
Gross Yearly Income
Years There
  Self Employment Information
Self Employed? Yes   No
Business Name
Business Type
Business Gross Revenue
Business Net Income
Business Bank Name
Business Accountant
FINANCIAL AND PROPERTY INFORMATION
Details of Mortgage Loan & Property Information

Loan amount ?Value of home?
Property taxes? (mth)Purchase price?
Date purchased?
Kind of ResidenceCondo
If DetachedGarage Size
HeatGarage
Property AgeLot Dimensions
Square Footage# of Rooms
Fireplace Yes   No# of Bedrooms
BathroomsHalf Baths
FIRST AND SECOND MORTGAGE INFORMATION
First Mortgage

Mortgage Lender (held by)
Mortgage #
Balance
Rate %
Monthly Payment
Maturity Date
Property Address
Second Mortgage

Mortgage Lender (held by)
Mortgage #
Balance
Rate %
Monthly Payment
Maturity Date
Property Address
  LIABILITIES AND ASSET INFORMATION
Assets

First Vehicle Make, Model, Year
Second Vehicle Make, Model, Year
RRSPs
Stocks/Bonds
Cash/Savings
Other
Primary Bank(s)
Other sources of income? explain
Liabilities

Total outstanding balances:
Credit Cards
Loans/Lines of Credit
Other
Total monthly payments:
Car Payments
Alimony/Support
Other
  OTHER INFORMATION
Are you currently a co-signor on another loan? Yes   No
Do you currently guarantee a business loan? Yes   No
Are you a non-Canadian looking to purchase property in Canada? Yes   No
Country of Citizenship
First Time Homebuyer? Yes   No
Is this an investment purchase? Yes   No
COMMENTS
Please provide any additional information that you may think is necessary.

By submitting this form , I/WE CERTIFY THAT all of the answers above are correct and complete. I authorize Gerry Orr, Mortgage Broker for Alberta Mortgages to obtain a credit report on me/us and in so doing acknowledge you may be giving others the above information. Alberta Mortgages not responsible for any failure, omission or mistake in seeking financing for me/us. I/we have reviewed the client service agreement (PDF) and acknowledge its terms.

BY FAX:

If you would rather print off this form and fax it to Gerry Orr’s office, please CLICK HERE to download a .PDF file. Print this file and fill out all fields completely and accurately. Then fax it to 403.249.6014 or (outside Calgary) 1.866.266.2681.

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