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Mortgage Application by cck10867


                                                                      APPLICANT*                                         CO-APPLICANT*
                               FIRST NAME *

                                LAST NAME *

                          HOME TELEPHONE *

                         WORK TELEPHONE *

                  CELL PHONE (if applicable) *


                         CURRENT ADDRESS *

                CITY / PROVINCE / POSTAL *

                                YRS THERE *

                             OWN OR RENT * OWN                        RENT      Payment/ Mth

               IF OWN GIVE DETAILS OF MORTGAGE       Balance                  Lender              Maturity

                       PREVIOUS ADDRESS
               (IF UNDER 3 YRS in PRESENT)
                  CITY / PROVINCE/ POSTAL
                               YEARS THERE
                           BIRTH DATE *                                                                          BIRTH DATE *
                                 S.I.N. *                                                                              S.I.N. *
                            MARITAL STATUS                                   # DEPENDANTS

                     CURRENT EMPLOYER *
                     EMPLOYER ADDRESS     *
                CITY /   PROVINCE/ POSTAL *


                             YEARS THERE *                                       HOURLY           SALARY                                 HOURLY         SALARY

                           ANNUAL INCOME *
                OTHER INCOME (Support/Alimony)
                         PREVIOUS EMPLOYER
                  (IF UNDER 3 YRS WITH PRESENT)

                   CITY /PROVINCE / POSTAL
                               YEARS THERE                             Annual Income                                             Annual Income

                                                     ASSETS*                                                 LIABILITIES
               CASH IN SAVINGS ACCOUNTS                                                                VISA            N/A
                         CHEQUING ACCOUNT                                                       MASTERCARD             N/A
                      REAL ESTATE DEPOSIT                                                            OTHER             N/A             Other than personal income

                                                                                                                                         tax or Alimony/support
                    TERM DEPOSITS & G.I.C's                                                          OTHER             N/A             payments - the liabilities do
                            STOCKS & BONDS                                                INCOME TAX OWED                                not have to be filled in.

                                      OTHER                                             ALIMONY / SUPPORT
                                       RRSP's                                    PRESENT MONTHLY RENT
                                                  Year         Make             Current Value                   Leased/Loan through     Monthly Pmt.     Balance
                             AUTOMOBILE #1                                                       LEASE/Loan
                             AUTOMOBILE #2                                                       LEASE/Loan
                              NAME OF BANK

                            TYPE of ACCOUNT Chequing                         Savings
             CURRENT CO-SIGNER ON LOAN Yes                     No                                 CURRENT GUARANTOR ON LOAN             Yes            No
             BANKRUPCY IN PAST 7 YEARS * Yes                   No                   Bankrupcy Amount                         Discharge Date

             Value of Property(sale price)                            DOWNPAYMENT *                             *MUST BE COMPLETED FOR PRE - APPROVAL
                                       FULL APPROVALS (You have made an offer on a home already)                                                                    (Pages 1 and 2)

                                        SOLICITOR'S FIRM                                                                          ADDRESS

                                       SOLICITOR'S NAME                                                            CITY/ PROVINCE /POSTAL

                                               TELEPHONE                                                                         FACSIMILE
                                        MORTGAGE TYPE          1ST          2ND              VARIABLE            FIXED           COVENTIONAL               HIGH RATIO

                                  AMORTIZATION PERIOD                              TERM                                        Weekly          Bi Weekly       Monthly

                                                                                                                 REPAYMENT :

                                        PROPERTY TAXES                By Lender                         By Owner                 FIRST TIME BUYER          Yes            No

                                    MORTGAGE PURPOSE           Purchase                       Refinance                        Consolidation

                       DOWN PAYMENT OR EQUITY AMOUNT                   $0.00
                                                                                             SOURCE of DOWN PAYMENT
                        PURCHASE PRICE/Appraised Value
                                                                                                          PROPERTY TAXES                             FOR THE YEAR
                       OTHER CONCURRENT MORTGAGE                          CLOSING DATE

                                                  ADDRESS                                                                                      PAVED ROADS

                               CITY / PROVINCE / POSTAL                                                                                 CONDO HEATING TYPE

                                                  LOT SIZE                                                                              PROPERTY CONDITION

                                             BLOCK / PLAN                                                                                       MLS NUMBER

                                                TOWNSHIP                                                                                       ANNUAL TAXES
                                           BUILDING TYPE 1 Storey          2 Storey           Townhouse            Apt
                                                                                                                                           SQUARE FOOTAGE
                                                    ZONING Residential             Commercial             Agricultural
                                                                                                                                                  YEAR BUILT
                                              OCCUPANCY Owner Occ                 Rental        Owner Occ & Rental
                                                                                                                                               TOTAL ROOMS
                                      CONTRUCTION TYPE Standard                                             Custom
                                                                                                                                        NUMBER of BEDROOMS
                                         EXTERIOR FINISH Brick             Vinyl            Stone         Wood
                                                                                                                                           HALF BATHROOMS
                                                BASEMENT Full            Partial           Finished       Unfinished
                                                                                                                                           FULL BATHROOMS
                                            GARAGE TYPE Single            Double           Attached       Detached
                                                                                                                                     NUMBER of FIREPLACES
                                              SEWER TYPE             Municipal                            Septic
                                                                                                                                        MONTHLY CONDO FEES
                                           WATER SUPPLY              Municipal                            Well                          SWIMMING POOL TYPE
                                           COPY of OFFER             To Follow

                                          COPY of LISTING            To Follow

                       I/We authorize the receipt and exchange of information about me/us with your affiliates from time to time as you deem necessary and appropriate and to the

                       sharing or exchange of reports and information with the various credit reporting agencies, credit bureaus, mortgage insurers and/or any other person,
                       corporation, firm or enterprise with whom I/we have or propose to have a financial relationship.

                                                            APPLICANT                                                                      CO-APPLICANT

                           DATE                                                                                  DATE

                        Sterling Wong | Mortgage & Real Estate Sales Rep | Xpress Property Xchange ( | Mortgage Centre | Re/Max Realty Specialists Inc. |tf|
Sterling Wong | Mortgage & Real Estate Sales Rep | Xpress Property Xchange ( | Mortgage Centre | Re/Max Realty Specialists Inc. |tf|
                                              877.979.4979 |f| 866.536.4751 |e|

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