Application for Mortgage Loan
Adam Hawryluk
adamhawryluk@[Link] Office: 250.754.7775 Fax: 250.754.5557 Toll Free Fax: 1.877.754.5550
If Purchasing
Purchase Price Down Payment Source of Down payment Realtor Name Realtor Phone
If Refinancing
What is the value of your home? Current Mortgage Amount Who is your mortgage with? Property Taxes Current Mortgage Payment Condo/Strata Fees Personal Email Address @
Pre-Approval
Price Range Desired Monthly Payment
Personal Information
Name of Applicant in Full Name of Co-Applicant Present Address
Marital
S.I.N. #
Birth Date
Deps.
Home Phone
Business Phone
Postal Code
Rent $
Years Years
Previous Address if less than three (3) years at current address Applicants Employer Previous Employer Co-Applicants Employer Co-Applicant Previous Employer Other Source of Income Location Of Property or Civic Address Legal Description Comments: Position Previous Position Co-Applicants Position Co-Applicants Previous Position Annual Income How Long? _______Yr. ______Mo. Annual Income How Long? ______Yr. _______Mo. Annual Income
Years Income Years Income
APPLICATION FOR MORTGAGE LOAN
Adam Hawryluk Mortgage Consultant
Personal Net Worth
Cash in Bank Investments RRSPs Personal Residence Real Estate Real Estate Auto(s) 2nd Property Address 3rd Property Address Year & Make Year & Make Household Goods Other Assets Boats/RVs/Tools etc. Other Assets Replacement Value Estimate Institution
Name of Institution/Description
Estimated Value
TOTAL ASSETS: Personal Liabilities
Credit Cards
Name of Institution/Lender
Monthly payment
Balance
Personal Line of Credit Loans
Auto Demand Residence Mortgage Other Mortgages Other Liabilities
TOTAL MONTLY LIABILITIES TOTAL LIABILITIES NET WORTH
I/We hereby certify that the information we have given, to the best of our knowledge is correct and true. I/We consent to Invis and/or its agent, obtaining reports containing credit and/or personal information as necessary in connection with this application. Date:______________________________________________ Date: ______________________________________________ Signature: ______________________________________________ Signature:_______________________________________________
CLIENT AGREEMENT
I/we warrant and confirm that the information provided to Invis (you) by me/us in the mortgage application form is true and correct and I/we understand that it is being used to determine my/our credit responsibility. You are authorized to obtain any further information you may require relative to this application from any sources to which you may apply and each such source is hereby authorized to provide you with such information. You are further authorized to disclose to any other lender, credit bureau or insurer or insurance agent such personal and financial information, as you consider appropriate. And I/we agree to indemnify you against and save you harmless from any and all claims in damages or otherwise arising from such disclosure on your part. I/we agree to pay all applicable legal, property appraisal, registration fees and expenses incurred in connection with this mortgage application. You are also authorized to retain the application whether or not the relative mortgage is approved. I/we acknowledge that Invis may be paid a referral fee from the mortgage lender for placement of this mortgage. I/we give Invis permission to phone me/us in the future to discuss our mortgage needs. Y / N
_____________________________ Applicant Signature Date
___________________________ Co-Applicant Signature Date
________________________________________________________________
_____________________________________________________________________
Applicant Name (Please Print)
Co-Applicant Name (Please Print)
Effective October 17, 2008
