Fill and Sign the International Paper Insurance Documentation Form

505 – 205 Newport Drive, Port Moody, B.C. V3H 5C9 Office: (604) 949 1070 Fax: (604) 949 1040 Toll Free: 1-800-773-0314 Toll Free Fax: 1-866-346-8101 MORTGAGE APPLICATION Purchase Down Payment Amount $ Transfer Refinance Applicant Information Last name: Given name(s): Social Insurance Number: Date of Birth: (mm/dd/yyyy) Address: Own: City: Home: Marital Status: Yrs: Months: Monthly Rental: $_ Dependents: Yrs: Months: Cell: Province: Postal Code: Previous address if less than 4 years: Work: Email address: Co-Applicant Information Last name: Given name(s): Social Insurance Number: Date of Birth: (mm/dd/yyyy) Address: Own: _ Home: City: Marital Status: Yrs: Months: Monthly Rental: $_ Dependents: Yrs: Months: Cell: Province: Postal Code: Relation to Applicant: Employment / Income Information: Current Employer Applicant Work: Email address: Occupation /Job Title Gross Annual Income Number of Years Previous employer if less than 4 years Co-Applicant Previous employer if less than 4 years Additional Income Source(s) www.canadianmortgagelenders.com Page 1 of 2 info@canadianmortgagelenders.com Financial Net Worth Cash on Hand: Bank: Assets Value ($) Liabilities Principal Residence value: Mortgage Balance: Other Real Estate: Other MTG(s): Investments: RSP RESP Line(s) of Credit: GIC/TERM DEP Credit Cards: Balance Owing ($) Payment ($) Personal Loan(s): STOCKS/BONDS Automobile(s): year/ make / model Auto Loan(s): Lease(s): Income Tax Owning: Other: Other: Total assets Total liabilities Personal Net Worth (assets – liabilities) $ Existing Mortgages Lender: Mortgage Number: Property Address: First or Second Mortgage: Mortgage Balance: Principal Residence: Maturity Date: Brief Legal Description (lot, plan etc.): Square footage: Lot size: Interest Rate: Property Value: Payment: Estimated Heat: Property Taxes: Condo Fee: Original Date of Purchase: Purchase Price: Lender: Rental Income: Mortgage Number: Property Address: First or Second Mortgage: Mortgage Balance: Principal Residence: Maturity Date: Brief Legal Description (lot, plan etc.): Square footage: Lot size: Interest Rate: Original Date of Purchase: Purchase Price: Property Value: Payment: Rental Income: Estimated Heat: Property Taxes: Condo Fees: I/We warrant and confirm that the information given in the mortgage application form is true and correct and I/we understand that it is being used to determine my/our credit responsibility. Your are authorized to obtain any information you may require relative to this application from any sources to which you any apply and each such source is hereby authorized to provide you with such information. You are furthermore authorized to disclose in response to direct enquiries from any other lender or credit bureau, such information on my loaning account as our consider appropriate and I agree to indemnify you against and say you harm from any and all claims in damages or otherwise arising from such disclosure on your part. You are also authorized to retain the application whether or not the relative mortgage is approved. Applicant: ________________________________________________________ Date:_____________________________ Co-Applicant:_____________________________________________________ Date: _____________________________ www.canadianmortgagelenders.com Page 2 of 2 info@canadianmortgagelenders.com