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Application
Please print on legal size paper. Fax this app to 519.945.2934 or scan and email to bachynsky2001@yahoo.com
| Details of Loan | ||||
| First? | ||||
| Second? | ||||
| Price/Value: | Insurance Fee: | Closing Date: | ||
| Mrtg. Type: | Purpose of Loan: | Guarantor: | ||
| Source(s)
of Down Payment: Asset Breakdown: |
||||
| Personal | ||||||
| Name: | SIN# | DOB | Age | Dpndnts: | ||
| Present Address: | Home #
Work # |
Years: | ||||
| Previous Address: | Years: | Marital Status: | Rent | |||
| Current Employer: | Years: | Gross Ann. Income | Occupation: | |||
| Previous Employer (-3 yrs): | Years: | Gross Ann. Income | Occupation: | |||
| Co-Applicant Name: | SIN# | DOB | Age | Dpndnts: | ||
| Present Address: | Home #
Work # |
Years: | ||||
| Current Employer: | Years: | Gross Ann. Income | Occupation: | |||
| Previous Employer (-3 yrs): | Years: | Gross Ann. Income | Occupation: | |||
| Source of Other Income | Amount: | Source: | Amount: | |||
| Financial Net Worth: $ | |||||||||||||||||||||||||||||||||||||||||
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| Property Description | ||||||
| Municipal Address | Area (sqM) | Age: | ||||
| Owner Occupied? Y N | Rental? Y N | Zoning: | Lot Size: | |||
| Taxes: $ | Heat: $ | Condo Fees: $ | Rental Income: | |||
| RENTAL EXPENSES | Insurance: $ | Repairs: $ | Hydro: $ | Mgmt: $ | Other: $ | |
| Appraised Value: $ | Date Appraised: | |||||
| Existing Mortgages/Properties | |||
| #1 Held By: | Mortgage #: | ||
| Address: | Amount: $ | ||
| Mortgage Type: | Rate as %: | Maturity Date: | |
| Property Value: | Payment: | ||
| Principal Residence? Y N | Remain After Closing: | Rental Income: $ | |
| #2 Held By: | Mortgage #: | ||
| Address: | Amount: $ | ||
| Mortgage Type: | Rate as %: | Maturity Date: | |
| Property Value: | Payment: | ||
| Principal Residence? Y N | Remain After Closing: | Rental Income: $ | |
| Refinance Information | ||
| Purchased: | Closing/Switch Date: | Original Mortgage: |
| Purpose: | Improvements: | |
| Mortgage Holder: | ||
| I/We warrant and confirm that the
information given in this 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 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
furthermore authorized to disclose, in response to direct
enquiries from any other lender or credit bureau, such
information on my loaning account as you consider
appropriate, and I agree to indemnify you against and
save 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: ___________________________________ Richard Bachynsky- CENTUM. 418 Carling Crescent. Windsor, Ontario, Canada N9A 4M6 Bus:
1.519.990-5036 Fax:
1.519.945.2934 |