ONLINE APPLICATION FORM

Select Broker to Send to
Purpose of Mortgage

If Purchasing a Property:

Purchase Price
Down Payment
First Time Buyer	yes no
Working with a Realtor	yes no

For all other inquiries:

Value of property to be mortgaged
Amount of existing mortgage
Amount of Rental Income for property (if any)

Personal Information:

Applicant Name
Address
City
Province
Postal Code
Years at current address

I prefer to be contacted by
Home Phone
Work Phone
Cell Phone:
Fax
Email

Date of Birth
S.I.N.
Current Employer
Position
Gross Annual Income
Other Income
Years at present job

Co-Applicant Name
Address
City
Province
Postal Code
Years at address

Date of Birth
S.I.N.
Employer
Position
Gross Annual Income
Other Income
Years at present job

Assets: Please list financial assets such as savings, RSPs, GICs, real estate, vehicles

Asset:	Value:

Liabilities: Please list monthly obligation such as loans, mortgages, credit cards, lines of credit

Liability:	Amount:	Monthly Payments:









Additional Comments:



To apply for mortgage financing including a mortgage pre-approval please read the following credit authorization. I/we warrant and confirm that the information given to Strategic Mortgage Professionals Inc. is true and correct and I/we understand it is being used to determine my/our credit responsibility. You are authorized to obtain any further information you may require from any sources, which you may apply and each such source is hereby authorized to provide you with such information. You are further 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 from any harm 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. I/We agree to pay all applicable legal, property appraisal, registration fees and expenses incurred in connection with this mortgage application. I/We acknowledge that Strategic Mortgage Professionals Inc. may be paid a referral fee from the mortgage lender for placement of this mortgage.