Summit Mortgage Services - Ontario Mortgages

	Wednesday, Feb 22, 2012


	FSCO License # 10217

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It's so convenient! Simply complete the mortgage application below.

All information provided is strictly confidential and protected by Verisign encryption for the highest level of security. For more information, please refer to our Security and Privacy Statements.

Upon receipt of your mortgage information, a Summit Mortgage Services Mortgage Consultant will contact you within 48 hours to discuss the status of your mortgage application.

Need us to go to work even faster? Call 1-888-707-0883 or 705-645-8645 and a Summit Mortgage Consultant will go to work for you immediately.

And remember - there is no obligation - you decide if the mortgage we present feels right.

Home Mortgage Pre-Approval Application

Please provide the following information to the best of your ability to help us get started on finding a mortgage strategy that's right for you.

If you need assistance call 1-888-707-0883.

1. Applicant Information

*Title:	*Applicant First Name:	*Last Name:

*S.I.N.:	*D.O.B. (MM/DD/YYYY):	*Home Phone:

*Email:	Marital Status:	Dependants:

# Yrs. at Address:	Rent/Mtg. Payment:	*Residence:

*Address:	Apt./Suite #:	*City:

PO Box:	*Province:	*Postal Code:

Previous Address:		How Long:


1.a Co-Applicant Information Only fill out this section if there is a co-applicant.

Title:	First Name:	Last Name:

S.I.N.:	D.O.B.(MM/DD/YYYY):	Home Phone:


2.Applicant Employment History

Self Employed
*Present Employer:	Work Phone:	How Long:

*Occupation:	*Type of Business:	*Income:

Previous Employer (if less than 3 years):		How Long:

2.a Co-Applicant Employment History
Only fill out this section if there is a co-applicant.

Self Employed
Present Employer:	Work Phone:	How Long:

Occupation:	Type of Business:	Gross Income:

Previous Employer (if less than 3 years):		How Long:

3. Assets

Other Source of Income:	Gross Annual Income:


Assets	Value
Cash in Bank:
Real Estate - Residence:
Real Estate - Other:
Deposit on Purchase:
Auto:	yr make
Auto 2:	yr make
Stocks/Bonds/CSB's:
RRSP's:
Other:
Personal Effects:
Total Assets

4. Liabilities

	Total Debt	Monthly
Student Loans:
Mortgages:
Loans:
Finance/Lease Payments:
Personal Line of Credit:
Credit Cards:
Signed as Guarantor:
Total Liabilities:


5. Mortgage Details

Anticipated Closing Date:	Estimated Purchase Price:

Mortgage Term:	Downpayment Available:

Lawyer:


*By clicking Submit I/We hereby authorize Summit Mortgage Services hereinafter referred to as "the Broker", to arrange on my/our behalf the loans described above and certify that the above information which is furnished with the intent that it be relied upon by the Broker to obtain said credit, is true and correct and: i) Agree (if this application is for a loan to be secured by a mortgage) that the evaluation inspection and legal expenses incidental to this application will be paid by me/us and that I am not in arrears on my present mortgage. ii) the above information includes all my/our debts and that we have no current unsatisfied judgements and that I/we have not declared bankruptcy in the last six years and that all my/our outstanding credits are current and in good standing. iii) I/we also acknowledge that the Broker may also be receiving a fee in respect to the arranging of the loan and I/we hereby waive any right to deny or dispute the Broker from receiving said fee. iv) In connection with my application for credit, I/we hereby take notice that you may be procuring and may be referring to a consumer report respecting me/us containing personal information and I/we hereby consent thereto and to the disclosure of such information to other credit grantors or consumer reporting agency and to retain this application for the Brokers records.

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