VERICO LEGEND FINANCIAL INC.# 12000 4 Lansing Square, suite 203 North York, ON.

M2J 5A2

Yuhong Bi

Mortgage Broker, AMP, M.B.A., P.M.P.

Tel: 416-668-4622 Fax: 1-800-516-7088

yuhong_bi@hotmail.com www.verisite.ca/yuhongbi

Applicant
Name SIN

Co-Applicant

Address
City /Province /Postcode // Address (if current < 3 year)

Home Tel Number Email Address Date of Birth (mm / dd / yy) Marital Status
# of dependents
Previous Employer , address(if current < 3 years)

Married

Single

Common Law

Married

Single

Common Law

, , ,

Current Employer Address, Postal Code Occupation Years of Service Bus Tel Number Gross Annual Income $
: , , , ,

$ Balance $ $ $
$

: , , , ,

Assets
Cash in Which Bank

Balance/Value $ $ $ $ $

Liabilities
Bank Loans Mortgages Credit Cards Other Loans

Monthly Payment $ $ $ $ $

Real Estate Vehicles (year, model) Other Assets

Total Assets

Total Liabilities

House Price $_______________ Mortgage Amount $_______________ Down Payment Amount $_________________
Purpose of Mortgage : Pre-Approval Refinance Type of Mortgage Requested : ___________ Renewal (if renewal, please indicate renewal date:_________________ ) Purchase (if purchase, please indicate closing date:________________ ) Personal loan ( please indicate amount required:________________ )

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. 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. Applicants Signature: ____________________________________________________ Date: _______________________________ Co-Applicants Signature: ______________________________________________Date: _________________________________

Verico Legend Financial . #12000 4 Lansing Square, Unit 203, North York, ON. M2J 5A2

VERICO LEGEND FINANCIAL INC.# 12000 4 Lansing Square, suite 203 North York, ON. M2J 5A2

Yuhong Bi

Mortgage Broker, AMP, M.B.A., P.M.P.

Tel: 416-668-4622 Fax: 1-800-516-7088

yuhong_bi@hotmail.com www.verisite.ca/yuhongbi

Properties owned:
Property address
Purchase Price Purchase day Current Market Value Proper ty Tax Condo fee Mortgag e balance Mortgag e Monthly payment Mortgage Bank, Rate, and expiration month/year Monthly Rent, if rental Sell / Hold?