Mortgage Advisor Javier Franco

Phone 1-877-215-7340
Fax 1-866-350-4649
Email Javier.franco@cibc.com
Mortgage#:
Please tell us about yourself and the co-applicant
Your title Your Last
name Co-applicant
Mr. Mr. Last name
Mrs. Mrs.
Miss. Miss.
Ms. Ms.
Dr. Your First Dr. Co-applicant
name First name
Co-applicant
Your SIN SIN
Your Birth Co-applicant
Date Birth Date
Day Month Year Day Month Year

Current Street # and Name Apt / Suite City Province Postal Code
Address
(Applicant)
How long Your Area Code Your Area Code Ext.
have you Home Business
lived there? Telephone Telephone
If less than 3 Street # and Name Apt / Suite City Province Postal Code How long
years, previous there?
address
Current Street # and Name Apt / Suite City Province Postal Code
Address
(Co-App.)
How long Your Area Code Your Area Code Ext.
have you Home Business
lived there? Telephone Telephone
If less than 3 Street # and Name Apt / Suite City Province Postal Code How long
years, previous there?
address
Status: Married Common-Law Number of
Dependents:
Single Divorced
Widowed Separated Name Age

Name Age

Please tell us about your employment

Are you Self Employed? (If more than 3 years) Is the Co-Applicant Self Employed: (If more than 3 years)
Yes No Yes No
Your Employer Co-Applicant
Name: Employer Name:

Address: Address:

Occupation: Occupation:

How
How Long?
Long?

Annual Hourly Annual Hourly

$ $
Income: Salary Income: Salary

Part-time Details: Part-time Details:

Rental How long? Rental How long?
Other Alimony/Child Support Co-Applicant Alimony/Child Support
Income Other Income
Source
Pension
Source
Pension
Business Amount Business Amount
Investment $ Investment $
Previous Co-App. Prev.
Employer Employer
Address: Address:
 How How
Occupation: Occupation:
Long? Long?

Annual Hourly Annual Hourly

$ $
Income: Salary Income: Salary

Please tell us about the property to be mortgaged

Purpose:
Term: Yrs Amortization: Yrs
Purchase
If Purchase, For 1st Home? Closing Required
$
Yes No Date: Amount

Refinance Transfer Source of

Downpayment $
Downpayment:
New Construction (Completion)
New Construction (CMHC Draws) Payment Frequency: Add Property Tax to payment:
Equity Take-Out Weekly Yes

Reason for Equity Take-out: Bi-Weekly No

Semi-Monthly
Monthly

Property Street # and Name Apt / Suite City Province Postal Code
Address

Zoned
Legal Description:
Lot #: Plan#: Block:
Residential
Commercial
Other

Lot Size:
Property Type: Occupancy Type:
Detached Single Owner Occupied
Square Feet:
Semi-detached Rental
Duplex Condition:
Purchase Date:
Triplex
Fourplex Age:
Tenure:
Townhouse Freehold Freehold Heating
Estimated Value
Type:
Townhouse Condominium Or Purchase Price:
Leasehold
Apartment / Condominium $ Condo
Other, specify

# Stories:
Construction: Garage: Sewer:
Brick None Municipal
# Total Rooms:
Frame Single Septic
Insul-brick Double # Bathrooms:
Aluminium Attached
Basement:
Concrete Detached # Bedrooms:
Full
Stone Underground
Partial
# Fireplaces:
Vinylsiding Other
Finished
Stucco
Unfinished Monthly Condo Fees $
WoodFrame
Crawl
Log
Pool: Annual Property Taxes $
None
Other No
In Ground
Water Type: Insulation Type:
Above Ground
Municipal No UFFI
Whirlpool
Well UFFI
Other
Other:

Please tell us about your financial resources

ASSETS LIABILITIES
Name of Bank /
Type Amount Monthly Payment Outstanding Balance
Institution
Cash in bank
Credit Card: $ $
Savings/Chequing $
Term Deposit/GIC: Credit Card: $ $
$
Stocks / Bonds: Credit Card: $ $
$
Support /
RRSPS /RIFS: $ $
$ Alimony:
Deposit with offer: Line of Credit: $ $
$
Existing 1st
Principal Residence: $ $
$ Mortgage:

Other Real Estate: $ Maturity Date: Term / Rate: Amortization:

Description: Existing 2nd $ $

Mortgage:
Maturity Date: Term / Rate: Amortization:

Automobile (Value) Bank Loan: $ $

$
Make/ Type/ Year Bank Loan: $ $
Outstanding
Make/ Type/ Year $ $
Income Taxes:
Personal Effects
Other: $ $
(contents of home) $
Monthly Rent
$
(if applicable)

Bank Reference: Address: Phone #: Account #: Account #:

Please provide us with some legal information

Name of Solicitor Solicitors Firm Address Phone # Fax #

(N/A for Transfers)

Have you ever declared bankruptcy? If yes, please explain: Discharge Date:
No
Yes
If yes, Amount $