<%@LANGUAGE="VBSCRIPT"%> Mortgage Application
Mortgage Alliance Ontario APPLICATION FOR CREDIT
Fax: (613) 822-8000
Toll Free Fax: (888) 853-4752 
PURPOSE
 OWNER OCCUPIED
RENTED		 AMOUNT
APPLICANT'S LAST NAME
 APPLICANT'S FIRST  NAME
  INIT.
 TITLE
BIRTHDATE (Y/M/D)
 MARITAL STATUS
DEP
CO-APPLICANT'S LAST NAME
 CO-APPLICANT'S FIRST  NAME
  INIT.
TITLE
BIRTHDATE (Y/M/D)
MARITAL STATUS
  
PRESENT ADDRESS
 CITY & PROVINCE
 POSTAL CODE
 HOW LONG?
 RES. PHONE
PREVIOUS ADDRESS
 CITY & PROVINCE
 POSTAL CODE
 HOW LONG?
 
APPLICANT'S PRESENT EMPLOYER
 OCCUPATION
 HOW LONG?
 ANNUAL INCOME
BUS. PHONE
CO-APPLICANT'S PRESENT EMPLOYER
 OCCUPATION
 HOW LONG?
 ANNUAL INCOME
BUS. PHONE
SOURCE OF OTHER INCOME
 ANNUAL  INCOME
EMAIL ADDRESS
PRESENTLY YOU
  OWN        RENT		 MORTGAGE  / MONTHLY RENT
 PURCHASE PRICE
 YEAR PURCHASED
 PRESENT / SALE VALUE
MORTGAGE LENDER NAME
 LENDER ADDRESS
 BALANCE
 RATE 
 MATURITY DATE
COMBINED  FINANCIAL INFORMATION
ASSET / LIABILITY STATEMENT ASSET LIABILITY MONTHLY PAYMENT
 
 
 
 
 
 
 
By signing below you affirm that the information you have given in this Application is true and complete and that you have not withheld any information.  We will rely on the information you have given to decide on your Application. You also agree to the terms below.
 Social Insurance Number     Applicant    Co-Applicant


_________________________________________________________________________________________
Date                                                Applicant's Signature                                                   Co-Applicant's Signature
CONSENT TO COLLECT AND USE PERSONAL INFORMATION
When you apply for a mortgage with us, you agree that:
1 We may collect and use personal information from you and about you for the following purposes: (a) to understand your needs (b) to determine the suitability of our products and services for you (c) to determine your eligibility for our products and services (d) to establish, manage and offer products and services that meet your needs (e) to provide you with on-going service and (f) to meet our legal and regulatory requirements.
2 We may use, give to, obtain, verify, share and exchange credit and other information about you with others including credit bureaus, mortgage insurers, credit insurers, registries and other persons with whom you may have financial dealings, as well as any other person as may be permitted or required by law. You also authorize any person whom we contact in this regard to provide such information to us.
3 We may ask you for your Social Insurance Number to use in verifying and reporting credit information to credit bureaus and credit reporting agencies. You may refuse to consent to its use or disclosure for these purposes.
All Consultants are licenced mortgage agents of The Mortgage Alliance Company of Canada, 200-2005 Sheppard Ave. E Toronto, ON M2J 5B4