Mortgage Application for a Switch or Renewal

Name: __________________________________________________________________________

Preferred Method of Contact:

__ Phone Number (and best time to call): ____________________________________________

__ Email: ________________________________________________________________________

To Email this Application: Fill it out on your computer, then save & email it to dc.walker@rogers.com

or

To Fax this Application: Fill it out on your computer, then print & fax it toll-free to 705.353.0210.

Who Are You? Applicant:

Full Name: _________________________________________ Number of Dependants: __________

Telephone #: _________________________________ Cell #: _______________________________

Email Address: ______________________________________________________________________

S.I.N #: ________________ Date of Birth: ___________________ Marital Status: _____________

Co-Applicant:

Full Name: _________________________________________ Number of Dependants: __________

Telephone #: _________________________________ Cell #: _______________________________

Email Address: ______________________________________________________________________

S.I.N #: ________________ Date of Birth: ___________________ Marital Status: _____________

Where Do You Live? Applicant:

Current Address: ____________________________________________________________________

City: ______________________ Province: ________________ Postal Code: __________________

How many years at current address? _______ Is this the property you'd like to renew? ________

Previous Address (If less than 3 years at current address):____________________________________________

City: ______________________ Province: ________________ Postal Code: __________________

How many years at previous address? _______ Did you Own/Rent/Other? ____________________

Co-Applicant:

Current Address:_____________________________________________________________________

City: ______________________ Province: ________________ Postal Code: __________________

How many years at current address? _______ Is this the property you'd like to renew? ________

Previous Address (If less than 3 years at current address):____________________________________________

City: ______________________ Province: ________________ Postal Code: __________________

How many years at previous address? _______ Did you Own/Rent/Other? ____________________

What Do You Do? Applicant:

Current Employer: ________________________________ Occupation: ______________________

Address: __________________________________________________ City: ___________________

Province: _______________ Postal Code: _______________ Telephone #: ___________________

How long with current employer? __________________ Annual Income: _____________________

Income Type: __ Salary __ Hourly __ Commission __ Self-Employed __ Other: ____________

If current employment is less than 3 years, please enter previous employment information:

Previous Employer: ________________________________ Occupation: ______________________

Address: __________________________________________________ City: ___________________

Province: _______________ Postal Code: _______________ Telephone #: ___________________

How long with previous employer? __________________ Annual Income: ____________________

Income Type: __ Salary __ Hourly __ Commission __ Self-Employed __ Other: ____________

Co-Applicant:

Current Employer: ________________________________ Occupation: ______________________

Address: __________________________________________________ City: ___________________

Province: _______________ Postal Code: _______________ Telephone #: ___________________

How long with current employer? __________________ Annual Income: _____________________

Income Type: __ Salary __ Hourly __ Commission __ Self-Employed __ Other: ____________

If current employment is less than 3 years, please enter previous employment information:

Previous Employer: ________________________________ Occupation: ______________________

Address: __________________________________________________ City: ___________________

Province: _______________ Postal Code: _______________ Telephone #: ___________________

How long with previous employer? __________________ Annual Income: ____________________

Income Type: __ Salary __ Hourly __ Commission __ Self-Employed __ Other: ____________

How Are Your Finances?

Assets Current Value

Cash & Savings $

Investments/Stocks/RRSPs $

Vehicles (Year, Make & Model): _________________________________________ $

Real Estate: (Property Details): _______________________________________ $

Other: ________________________________________________________ $

Total Assets $

Liabilities Current Balance Monthly Payments

Credit Cards $ $

Rent/Mortgage Payments $ $

Loans/Lines of Credit $ $

Vehicle Loans $ $

Support/Alimony $ $

Other: _____________________________________ $ $

Total Liabilities $ $

What Are Your Property Details ? Some information required by the lenders about the property that you're looking to renew.

Address: ___________________________________________________________________________

City: ______________________ Province: ________________ Postal Code: __________________

Type of Home: __Detached __ Semi-Detached __ Townhouse __ Condo __ Other: ________

Number of Storeys: __ One __ Two __ Three __ Split Level __ Other: ____________________

Age of Home: _______ Size of Home (in square feet): _________ Lot Size (in square feet): __________

Type of Heating: __ Gas __ Oil __ Space Heater __ Wood Stove __ Other: ________________

Type of Garage: __ Attached __ Detached Size of Garage: __ Single __ Double __ Triple

Estimated Property Value: $_________________ Original Purchase Date: _____________________

Original Purchase Price: $__________________ Original Mortgage Balance: $_________________

Annual Property Taxes: $___________________

What Are Your Current Mortgage Details? Current Lender (1st

Mortgage): __________________________ Mortgage Number: _______________

Current Mortgage Balance: $__________________ Mortgage Maturity Date: __________________

Type of Term: __ Variable __ Fixed __ I don't know Rate: ____% Monthly Payment: $_______

Current Lender (2nd Mortgage): __________________________ Mortgage Number: ______________

Current Mortgage Balance: $__________________ Mortgage Maturity Date: __________________

Type of Term: __ Variable __ Fixed __ I don't know Rate: ____% Monthly Payment: $_______

Did You Read the Fine Print?

You knew the fine print was coming, right? Read it carefully, then make sure you check the two boxes below to let us know that you understand the fine print, and that you give us the ok to start working on your renewal.

I/We hereby warrant and affirm that all the information given in the above mortgage application is true and correct and I/we understand that it is being used to determine my/our credit responsibility and to evaluate and respond to my/our request for mortgage financing. You are authorized to obtain any information you may require for these purposes from other sources (including, for example, credit bureaux) and each source is hereby authorized to provide you with such information. I/We also understand, acknowledge and agree that the information given in the mortgage application as well as other information obtained in relation to my/our credit history may be disclosed to potential mortgage lenders, mortgage insurers, other service providers, organizations providing technological or other support services required in relation to this application, and any other parties with whom I/we propose to have a financial relationship.

I/We further acknowledge and agree that each potential mortgage lender, mortgage insurer or service provider to whom you provide the mortgage application and/or my/our personal information is permitted to receive such application and information and maintain records relating to me/us and my/our mortgage application and to hold, use, communicate and disclose personal information about me/us, including our Social Insurance Number (SIN) if I/we provide it, and collect personal information from me/us, you and from third persons, including credit bureaux, credit reporting and collection agencies, financial institutions, my/our past and present employers, creditors and tenants, my/our spouse or any other person who has information about me/us for the purposes of recording, evaluating and responding to my/our application for mortgage financing or related activities and I/we specifically consent to the release and disclosure of personal information by such persons to and among you and each potential mortgage lender, mortgage insurer or other service provider.

__ I/we agree that I/we understand and accept the terms in the above paragraphs (“Fine Print”)

__ I/We authorize my/our credit bureau report to be requested and used for the purposes of completing this mortgage application

Congratulations!! You've made it to the end of the mortgage application form! Now you have one more choice to make:

Email this Application or Fax this Application