Gus Koutoumanos
Mortgage Agent Level 2
Licence:
M08006202
Mortgage Edge Inc.
Licence:
10680
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Applicant's Information
Name
Birthdate
SIN#
Marital Status
Married
Single
Seperated
Divorced
Widowed
Dependants
0
1
2
3
4
5
6
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8
9
10
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18
19
20
Address
City
Zip
Years at Present Address
Phone (Home)
Phone (Work)
Phone (Cell)
Employer Name
Occupation
Annual Income
Employment Tenure
Email
Co-Applicant's Information
Name
Birthdate
SIN#
Marital Status
Married
Single
Seperated
Divorced
Widowed
Dependants
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Address
City
Zip
Years at Present Address
Phone (Home)
Phone (Work)
Phone (Cell)
Employer Name
Occupation
Annual Income
Employment Tenure
Email
Financial Worth
Properties owned
Property 1
Property 2
Property 3
Address
Value of Property
Mortgage on Property
Monthly Mortgage Payment
Property tax amount
Rental Income earned per month
Original Purchase price and Date
Maturity Date
Monthly Condo Fees
ASSETS
Who Do You Bank With
Savings in the Bank
Mutual Funds/Stocks/Bonds
RRSP’s
Automobile Year & Make
Other Assets
LIABILITIES
Bank Loans
Credit Card
Credit Card
Credit Card
Line of Credit
Other Loans
Purpose of this request for financing: (Please provide a brief explanation )
PROPERTY DESCRIPTION (FOR EXISTING PROPERTY OR NEW PROPERTY BEING PURCHASED)
Municipal address, City & Postal Code
Legal Description
Sq. Feet
Condo Fees
Property Taxes
Closing Date
DETAILS OF NEW MORTGAGE REQUIRED
Purchase Price
Down Payment
Mortgage Needed
Payment Frequency
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Monthly
Accelerate Bi-Weekly
Bi-Weekly
Accelerate Weekly
Weekly
Source of Down Payment
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RRSP/GIC
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GIFT
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CASH SAVINGS
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Other
Other Source of Payment
Additional Comments
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I/We certify that the information provided is complete and accurate. By electronically submitting this application I/We authorize Mortgage Edge to complete a credit bureau inquiry for mortgage purposes.
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