Mortgage Application

broker: Crina Jurju company: TMG The Mortgage Group license #: 511309

street: 11067 8th Street East city: Saskatoon province: Sk. postal code: S7H 0S4

phone: 306-321-4982 fax: email: crina.jurju@mortgagegroup.com cellphone:

toll free fax: toll free phone:

PERSONAL INFORMATION (client)

PRINCIPAL APPLICANT CO-APPLICANT (if necessary)

Title Mr. Mrs. Ms. Miss. Title Mr. Mrs. Ms. Miss.

First Name First Name

Middle Name Middle Name

Last Name Last Name

Date of Birth SIN Date of Birth SIN

Married Single Common Law Divorced Married Single Common Law Divorced

# of dependants # of dependants

CURRENT ADDRESS CURRENT ADDRESS

Street Street

City City

Province Province

Postal Code Postal Code

Years There Own Rent Years There Own Rent

Monthly Payment/Rent Monthly Payment/Rent

Home Phone
Home Phone
Cellphone
Cellphone
Work Phone
Work Phone
Email
Email
If less than 3 years, please provide your previous address If less than 3 years, please provide your previous address

Street Street

City City

Province Province

Postal Code Postal Code

Years There Owned Rented Years There Owned Rented

The Mortgage Group (Brokerage License #315872) Mortgage Application Page 1 of 3 Revised June 2016
 EMPLOYMENT INFORMATION

PRINCIPAL APPLICANT CO-APPLICANT

Current Employer Current Employer

Street Address Street Address

City, Prov, Postal Code City, Prov, Postal Code

Position Position

Income Type Salary Contract Self Income Type Salary Contract Self
Hourly Full-Time Part-Time Hourly Full-Time Part-Time

Annual Income Years There Annual Income Years There

Comm. or Bonus Income Comm. or Bonus Income

If less than 3 years, please provide your previous employer If less than 3 years, please provide your previous employer

Previous Employer Previous Employer

Address Address

City, Prov, Postal Code City, Prov, Postal Code

Position Position

Income Type Salary Contract Self Income Type Salary Contract Self
Hourly Full-Time Part-Time Hourly Full-Time Part-Time

Annual Income Years There Annual Income Years There

Comm. or Bonus Income Comm. or Bonus Income

Monthly Rental Income Monthly Rental Income

ASSETS
PRINCIPAL APPLICANT Balance Name of Bank CO-APPLICANT Balance Name of Bank
Savings Account Balance Savings Account Balance

Chequing Account Balance Chequing Account Balance

RRSP Balance RRSP Balance

Stocks/Bonds Stocks/Bonds

Vehicle(s) Value Vehicle(s) Value

Residence Residence

Other Real Estate Other Real Estate

Other Other
Number of other Number of other
properties owned. properties owned.

Property details for any Property details for any

Investment/Revenue Investment/Revenue
Property Property
Full address: Full address:

The Mortgage Group (Brokerage License #315872) Mortgage Application Page 2 of 3 Revised June 2016
 LIABILITIES

PRINCIPAL APPLICANT Monthly Payment Balance Name of Bank CO- APPLICANT Monthly Payment Balance Name of Bank

Mortgage Mortgage

Credit Cards Credit Cards

RRSP Loan RRSP Loan

Auto Loan(s) Auto Loan(s)

Bank Loan(s) Bank Loan(s)

Principal Res Mtge Principal Res Mtge

Strata Fees Strata Fees

Taxes Taxes

Rental property Mtg Rental property Mtg

Other Other

SIGNATURES

Signature of Applicant Date

Signature of Co-Borrower Date

(if applicable)

We hereby certify that the information given in my/our mortgage application is complete, correct and is given for the purpose of obtaining the mortgage loan and/or
financial services applied for.

I/We authorize the receipt and exchange of information about me/us with your affiliates from time to time as you deem appropriate and to the sharing or exchange of reports
and information with the credit reporting agencies, credit bureaus, mortgage insurers, and/or any other person, corporation, firm or enterprise with whom I/We have or
propose to have a financial relationship.

The Mortgage Group (Brokerage License #315872) Mortgage Application Page 2 of 3 Revised June 2016