Make sure all required information is filled out so we may process your information promptly.

Loan / Mortgage Application

Please Note:
You must be a Member and a Canadian Resident to qualify for a loan or mortgage
Contact your Credit Union for further details.

 Please select all that apply:

This is an application for a loan/mortgage in the name of:
Spouses name if joint application
This is an application completed by:
Reason for loan:




APPLICATION

Amount Required: 		Payment Amount:
Repayment Period (Months): Repayment Frequency:
Email Address:
Fax Number:

PERSONAL INFORMATION

Last Name:
Given Names:
Social Insurance Number: Date of Birth (MM/DD/YY):

Please Note: You must be a Member and a Canadian Resident to qualify for a loan. Contact your Credit Union for further details.

Address:
City: Province:
Postal Code: How Long? Residence:
Home Phone:



Previous Address (if current address less than 2 years)
City: Province: Postal Code:

Marital Status:

Number and Ages of Dependents (excluding spouse or co-applicant):


EMPLOYMENT

Employer: How Long (Years):

Occupation: Annual Salary:

Work Phone/Ext: Other Income:

Employer's Address (Dept. name & bldg. #)

City: Province:
Postal Code:



Previous Employment (if worked less than 3 years with current employer) :

Employer: How Long (Years):

Occupation: Annual Salary:

Employer's Address (Dept. name & bldg. #)

City: Province: Postal Code:


SPOUSAL INFORMATION

Last Name:

Given Names:

Social Insurance Number: Date of Birth (MM/DD/YY):

SPOUSE'S EMPLOYMENT

Employer: How Long (Years):

Occupation: Annual Salary:

Work Phone/Ext: Other Income:

Employer's Address (Dept. name & bldg. #)

City: Province:
Postal Code:



Previous Employment (if worked less than 3 years with current employer):

Employer: How Long (Years):

Occupation: Annual Salary:

Employer's Address (Dept. name & bldg. #)

City: Province:
Postal Code:

REFERENCES

Please provide the name and address of two close friends or relatives not living with you:

NAME ONE:

Name:
Phone: Relationship:
Address:
City: Province:
Postal Code:



NAME TWO:

Name:
Phone: Relationship:
Address:
City: Province:
Postal Code:

ASSETS

Real Estate

Type: Address: Est. Value:


Value: Yr.Purch'd.Price: Mortgage Renewal Date: 

Investments (Cash, G.I.C.'s, Stocks, Bonds)
Type: Where: Value: 

R.R.S.P./R.R.I.F.
Type: Where: Value: 
                          
Automobiles
(If your vehicle is leased, please complete the information under "Other Obligations (Leases, etc.)". Do not include here.)
Year/Make: Model: Value: 
                    
Other Assets
Type: Description: Value:



OBLIGATIONS

Mortgages/Rent
(P.I.T. = Principal, Interest and Taxes)
Address: Landlord/Mortgagor:  
 

 
Monthly Pmnt: Balance: Property taxes:  
 
  

Loans
Purpose: Financial Institution:  
 
 
 
 
Monthly Pmnt: Balance:  
 
 
 
 

 

Lines of Credit:
Description: Financial Institution  
 
 
Monthly Pmnt: Balance:  
 
 
 
Credit Cards:
Description: Credit Card Company:
Monthly Pmnt: Balance: 

Department Store Cards/Accounts
Description: Department Store:
Monthly Pmnt: Balance: 

Other Debts
Description: 		Purpose Creditor:
Monthly Pmnt:		 Balance: 

 Other Obligations (Leases, etc.)
Description: Purpose Creditor:
Monthly Pmnt: Balance:



DECLARATION AND AUTHORITY TO OBTAIN INFORMATION

By selecting "Yes" in the box below, I/we acknowledge that:

The Credit Union may obtain information about me and/or my spouse, from my/our employer, any credit bureau or any other person in connection with any of my/our dealings with the Credit Union and the Credit Union may disclose (automatically or upon request) credit information about me/us to credit bureaus and persons with whom I/we have or propose to have financial dealings, if the Credit Union believes disclosure is required by law.

I/We certify that the information in this application is true and correct and that each asset is shown at its present fair market value and I/we own all such assets. I/We am/are not being sued and there are no judgments or executions against me/us. If any or part if this statement is incorrect or if there is a breach of this agreement, then I/we hereby agree with the Credit Union that all my/our present and future indebtedness to the Credit Union shall become due and payable without notice of demand.

If you agree with the terms outlined above, please click on the "YES" button following and click on the
"SUBMIT" bar to submit the application. Otherwise, please select the "NO" button and click on the "CANCEL" line.

YES NO

If you do not agree with the terms outlined above, please click on the line,
following.