UCC Mortgage Co. Application

Mortgage Broker/Agent*

Reason for Financing*

Date*

Amount Needed*

Applicant Information

Applicant Name*

First Last

Applicant Gender*

Applicant Phone*

Applicant Alternative Phone

Applicant Email

Applicant Date of Birth*

Applicant Social Insurance Number

Applicant Marital Status*

Occupancy Status*

Applicant Number of Children & Ages

If renting, what is your monthly payment?

Applicant Current Address*

Street Address City State / Province / Region ZIP / Postal Code Country

How long at current address?*

Applicant Previous Address (if less than 3 years at current)

Street Address City State / Province / Region ZIP / Postal Code Country

How long at previous address?

Applicant Employment

Applicant Employer Name

Applicant Job Title / Description

How long have you been with your current employer?

Applicant Income Type

Applicant Weekly Hours Worked

Applicant Annual Income

Applicant Hourly Rate of Pay

Applicant Additional Income

Please provide a brief description and the monthly amount (i.e. child tax benefit, rental, pension, etc).

Co-Applicant Information

If you do not have a co-applicant, you can skip this section.

Co-Applicant Name

First Last

Co-Applicant Gender

Co-Applicant Phone

Co-Applicant Email

Co-Applicant Relationship to Applicant

Co-Applicant Date of Birth

Co-Applicant Social Insurance Number

Co-Applicant Marital Status

Co-Applicant Number of Children & Ages

If renting, what is your monthly payment?

Occupancy Status

Co-Applicant Current Address

Street Address City State / Province / Region ZIP / Postal Code Country

How long at current address?

Co-Applicant Previous Address (if less than 3 years at current)

Street Address City State / Province / Region ZIP / Postal Code Country

How long at previous address?

Are you a Guarantor for the Applicant?

Yes

No

Do you have Power of Attorney for the Applicant?

Yes

No

Co-Applicant Employment

Co-Applicant Employer Name

Co-Applicant Job Title / Description

How long have you been with your current employer?

Co-Applicant Income Type

Co-Applicant Weekly Hours Worked

Co-Applicant Hourly Rate of Pay

Co-Applicant Annual Income

Co-Applicant Other Income

Please provide a brief description and the monthly amount (i.e. child tax benefit, rental, pension, etc).

Subject Property

Address of Property to be Mortgaged

Street Address City Province Postal Code

Purchase Price

Purchase Date

Property Value

Annual Property Tax Amount

Age of Property

Lot Size

House Size

Property Type

Garage Type & Size

Property Style

Are you a first time homebuyer?*

Yes

No

Additional Subject Property Information

Current Mortgage

Mortgaged Property Address

Street Address City Province Postal Code

Mortgage Company

Mortgage Type

Maturity Date

Mortgage Balance

Monthly Mortgage Payment

Interest Rate

Are your property taxes up to date?

Yes

No

Are your property taxes up to date?

Yes

No

If not, what is the amount owing?

Additional Mortgage Information

Assets & Libilities

Have you ever filed for consumer proposal or bankruptcy?*

Yes, consumer proposal

Yes, bankruptcy

No

If yes, when were you discharged?

Do not fill out a date if you have not yet been discharged.

Do you have any outstanding liens, judgements or collections?*

Yes

No

If yes, please provide a brief explanation.

Have you a cosigned for any mortgages or loans?*

Yes

No

If yes, please provide a brief explanation.

Assets

Please provide a brief description of the asset and current value.

Liabilities

Please provide a brief description of the debt, monthly payment and current balance owing (i.e. Visa - $100 monthly, $5,000 balance).

Submit Application

Additional Notes

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