Capri Mortgage Corporation :: Application Form

Capri Mortgage Corporation: Application Form

Amount $	First Mortgage $	Second Mortgage $
Purpose

Personal Information

Applicant Name	Co-Applicant Name		M S W D
Full Address	City	Province	Lived There (years)
Residential Phone Number	Business Phone Number
E-mail Address: Postal Code

Applicants Birthday (mm/dd/yyyy) SIN -	Co-Applicants Birthday (mm/dd/yyyy) SIN -	Number of Dependents
Bank	Branch	Acct. No.
Applicant Employer	Address	Position	How Long	Salary
Co-Applicant Employer	Address	Position	How Long	Salary
Other Income (explain)				Amount $

Total Income $

Personal Financial Statement

	Assets
Cash on hand	$
R.R.S.P	$
Stocks & Bonds	$
Real Estate (specify)	$
Furniture	$
Auto (make and year)	$
Other (specify)	$

Other (specify)

Total Assets $

Bank loans	Liabilities	Payments
Mortgages	$	$
Mortgages	$	$
Credit Cards	$	$
Other (specify)	$	$
Other (specify)	$	$
Total Liabilities	$	$

I/We hereby certify that the information given above is correct.
I/We hereby consent to have Capri Mortgage Corporation conduct or cause to be conducted a personal investigation.