1. Personal Information
First Name
 MI
 Last Name
 D.O.B.
 S.I.N.
 Marital Status
 Dependents
Current Address
 City
 Prov.
 Postal code
 Years There
Previous Address (if less than 3 years ago)
 City
 Prov.

 Postal code
 Years There
E-mail Address
 Home Phone
 Residential Status
Current Occupation
 Current Employer
Work Phone
   Ext.
Gross Yearly Income
$
Years There
Current Employer Address
 Type of Income
Previous Occupation (if less than 3 years ago)
 Previous Employer
 Gross Yearly Income
$
Years There

2. Co-Applicant Information (Complete this section if you are married or have a co-applicant.)

First Name
 MI
 Last Name
 D.O.B.
 S.I.N.
 Relation to Co-Applicant
Current Occupation
 Current Employer
Work Phone
   Ext.
Gross Yearly Income
$ 
Years There
Current Employer Address
 Type of Income
Previous Occupation (if less than 3 years ago)
 Previous Employer
 Gross Yearly Income
$ 
Years There

3. Details of Mortgage Loan
I am applying for a mortgage. How much of a loan do you need? $ 
Monthly property taxes? $  Current value of your home? $ 
Date purchased? (Approx.)   Original purchase price? (Approx.) $ 

4. Details of First Mortgage
Mortgage Lender (held by)
 Mortgage Number
$  		 Balance
 Rate %
$   		 Mthy Paymnt
 Maturity Date
Property Address 

5. Details of Second Mortgage
Mortgage

 Mortgage Lender
 Mortgage Number
$  		 Balance
 Rate %
$   		 Mthy Paymnt
 Maturity Date
Property Address 

6. Liabilities
Enter total outstanding
balances:		 Credit Cards $   Loans/Lines of Credit $  
Enter total monthly
payments:		 Car Payments $  Alimony/Support/Other $  

7. Assets
Vehicle 1 (Year, Make, Model) RRSPs $  
Vehicle 2 (Year, Make, Model) Stocks/Bonds $ 
Name of your bank(s) Cash/Savings $  

8. Property Information Required By WCM
Dwelling Type Property Age Tenure
Dwelling Style Square Footage Garage Size
Heating Type Lot Size Garage Type

9. Comments (Please provide any additional information which could help us to approve your loan.)

By submitting this online application, we hereby authorize you to obtain a credit report and make any necessary inquiries regarding our mortgage application and to release this information to any lenders who may be interested in providing funds on your behalf.