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RBLCAPITAL CORP APPLICATION Personal InformationApplicant 1 Applicant 2
| First Name |
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First Name |
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| Last Name |
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Last Name |
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| Date of Birth |
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Date of Birth |
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| SIN |
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SIN |
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| Marital Status |
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Marital Status |
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| # of Dependents |
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# of Dependents |
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| Home Phone # |
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Home Phone # |
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| Cell |
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Cell |
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| Fax # |
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Fax # |
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| Email |
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Relationship to Applicant 1 |
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How do you prefer to be contacted by me? Address Information – Applicant 1
| Current Address |
| Time at Residence (yrs/mths) |
Own/Rent/Live with Parents |
Monthly Rent |
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# Street Name Street Ext (ex. Road) City Province Postal Code
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Previous Address (if less than 3 years at current)
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| Time at Residence (yrs/mths) |
Own/Rent/Live with Parents |
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# Street Name Street Ext (ex. Road) City Province Postal Code
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Address Information – Applicant 2
| Current Address - same as applicant 1 q |
| Time at Residence (yrs/mths) |
Own/Rent/Live with Parents |
Monthly Rent |
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# Street Name Street Ext (ex. Road) City Province Postal Code
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Previous Address (if less than 3 years at current) - same as applicant 1 q
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| Time at Residence (yrs/mths) |
Own/Rent/Live with Parents |
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# Street Name Street Ext (ex. Road) City Province Postal Code
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Employment Information – Applicant 1
| Do you have your last two years Notice of Assessment? |
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| Do you owe any income tax? |
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| Current Employer’s Name - |
| Time with Current Employer (yrs/mths) |
Full time/Part time/Contract/Self Employed |
| Address of Employer# Street Name Street Ext (ex.road) City Province Postal Code |
| Phone: |
Fax: |
Email: |
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| Job Title |
Annual Income |
| Income Type (salary/hourly/commission/self employed) – indicate one |
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Employment Information – Applicant 2
| Do you have your 2007 and 2006 Notice of Assessment? |
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| Do you owe any income tax? |
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| Current Employer’s Name - |
| Time with Current Employer (yrs/mths) |
Full time/Part time/Contract/Self Employed |
| Address of Employer# Street Name Street Ext (ex.road) City Province Postal Code |
| Phone: |
Fax: |
Email: |
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| Job Title |
Annual Income |
| Income Type (salary/hourly/commission/self employed) – indicate one |
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Other Income
| Interest |
Child Support |
Pension |
Alimony |
Other (specify) |
Assets
| Type |
Description |
Value |
| Savings |
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| RRSP |
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| Vehicle |
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| Vehicle |
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| Stock/Bonds |
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| Household Goods |
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| Other |
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| Other |
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Liabilities
| Type |
Description |
Balance |
| Credit Card |
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| Credit Card |
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| Credit Card |
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| Line of Credit |
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| Line of Credit |
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| Car Lease |
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| Other |
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Current Mortgages/Properties Owned
Address Owner Occupied Rental Second Home ______________________________________________________________________________________ # Street Name Street Ext (ex. Road) City Province Postal Code
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| Property Value |
Original Purchase Date |
Original Purchase Price |
| Annual Taxes |
Condo Fees |
Mortgage Payment |
Rental Income |
| Mortgage Holder |
Balance on Mortgage |
Interest Rate |
Mortgage Maturity Date |
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Address Owner Occupied Rental Second Home ______________________________________________________________________________________ # Street Name Street Ext (ex. Road) City Province Postal Code
|
| Property Value |
Original Purchase Date |
Original Purchase Price |
| Annual Taxes |
Condo Fees |
Mortgage Payment |
Rental Income |
| Mortgage Holder |
Balance on Mortgage |
Interest Rate |
Mortgage Maturity Date |
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Address Owner Occupied Rental Second Home ______________________________________________________________________________________ # Street Name Street Ext (ex. Road) City Province Postal Code
|
| Property Value |
Original Purchase Date |
Original Purchase Price |
| Annual Taxes |
Condo Fees |
Mortgage Payment |
Rental Income |
| Mortgage Holder |
Balance on Mortgage |
Interest Rate |
Mortgage Maturity Date |
|
Address Owner Occupied Rental Second Home ______________________________________________________________________________________ # Street Name Street Ext (ex. Road) City Province Postal Code
|
| Property Value |
Original Purchase Date |
Original Purchase Price |
| Annual Taxes |
Condo Fees |
Mortgage Payment |
Rental Income |
| Mortgage Holder |
Balance on Mortgage |
Interest Rate |
Mortgage Maturity Date |
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In submitting this application, I/we warrant and confirm that the information given in this application is true and correct and I/we understand that it is being used to determine my/our credit responsibility. I/we authorize Dominion Lending Centres to obtain and/or exchange personal information with any personal information agent towards establishing or verifying my financial standing. You are furthermore authorized to disclose, in response to direct enquiries from any other lender or credit bureau, such information on my loaning account as you consider appropriate and I agree to indemnify you against and save you harm from any and all claims in damages or otherwise arising from such disclosure on your part. You are also authorized to retain the application whether or not the relative mortgage is approved.
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