Prequalify

You Could Be Qualified For A Preapproved Mortgage and Don't Even Know It.

Getting a mortgage doesn't have to be stressful and full of frustration. Simply fill out the form below and I'll get to work to find you a mortgage that fits your budget and lifestyle.

Your privacy is HIGHLY RESPECTED; your personal information will NOT be shared, sold, or rented to any unauthorized person or organization.

Borrower Information:

Borrower (Full Name):
Date of Birth:	(ex. dd/mm/yyyy)
Soc. Insurance #:
Residence Phone #:
Business Phone #:
Present Address:
City:
Province:
Postal Code:
E-mail Address
Years at Present Address:		Rent $	/month
	or	Own $

Previous Address:
City:
Province:
Postal Code:

Marital Status:	Married Separated Unmarried (including single, divorced, or widowed)

Occupation: (Position & Title)
# of years:
Place of Employment: (Name & Address)
Previous Employer: (Name & Address)

Co-Borrower Information:

Co-Borrower (Full Name):
Date of Birth:	(ex. dd/mm/yyyy)
Soc. Insurance #:
Residence Phone #:
Business Phone #:
Present Address:
City:
Province:
Postal Code:
E-mail Address
Years at Present Address:		Rent $	/month
	or	Own $

Previous Address:
City:
Province:
Postal Code:

Marital Status:	Married Separated Unmarried (including single, divorced, or widowed)

Occupation: (Position & Title)
# of years:
Place of Employment: (Name & Address)
Previous Employer: (Name & Address)

Gross Annual Income:

	Borrower	Co-Borrower
Self-Employed ?	Yes No	Yes No
Base Salary:	$	$
Overtime:	$	$
Bonuses:	$	$
Commissions:	$	$
Dividends:	$	$
Net Rental Income:	$	$
Other:	$	$

Total:	$	$

Do You Intend To Occupy This Property ? Yes No
Number of Children:
Ages:
Other Dependents:

Assets:

Other Assets (Specify):

Checking:	$	Bank:
	$	Bank:
Savings:	$	Bank:
	$	Bank:
Credit Union:	$	Bank:
Stocks:	$
Bonds:	$
Life Insurance:	$

Present Residence (If Owned):
Market Value:	$
Morg. Value:	$
Lender:

Liabilities:

(List outstanding obligations including auto loans, mortgage payments,credit cards,
personal loans, and all other loans.)

Type	Creditor's Name	Unpaid Balance	Due Date	Monthly Payment
		$		$
		$		$
		$		$
	Total:	$		$

Additional Monthly Obligations:
Alimony:		$
Child Support:		$
Child Care:		$

Are There Any Judgements or Lawsuits Present?

Yes No

Amount:

Is Any Part of the Down Payment or Settlement Costs
Being Obtained From a Source Other Than From Assets
Listed Above?

Yes No

I hereby give my consent to have my credit report secured
from any credit reporting agency which you designate.

Yes No

Paul Sinclair

Royal LePage Prime Real Estate

1877 Henderson Hwy, Winnipeg, MB R2G1P4

Phone: 204-979-0612

Fax: 339-5060