PAUL PIFFARD'S  Home selling System

 "Call Paul & Start Packin"

1319 Exmouth St Sarnia, Ontario, N7S 3Y1
Office: (519) 542-9999
Fax: (519) 882-3133
E-mail: ppiffard@gmail.com
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Mortgage Application

REAL ESTATE
Financial Information Sheet

Purchaser Information:
 
Purchaser (Full Name):
Age:
Soc. Security #:
Residence Phone #:
Business Phone #:
Present Address:
Years at Present Address: Own $ or
Rent $/month
 
Previous Address:
 
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-Purchaser Information:
 
Co-Purchaser (Full Name):
Age:
Soc. Security #:
Residence Phone #:
Business Phone #:
Present Address:
Years at Present Address: Own $ or
Rent $/month
 
Previous Address:
 
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:
 
Purchaser Co-Purchaser
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:
 
Checking: $  Bank:
$  Bank:
Savings: $  Bank:
$  Bank:
Credit Union: $  Bank:
Stocks: $
Bonds: $
Life Insurance: $
 
Present Residence  (If Owned):
Market Value: $
Morg. Value: $
Lender:
 
Other Assets (Specify):
 

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
    

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1319 Exmouth St Sarnia, Ontario, N7S 3Y1
Office: (519) 542-9999
Fax: (519) 882-3133
E-mail: ppiffard@gmail.com