Appliocation Form – HVR Financial

MORTGAGE DETAILS

IDENTIFICATION

TYPE OF LOAN:*

PURPOSE OF LOAN:*

VALUE OF HOME:*

MORTGAGE AMOUNT REQUIRED:*

APPROX DATE FUNDS REQUIRED: (MMDDYYYY):

PERSONAL INFORMATION - APPLICANT 1

IDENTIFICATION

TITLE:

FIRST NAME:*

LAST NAME:*

INITIAL:

DATE OF BIRTH: (MMDDYYYY)*:

SIN:

E-MAIL ADDRESS:*:

CURRENT LIVING ADDRESS

NUMBER:*

STREET NAME:*

UNIT #:

CITY/TOWN:*

PROVINCE:*

POSTAL CODE:*

HOME PH.#: (1112223333)*

CELL PH.#: (1112223333)

TIME AT ADDRESS: (YYMM) (EG. 4 YEARS & 2 MONTHS = 0402)

PRESENT EMPLOYER

OCCUPATION TYPE:*

NAME OF EMPLOYER:*

JOB TITLE:*

WORK PH.#: (1112223333)

LENGTH OF EMPLOYMENT: (YYMM) (EG. 4 YEARS & 2 MONTHS = 0402) *

ANNUAL INCOME:*

TYPE OF INCOME:*

PERSONAL INFORMATION - APPLICANT 2 (leave this section blank if you do not wish to enter a second applicant)

IDENTIFICATION

TITLE:

FIRST NAME:*

LAST NAME:*

INITIAL:

DATE OF BIRTH: (MMDDYYYY)*:

SIN:

E-MAIL ADDRESS:

CURRENT LIVING ADDRESS

NUMBER:*

STREET NAME:*

UNIT #:

CITY/TOWN:*

PROVINCE:*

POSTAL CODE:*

HOME PH.#: (1112223333)*

CELL PH.#: (1112223333)

TIME AT ADDRESS: (YYMM) (EG. 4 YEARS & 2 MONTHS = 0402)

PRESENT EMPLOYER

OCCUPATION TYPE:*

NAME OF EMPLOYER:*

JOB TITLE:*

WORK PH.#: (1112223333)

LENGTH OF EMPLOYMENT: (YYMM) (EG. 4 YEARS & 2 MONTHS = 0402) *

ANNUAL INCOME:*

TYPE OF INCOME:*

FINANCIAL INFORMATION

ASSETS

TYPE	WHERE/FINANCIAL INSTITUTION(S)	AMOUNT/VALUE
Cash Savings
RRSP
Stocks/Bonds/Mutual
Automotive: present value
Value of present home (if owned)
Other
Total

LIABILITIES

TYPE	WHERE/FINANCIAL INSTITUTION(S)	BALANCE OWING	MONTHLY PAYMENTS
Debts/Loans
Credit Cards
Amount owing on current mortgage(s)
Finance company loans and other debts
Total

NET WORTH (TOTAL ASSETS - TOTAL LIABILITIES) = $

OTHER INFORMATION

ADDITIONAL NOTE FOR FINANCIAL INFORMATION: (MAX. 500 CHARACTERS)

I/We warrant and confirm that the information given in the mortgage application form is true and correct and I/We understand that it is being used to
determine my/our credit responsibility. I/We authorize HVR Financial Incorporated to obtain any information you may require for these purposes from other
sources (including, for example, credit bureau) and each such source is hereby authorized to provide you with such information. I/we also understand that the
information given in the mortgage application form as well as other information you obtain in relation to my credit history may be disclosed to potential
mortgage lenders, financial intermediary and mortgage insurers, organizations providing technological or other support services required in relation to this
application and any other parties with whom

Online Applications

Please read the paragraph above prior to sending completed application. By transmitting the online mortgage application you are accepting the terms of theparagraph noted above.

CANADA'S ANTI-SPAM LEGISLATION

Canada's Anti-Spam Legislation was effective as of July 1, 2014. Under this legislation, I am required to obtain your consent in order to continue sending you email communications about the latest mortgage news, events, products, and services.

PLEASE CONFIRM YOUR CONSENT TO RECEIVING ELECTRONIC COMMUNICATIONS.*
YESYESNO

SIGNATURE REQUIRED IF THIS DOCUMENT IS PRINTED. NOT REQUIRED FOR ONLINE SUBMISSION.

APPLICANT 1'S SIGNATURE:

DATE:

APPLICANT 2'S SIGNATURE:

DATE: