Find Out How Much Home You Can Afford

How To Start Looking For Your Mortgage The Easy Way

Finding a mortgage that fits your budget can often be challenging. I want to help make it easier for you.

Simply complete the form below and Ill put my expert mortgage brokers to work for you. Yes! I can help you find 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

Steve Hunt-Lesage

Re/Max Executives Realty

520 Academy Road, Winnipeg, MB R3N 2A8

Phone: (204) 947-9800

Cell: (204) 295-4713

Fax: (204) 987-9844