Bonita Smith Breast Cancer Run for the Cure
    416 410 6899  

Apply Online

You can use this form to apply online, simply fill out all the information and press "submit".
To print the form and fax it to 416-410-6899 click here.

If you have any questions about the application, call Bonnie at 416-410-6899, once your application has been received we will be in touch with you.

All information provided is considered private and confidential.

General Information

Complete this section if you are seeking financing for the purchase of a home.
Purchase Price
First time buyer?
Down Payment
Realtor's Name & Company

Complete this section if you are looking to refinance or obtain additional financing on your current home.
Market Value Annual Property Taxes
Existing 1st Mortgage To be paid out? 
Existing 2nd Mortgage To be paid out? 
Amount Required

Personal Information

Applicant Name Co-Applicant
Address  Address
Postal Code Postal Code
Years at Address Years at Address

If less than 3 years please provide previous address.

Prev. Address Prev. Address
Home Phone Home Phone
Work Phone Work Phone
Date of Birth Date of Birth
Please use "MM/DD/YY" format
S.I.N. S.I.N.
Marital Status  Marital Status 
# of Dependents

Employment Information

Applicant Co-applicant
Employer Employer
Job Title Job Title
Annual Income Annual Income
Years at Job Years at Job

If less than 3 years please provide previous employment information.

Prev. Employer Prev. Employer
Other Income Other Income
Other income could include P/T, investment or rental income.
Fax # E-mail

Assets and Liabilities
Please list details of assets - bank accounts, RRSP's, term deposits, GIC's, real estate, vehicles etc.. Account information should include name of bank and approximate balance. 
Real estate information should include address and market value.
Please list details of monthly obligations - loans, mortgages, credit cards, etc. 
Include name of bank, approximate balance and monthly payments.

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. You are authorized 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 I/we propose to have a financial relationship.

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

The information that is obtained is strictly confidential.

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Dominion Lending Centres - Family Mortgage Group FSCO Lic. #12388
Bonita Smith - Mortgage Agent Lic# M08000698