Personal Information
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Home
Phone
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Email
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Marital
Status
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Gender
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Spouse Information
Assets (including those of your spouse)
Home/Properties
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Automobile(s)
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Investments/RRSP's
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Liabilities (including those of your spouse)
Other
Income | Other Expenses
Income
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Amount
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Payment
Frequency
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Expenses
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Amount
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Payment
Frequency
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Child
support/Alimony
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$
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Child
support/Alimony
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$
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Pension(s)
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$
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Auto
lease
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$
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Interest/dividends
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$
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Rent
(if applicable)
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$
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Other
income
(e.g. tips, rent)
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$
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Heat
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$
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Property
taxes
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$
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Other
expenses
(e.g. condo fees)
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$
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Please
indicate how you want us to communicate our decision back to you.
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Best Time
of the day to reach me is:
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Comments:
. Judgement or collection in the last 7 years:
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. Lateness of credit cards, loans:
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. Current mortgage payments up-to-date:
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. Lateness of mortgage payments:
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Years since bankruptcy discharged: (0=Never Bankrupt)
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