Loan Depot Canada
LOAN DEPOT CANADA
64 TRIDER CRESCENT, DARTMOUTH NS
902-468-5333
CREDIT APPLICATION

 
Mr.     Ms.
Mrs.  Miss
Applicants Name (first name, initial, last)

Birth Date
MM             DD        YY
    
Spouse's Name (first, initial, last)


# Dependants

Applicants Social Ins. #

Applicants Drivers Lic. #

Co-Applicant's (first name initial & last name)


Social Insurance #

Birth Date
MM             DD        YY
    
 
Present Address (street number and name)


City

Province


Postal Code


How Long?
YY        MM
    
Home Phone

Rent
Own
Room & Board
Rent/Mortgage Amount

$
Landlords Name and Telephone Number/Mortgage Holder

Former Address (Street # and Name) if less than 3 yrs at present

City

Province

 
Present Employer Name

Address

Business Tel. #

Nature of Business

How Long?

Occupation

Gross Monthly Income

Former Employer Name
(if less than 3 yrs at present)

Address


How Long?


Occupation


Spouse/Co-applicant's Employer Name

Address

Business Tel. #

Spouse/Co-applicants Former Employer Name
(if less than 3 yrs at present)

Address


How Long?


Occupation


How Long?


Occupation


Gross Monthly Income

Source of other Income

Other Monthly Income


 
Financial Institution Name Address Account # Balance Account Type




$
Chequing
Savings   
Other      




$
Chequing
Savings   
Other      
Credit/Shopping Cards
(eg. VISA, Mastercard)
Limit
Creditor
(eg. CIBC, Royal Bank)
Monthly Payment
Balance


$


$

$


$


$

$
 
Asset Description Value Creditors Name & Address Monthly Payment Balance


$


$

$


$


$

$


$


$

$


$


$

$


$


$

$
Have you ever been bankrupt?

Yes:    No:
Have you ever had a repossession?

Yes:    No:
 
Type of Loan


Amount Requested

$

Your Email Address

Comments

By checking off the "Agreement To Terms Checkbox below (a), I affirm that all information given above is true and complete (b) consent loan depot (herein called the "Bank") obtaining credit information from any credit reporting agency or credit grantor or any other source by lawful means and (c) concent to the (i) use of the information herein disclosed or hereafter collected by the Bank and its subsidiaries in connection with the granting administering and collecting of credit granted by the Bank to me and in connection with offering the products and services of the Bank and it agrees to extend credit to me by accepting an assignment of a Mortgage Agreement signed by me or my co-applicant the Bank will not make an application for insurance on my life under such Contract or for any other form of insurance. If I have given the Bank my Social Insurance number the Bank may use it as an aid to identify me with credit reporting agencies, credit grantors and any other parties.

Yes, I agree to the terms listed above.