Home Loan Application

PRINCIPAL APPLICANT

CO-APPLICANT

PRINCIPLE APPLICANT
CURRENT ADDRESS

CO-APPLICANT
CURRENT ADDRESS

PRINCIPAL APPLICANT

CO-APPLICANT

PRINCIPAL APPLICANT

CO-APPLICANT

I/we warrant and confirm that the information provided by me/us and/or our mortgage broker/lender in the mortgage application 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 further information you may require relative to this application from any sources to which you may apply, and each such source is hereby authorized to provide you with such information. You are further authorized to disclose to any other mortgage broker/lender or their mortgage lenders/associates, credit bureau, insurer or insurance agent, such personal and financial information, as you consider appropriate. I/we agree to indemnify you against and save you harmless from any and all claims in damages or otherwise arising from such disclosure on your part. I/we agree to pay all applicable legal, property appraisals, registration fees and expenses incurred in connection with this mortgage application. You are also authorized to retain the application whether or not the relative mortgage is approved.

I/We hereby acknowledge that Mortgage Life, Health or Disability Insurance is not available through Premiere Home Mortgage Ltd., but may be available in the marketplace for this mortgage, and we hereby agree to take sole responsibility to investigate and secure such coverage if desired.

By sending your application, you acknowledge and accept the above statements.