Keith Stapleton
 

 
Keith Stapleton Mortgage Broker, St.John's, NL Professional Mortgage Services and Advice


Keith Stapleton

Print and Fax to Our Secure Line, 888-813-1567


 

 

Personal Information
Primary Applicant                                                                              Co Applicant
 
 
First Name ____________________Init _____     First Name __________________________ Init ­­­­­­­­­­­­­_____
 
 
Last Name ____________________________     Last Name __________________________________
 
 
SIN _______________________________                 SIN_____________________________________
 
 
Date of Birth (M/D/Y) __________________                 Date of Birth (M/D/Y) ______________________
 
 
Marital Status _____________________              Dependants ______________________
 
 
____________________                                                                                                                          
Home #                               Cell #                                      Work #         Can you be called here? ( Yes/ No)
                                                                                                                                                                                                            
 
Email addresses _____________________________________________________________________________
 
Present  Address
 
 ______________________________________________________________________________________________
Apt No.                 Street                                        City                               Prov                      Postal
 
How long at this address ______________  Rent or Own _________ Monthly Payment ________________________
 
 
 _______________________________________________________________________  __________
Previous address
(if above is <3yrs)                             City                                          Prov                                     Postal
 
 
Employment  Information
 
 
 _____________________________________________________________________________________________
Present Employer                                            Street                         City                              Prov                                 Phone #
 
 
 __________________________________________________________________________________ __________
Position - (Full time/Part Time)                                 Salary/Hourly Rate                   Start Date                      Contact Name
 
 
 _________________________________________________________________________________
Previous Employer (If above is < 3 yrs)               Street                         City                              Prov                                 Phone #
 
 _____________________________________________________________________________________________
Position - (Full time/Part Time )                               Salary/Hourly Rate                   Start Date                      Contact Name
 
 
__________________________________________________________________________________
Co Applicant Employer                                            Street                         City                             Prov                             Phone #
 
 _____________________________________________________________________________________________
Position - (Full time/Part Time)                                  Salary/Hourly Rate                   Start Date                      Contact Name
 
 
 _____________________________________________________________________________________________
Previous Employer (If above is < 3 yrs)               Street                         City                              Prov                                 Phone #
 
 
Assets
 
 
Property Address _________________________________________________          Value _____________________
 
 
Car ( Year, Make, Model ) __________________________________________          Value _____________________
 
 
Car ( Year, Make, Model ) __________________________________________          Value _____________________
 
 
Savings and Investments (Bank or Investment Co) _____________________          Value ____________________
 
 
RRSPs (Bank or Investment Co) ____________________________________           Value ___________________
 
 
Other Assets ____________________________________________________          Value ___________________
 
 
Other Assets ____________________________________________________          Value __________________
 
 
 
 
Liabilities
 
 
Mortgage (Bank/Other) ______________________________ Balance ____________________ Pmt _______________
 

Car Loan/Lease(Bank/Other) _________________________ Balance ____________________ Pmt _____________
 
 
Loan (Bank/Other) _______ __________________________ Balance ____________________ Pmt  ____________
 
 
Loan (Bank/Other) __________________________________ Balance ____________________ Pmt _____________
 
 
Line of Credit (Bank/Other) __________________________ Balance _____________________ Pmt ____________
 
 
Other (Bank/Other) _________________________________ Balance _____________________ Pmt _____________
 
 
Credit Card (Bank/Other) ____________________________ Balance _____________________  Pmt ____________
 
 
Credit Card (Bank/Other) ____________________________ Balance _____________________  Pmt _____________
 
 
Credit Card (Bank/Other) ____________________________ Balance ______________________ Pmt ____________
 
 
Student Loan (Bank/Other) ___________________________ Balance ______________________ Pmt ____________
 
 
 
 
Banking Details
 
 
Which Bank do you deal with ________________________________   For how long _________________   
 
 
 
Property Details
 
Details of  the  home  you  would  like  to buy
 
 
Purchase Price ______________________   Address ___________________________________________________
 
 
 
 Amount of down payment ___________________________    (from own savings / gift from family)
                                                                                                  (please circle one)                                                                              
 
 
If your down payment is from the sale of a home,
or if you are refinancing
 
 
Address _________________________________________________ date purchased __________________________
 
 
Approx. Value _____________________________________   Purchase Price _______________________________
 
 
Age of Home ______________   Ownership (Joint / One Name), Name __________________________________
                                                                    (circle one)
 
Mortgage lender ____________________________________   Maturity Date (M/D/Y) ______________________
 
 
Balance _______________ Payment ___________ Includes Property Tax (Yes /No)  CMHC insured     (Yes /No)                                                                                                                                                                        
 
 
Mortgage Architects Client Consent
We, Mortgage Architects in accordance with our privacy policy and our obligations at law, collect, receive, use and disclose personal information about you, our client, for the purposes  of: verifying the information provided; assessing your credit-worthiness; establishing credit and hold limits; maintaining our client relationship; presenting your mortgage application to various lenders and insurers for the purpose of securing and/or renewing a mortgage and/or related services and providing information to you about other products offered or approved by us, our affiliates, related entities or other third party financial partners that we believe may be of interest to you We may also disclose your personal information under strict confidentiality restrictions to (i) any potential purchaser of our business and their advisors, (ii) any third party service providers to whom we may outsource our business functions and  (iii) any parties involved in the securitization, assignment or pledge of loan(s)/mortgage (s) that are obtained through us.  
 By signing this form (or giving your verbal consent), you consent to our collecting, using and disclosing your personal information, at any time during the application and on an on-going basis thereafter, for the foregoing purposes, and to carry out these purposes you agree that we may disclose your personal information to and receive your personal information from:consumer reporting agencies, credit bureaus, real estate appraisers, your bank(s) or other financial institutions with whom you have or have had dealings, your past mortgage brokers, your present and past employers and such other third parties who may have information about your financial status.  If there is more than one applicant, you also agree that we may collect, use and disclose personal information about each  of you from the other for the purposes listed above. Without limiting the generality of the foregoing, you agree that if a mortgage default insurer is assigned to your application, such mortgage default insurer may obtain personal information about you from a credit reporting agency from time to time, and may use such information for any purpose related to the mortgage default insurance in connection with your application.  You agree that the approval or granting of any mortgage by a lender to you, with or without mortgage default insurance, is not to be construed or relied on by you as representing the value or condition of any underlying security or that it confirms that you have the ability to repay the mortgage debt.  
 If you do not wish to receive any information on any other products offered or approved  by us, and providing information to you about other products offered or approved by us, our affiliates, related entities or other third party financial partners that we believe may be of interest to you, please initial the box where indicated  [or indicate your refusal verbally].   
   NO, you may not send me any information on other products
 You hereby agree that Mortgage Architects and your independent mortgage planner____________________   may use and retain your personal information for the forgoing purposes for seven (7) years after the later of a) the date of your latest application to us, and b) the date that all of your loans/mortgages contracted through us have expired or were terminated.  A copy of our privacy policy and procedures summary is available on our website: www.mortgagearchitects.ca.  Alternatively, you may contact our privacy compliance officer at 1-877-802-9100.
 Mortgage Architects and your independent mortgage planner may receive from a lender fees or program incentives which vary with the mortgage interest rate and terms accepted by you.  Fees and program incentives may be money, points or goods and services having value to the recipient.
 Different lenders may provide Mortgage Architects and your independent mortgage planner with different fees and incentives for similar products.  A lender’s fees and incentives may also be dependent on the amounts and types of mortgage products originated through Mortgage Architects and your independent mortgage planner.
 By signing this form (or giving your verbal consent), you  acknowledge that Mortgage Architects and your independent mortgage planner may receive fees or program incentives from a lender.
 For phone transactions:  (verbal consent is not used for Credit Bureaus, and is for Privacy discussion only)
Telephone consent given on _____________(date) by ______________________________
                                                                                                  [name of client (s)]  and consent taken by Keith Stapleton   ______________________________ [signature]

 For all other transactions:  I hereby give my consent: 
 

Primary Applicant ___________________________________              Date ____________________
 
 
Co Applicant         __________________________________              Date ____________________
* Warning :  If you decide to send this Consent Form and any accompanying documentation by electronic mail you acknowledge that this mode of transmission may not be secure and you will not hold Mortgage Architects liable if any information transmitted to us electronically is received, used or disclosed by an unintended recipient
Legal*3015509.2
 
Keith Stapleton    49 Elizabeth Ave. #105,   St. John’s, NL     Ph: 709-754-7607,  Fax: 888-813-1567, www.keithstapleton.com
Mortgage Architects   6505B Mississauga Rd., Mississauga, ON, L5N1A6    Phone: 877-802-9100
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