Galon Mortgages | Saskatchewan's Mortgage Expert

Secure Mortgage Application

Mortgage Associate

Need help filling out the application form or have general questions? Please give me a call, I’m here to help.

T 306-244-7000
F 306-244-7005
inquires@galonmortgage.com

14%

Please read our Initial Disclosure Form before proceeding.
*
- I/We hereby acknowledge that I/we have read a copy of this Initial Disclosure Form.

Name*
First Last
Date of Birth*
MM
DD
YYYY
SIN
Marital Status*
# of Dependents*
Current Address*
Street Address Address Line 2 City Province Postal Code
How long have you been at this address?*
- More than 3 years
- Less than 3 years
Previous Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Current Residential Status*
Current Rent Payment
Monthly Mortgage and Property Tax Payment
Email*
Primary Phone*
Secondary Phone
Is there a Co-Applicant?*
- Yes
- No
Co-Applicant Name*
First Last
Co-Applicant Date of Birth*
MM
DD
YYYY
Co-Applicant SIN
Co-Applicant Marital Status*
Co-Applicant # of Dependents*
Co-Applicant Current Address*
Street Address Address Line 2 City Province Postal Code
How long have you been at this address? (Co-Applicant)*
- More than 3 years
- Less than 3 years
Co-Applicant Previous Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Co-Applicant Current Residential Status*
Co-Applicant Current Rent Payment
Co-Applicant Monthly Mortgage and Property Tax Payment
Co-Applicant Email*
Co-Applicant Primary Phone*
Co-Applicant Secondary Phone

Existing Mortgage Information

Address	Mortgage Lender	Balance	Interest Rate	Payment Amount	Frequency	Maturity Date

Additional Comments
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.
Subscribe to e-Newsletter*
- Yes
- No
Periodically we email out an informative newsletter, with up to date mortgage news, rates, and industry information. Select yes below to Opt-In to our e-newsletter. By opting in, I am confirming my consent to receive electronic communications from Galon Insurance & Mortgage Brokers.

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