Allegiance Tire Distributors Inc.

TOLL FREE:
1-877-754-6221

APPLY ON-LINE Fill out our short application form. This process will take 2-4 minutes. A mortgage consultant will contact you once we receive your application or call us at 1-877-754-6221 and will take your application over the phone.
Desired Loan Amount:
Desired Type of Loan:
Purchase Refinance Second Home Income Property
Desired Type of Financing :
Fixed Rate Variable Rate Line of Credit Second Mortgage

Customer Information

Borrower:

Single Married Divorced/Separated

Co-Borrower:

Single Married Divorced/Separated

E-mail:

Current Street Address:

City:

Province:

Postal Code:

Home Phone:

Work Phone:

(include extension if applicable)

Property Information

Purchase Price OR (current value of property if refinance):
Cash Down Payment (If Purchase):

Property Address:

Property City:

Property Province:

Property Postal Code:

Property Type: Single Condo/Townhouse Multi Family

Will you occupy the property? Yes No

If purchasing, do you have a Realtor® with whom you are working? Yes No

Credit Information
How would you rate your credit?	Excellent Good Fair Poor
How would you rate co-borrower credit?	Excellent Good Fair Poor

Borrower Employment Status	Co-Borrower Employment Status
Salaried/Hourly Self Employed	Salaried/Hourly Self Employed
Borrower Employer:	Co-Borrower Employer:

No. of years with Company:	No. of years with Company:
Borrower Gross Monthly Income:	Co-Borrower Gross Monthly Income:

Liquid Assets (include checking, savings, stocks, mutual funds, etc.):

Borrower Retirement Assets:	Co-Borrower Retirement Assets:

Borrower Monthly Payments: (credit cards, auto loans, child support, etc.)	Co-Borrower Monthly Payments: (credit cards, auto loans, child support, etc.)

If Refinancing, Answer the following:

Outstanding Balance Owed:
Current Interest Rate:

Type of Current Loan:

Fixed Rate Variable Rate Line of Credit Balloon Second Mortgage

Current Monthly Payment (excluding taxes):

Annual Property Taxes:

Do You Currently have Mortgage Insurance? Yes No

Do you have a Second Mortgage or a line of credit on the Subject Property? Yes No

Do you want to keep this loan or consolidate it with the first mortgage?

Keep Consolidate

You have permission to run a credit report for mortgage qualification purposes

Please call me before pulling a credit report

Borrower Social Insurance Number:

Co-Borrower Social Insurance Number:

Any additional information? Tell us what you'd like to do. Type in box below.

Thank You

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