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Personal Information

First Name:
Last Name:
Marital Status:
S.I.N:
Age:
Date of Birth:
Phone number:
Dependants:

Present Address:
City/Town:
Province:
Postal Code:
Landlord/Mortgage Holder:
Mortgage Payment/Rent:
How Long:	(Years)
Previous Address:
How Long:	(Years)

Employment Information

Employer:
Position:
How Long:	(Years)

Phone:
Monthly Income:
	Gross Income Net Income

Personal Information
First Name:
Last Name:
Marital Status:
S.I.N:
Age:
Date of Birth:

Employment Information
Employer:
Position:
How Long:	(Years)
Phone:
Monthly Income:
	Gross Income Net Income

Purchase Price:
Down Payment:
Amount Requested:

How did you hear about us?

Details

Agreement
I/We hereby affirm that the statements made herein are true to the best of my knowledge and belief. The undersigned, or each of them, AGREES THAT USUAL CREDIT INQUIRIES MAY BE MADE ANY TIME IN CONNECTION WITH THE CREDIT HEREBY APPLIED FOR and consents to the disclosure of such information to any person or to any credit reporting agency with whom the undersigned has or may have financial relations. Consent is hereby given pursuant to s.12 of the "Credit Reporting Act", R.S.B.C. 1996, Chapter 81. Broker and lender fees may apply.

Full Legal Name:
E-Mail Address:
Please Deliver This Application to:	(optional)
Date:
I Agree:	YesNo
We are unable to process your application online. Please contact a mortgage specialist at 1-800-625-7747.

Capital Direct Lending Corp. Privacy Statement
CAPITAL DIRECT LENDING CORP., ("Capital Direct") its employees, agents, or assigns, may collect personal information from me, from loan or debt arrangements I have made with or through you, from credit bureaus, appraisers and other financial institutions, and from the references I have provided you.

Capital Direct may collect, use and disclose my personal information for the following purposes:

To provide me with financial services;
To understand my financial needs;
To facilitate the offering of third party complimentary products or services;
To broker and administer my loan agreements;
To develop, manage and deliver products and services to me;
To develop and deliver marketing and promotional offers to me;
To determine my eligibility for different products and services;
To ensure that I receive a high standard of service;
To meet regulatory requirements;
To manage and transfer the assets and liabilities of Capital Direct and those assets under its administration; and
To verify my identity.

Capital Direct may provide my personal information to their solicitors, to credit bureaus, to appraisers and investors and, with my consent, to other parties. Capital Direct may share my personal information with its employees, its affiliates and investors, but only as needed for the provision of products and services.

Capital Direct may also use my personal information to introduce products and services that may be of interest to me through contacting me directly (via mail, telephone calls or e-mail only), and share it, (subject to applicable law) for marketing purposes within Capital Direct.

At any time, I can choose to opt-out of receiving direct marketing or sharing my personal information for marketing purposes. To opt-out, I will contact you through 604-430-1498.

I have read and agree with the above.
I Agree: YesNo

We are unable to process your application online. Please contact a mortgage specialist at 1-800-625-7747.

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