Finance and Mortgages Questionnaire

In order for us to assist you we need a little information to get started. We'll contact you for further details as required. This questionnaire is just a starting point.

Please enter the required information. You can tab to move between fields. Pressing the space bar will toggle the responses for the check boxes. Print off a finished copy and either fax, mail or drop it by our office at the address listed at the bottom of the form.

Due to concerns we have for security of your personal information, we do not offer email as an option at this time. If you have any questions regarding filling out the questionnaire either e-mail us or call us at (250) 492-2425. (Toll-free: 1-877-492-2644)

General Information

Your name:

Company
(if applicable):

Phone:

Fax:

Bus. Phone:

Email:

       

Address:

 

City:      Prov.

Postal Code:

Details

Check the appropriate boxes:

You are the
lender      borrower

1st Mortgage  2nd Mortgage
Other (specify):

Address of the property(s) and/or legal description (s):

Is the borrower a Company or other incorporated entity?
Yes No

Where is it registered?

Is the lender a Company or other incorporated entity?
Yes No

Where is it registered?

What is the name of the lender?:


Location:

Give particulars of the financing (Amount, term, annual interest rate, amortization, compounding period, etc.)

Check here if there is other collateral or if co-signers are involved?: 

If there is an existing mortgage (s) on the property please specify the amount and mortgage holder:

$


$

If there is collateral other than the property specified above, including chattels such as a mobile home, please specify here:

Please print and fax, mail or drop off this form to:
Preston S. Mott
Mott Rutherford Welsh & Greig
#100 - 166 Main Street, Penticton, B.C., V2A 5A4
Telephone: 250.492.2425      Fax: 250.492.2451

© Copyright 1999-2005 Preston S. Mott Personal Law Corporation All rights reserved. No part of this publication may be reproduced in any form without permission.