Please note that all the relevant fields must be completed for us to process your application. If you have any questions or concerns while completing this application, please contact us and we will be happy to assist you. Primary Applicant Full Name Social Insurance Number Birth Date Marital Status 1 - January 2 - February 3 - March 4 - April 5 - May 6 - June 7 - July 8 - August 9 - September 10 - October 11 - November 12 - December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901 1900 Single Married Common Law Divorced Income Proof (Check All That Apply) Paystub/T4       Bank Statement       Job Letter       Cash/No Proof Address City Postal Code How Long At This Address Dependants (How many people rely on your income; children, non-working spouse, parent, etc) Housing Rent       Own       Live With Family       Other: Monthly Rent/Mortgage Payment $ Daytime Phone Evening Phone Previous Address (If less than 2 years at current) How Long Additional Previous Address (If less than 2 years at previous) How Long Current Employer Employer Contact Name & Number Self Employed? Part Time or Full Time? Yes       No Part Time       Full Time How Long Position / Title Monthly Income Before/After Tax? Additional Income (CTC, Spousal Support, etc) $ Before Tax     After Tax $ Previous Employer (If less than 2 years at current) How Long Additional Previous Employer (If less than 2 years at previous) How Long Co-Applicant (If Required) Full Name Social Insurance Number Birth Date Marital Status 1 - January 2 - February 3 - March 4 - April 5 - May 6 - June 7 - July 8 - August 9 - September 10 - October 11 - November 12 - December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901 1900 Single Married Common Law Divorced Income Proof (Check All That Apply) Paystub/T4       Bank Statement       Job Letter       Cash/No Proof Address City Postal Code How Long At This Address Dependants (How many people rely on your income; children, non-working spouse, parent, etc) Housing Rent       Own       Live With Family       Other: Monthly Rent/Mortgage Payment $ Daytime Phone Evening Phone Previous Address (If less than 2 years at current) How Long Additional Previous Address (If less than 2 years at previous) How Long Current Employer Employer Contact Name & Number Self Employed? Part Time or Full Time? Yes       No Part Time       Full Time How Long Position / Title Monthly Income Before/After Tax? Additional Income (CTC, Spousal Support, etc) $ Before Tax     After Tax $ Previous Employer (If less than 2 years at current) How Long Additional Previous Employer (If less than 2 years at previous) How Long