Mortgage Application


Please provide the following information to the best of your ability to help Altex Realty Services Inc., Brokerage get started on finding the mortgage that's right for you.


If you need assistance please call or e-mail us.


Authorization box in the applications must specify yes as permission to process Application




I/We authorize Altex Realty Services Inc. Brokerage the Bank(s) or Trust Companies Associate with this application to obtain my/our credit report for the purpose of determining the amount of mortgage loan available to us/me. The information that is obtained is strictly confidential. A photocopy, e-mail or facsimile of this authorization may be deemed to be the equivalent of the original.





Completing this form enables for me to provide you with more information as requested.  You will be contacted by only myself.  I will NEVER release, sell or give your name, email address or telephone number to any other party or organization unless authorization is given by the client or consumer for the pupose of arranging financing or credit checks.


Mortgage Application Required
Contact Information
First Name
Last Name
Date of Birth
Street # 
Street Name 
Suite #
Zip/Postal Code 
PO Box
Phone Number
Email Address
Co-Applicant First Name
Co-Applicant Last Name
Co-Applicant Address if different
Co-Applicant Phone
Co- Applicant Date of Birth
Co- Applicant SIN#
Best time to contact you
Property Information
Purpose of Loan
Mortgage Amount Required
Value of Home
Date Funds Required
Contacts Current Employer Name
Employers Address
Employers Phone
Length of Employment
Annual Income
Other Income Amount
Previous Employer
Co-Applicant Employer Name
Employer Address
Employer Phone
Length of Employment
Annual Income
Other Income Amount
Previous Employer
 Enter the verification code in the field below and click the submit button.