Consent Form For Credit Check



First Name and Last Name (required)
your first name and your last name

Your Date of Birth (required)
please use format: yyyy-mm-dd, like 1970-02-06

SIN Number (required)
no space, no hyphen, no dash

Current Address (required)

City (required)

Province (required)

Post Code (required)

Your Email (required)

CBMR Agent's Name (required)

Your Message

I warrant and confirm that the information given in the mortgage application form is true and correct, and I understand that it is being used to determine my credit responsibility, evaluate and respond to my request for mortgage financing. Any licensed mortgage agent or broker of the CBMR Financial Group Inc. is authorized to obtain any information required for these purposes from other sources (including, for example, Credit Bureaux) and each source is hereby authorized to provide the mortgage agent/broker with such information. I also understand, acknowledge and consent that the information given in the mortgage application form as well as other information the mortgage agent/broker obtain in relation to my credit history may be disclosed to potential mortgage lenders, mortgage insurers, other service providers, organizations providing technological or other support services required in relation to this application and any other parties with whom I propose to have a financial relationship.

I further acknowledge and agree that each potential mortgage lender, mortgage insurer or service provider to whom the mortgage agent/broker provide the mortgage application and/or my personal information is permitted to receive such application and information and maintain records relating to me and my mortgage application and to hold, use, communicate and disclose personal information about me, including my Social Insurance Number (SIN) if I provide it, and collect personal information from me, the mortgage agent/broker and from the third persons, including credit bureau, credit reporting and collection agencies, financial institutions, my past and present employers, creditors and tenants, my spouse or any other person who has information about me for the purpose of recording, evaluating and responding to my application for the mortgage financing or related activities and I specifically consent to the release and disclosure of personal information by such persons to and among the mortgage agent/broker and each potential mortgage lender, mortgage insurer or other service provider. I/We also understand and agree that only the CBMR Mortgage can make decision to hold or process or cancel this mortgage application before closing date and this application is my/our decision for choosing the CBMR as my/our mortgage broker.

-- Important Notice: Please come back here to find out the sending status. You will see the successful sending status in GREEN below this buttom. Otherwise, please go back the form to check out where the problem is. All problems will be indicated by RED words.