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Dave W. White AMP
Mortgage Agent M08001777
Phone: 519-641-3487
Fax: 519-641-1720
Cell: 519-319-6872

Head Office: 3370 South Service Road, Garden Floor, Burlington, Ontario L7N 3M6

Don't let your bank give you the run-around. If you are shopping for a mortgage, contact me today!

You will be in good hands and at ease knowing that an Accredited Mortgage Professional with 35 years experience is assisting you in your financial needs.

Here are some of the options I can offer you:

  • Pre-approvals
  • Renewing your Mortgage
  • Purchasing a Home
  • Refinancing
  • Debt Consolidation
  • Rental/Investment Properties
  • Recreational Properties
  • Mortgages for Self-Employed
  • Multi-Unit Properties
  • Cash back Mortgages
  • Private Funds


All questions with a * must be filled in.  If your answer is NO or ZERO, please enter "N/A or NO" or "0"
First Name:*
Last Name:*
Unit #:
Postal Code
Years at Residence:*
Birth Date: Month*
Birth Date: Year*
Social Insurance No:*
Marital Status:*
No. of Dependents (exclusde spouse)*
How did you hear about me?
Do You Own or Rent?*
Current Rent Amount:
If you have lived here less than 3 years, what was your previous address:
Current Employer:*
Employer Address:
Years There:*
Employment Terms:*
Gross Annual Income (before taxes):*
Do you earn other income?:*
If yes, list income amount(s):
Additional Information:
If less than 3 years, where did you work previously?*
Assets: Principal Residence*
Asset: Cash/Savings*
Asset: Stocks/Bonds*
Asset: Auto Yr/Make/Model*
Additional Vehicle Information
Asset: RRSP's*
Asset: Other Real Estate*
Asset: Personal Effects*
Additonal Personal Effects Info:
Liabilities: Current Mortgage*
Liabilities: Personal Loans*
Liabilities: Line of Credit*
Liabilities: Car Payment*
Liabilities: Additional Car Payment*
Liabilities: RRSP Loan*
Liabilities: Other Mortgage*
Liabilities: Credit Cards*
Additional Info:

By clicking below you affirm that the information you have given in this Application is true and complete and that you have not withheld any information. We will rely on the information you have given to decide on your Application. You also agree to the terms below.

When you apply for a mortgage with us, you agree that:
1) We may collect and use personal information from you and about you for the following purposes: (a) to understand your needs (b) to determine the suitability of our products and services for you (c) to determine your eligibility for our products and services (d) to establish, manage and offer products and services that meet your needs (e) to provide on-going service and (f) to meet our legal and regulatory requirements.
2) We may use, give to, obtain, verify, share and exchange credit and other information about you with others including credit bureaus, mortgage insurers, credit insurers, registries and other persons with whom you may have financial dealings, as well as any other person as may be permitted or required by law. You also authorize any person whom we contact in this regard to provide such information to us.
We may ask you for your Social Insurance Number to use in verifying and reporting credit information to credit bureaus and credit reporting agencies. You may refuse to consent to its use or disclosure for these purposes.

Security Check
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