Mortgage Agent Application

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1 Mortgage Agent Application BROKER OFFICE INFORMATION Business Name Street Number Street Name Street Type Street Direction Unit # Unit Type City Province Postal Code Fax Principal Contact Position AGENT INFORMATION Last Name Note: Please include full legal name First Name Middle Name Street Number Street Name Street Type Street Direction Unit # Unit Type City Province Postal Code Fax Years as Mortgage Agent Broker License Number (provide copy of license, if applicable) Primary Website Years in Mortgage Industry Total Referral Volume in Last 12 Months (All Sources) Memberships CAAMP AMBA MBABC IMBA Other Interest in Bridgewater Bank Business Geographical Area Mortgage System Technology BUSINESS REFERENCES (e.g. Broker Office, Lawyer, Accountant, etc.) Name Address Name Address Page 1 of 3

2 Mortgage Agent Application BUSINESS INFORMATION How much volume do you fund annually? What amount of your volume is conventional Alt-A? What percentage of your business falls into the following categories? How much do you expect to fund in your first year with Bridgewater Bank? What is your preferred method of contact? How did you hear about Bridgewater Bank? Have you dealt with us in the past? Who are your preferred choices of A lender? Who are your preferred choices of alternative lender? Which private lenders do you use? Do you use social media? $ $ ( %) High Ratio A Business % Conventional A Business % Alt-A % B % Private % Commercial % Other % $ In Person Text (SMS) Other Referral (from) Advertising (location) Web (website) Social Media (ex. Blog, Linkedin, Twitter) BwB BDM _ Other (ex. Trade Show) No Yes (If Yes, when was the last time you submitted and/or funded a deal? RMG Exceed Merix First National Scotiabank Streetwise Lendwise CMLS Canadiana Street Capital Other Home Trust MCAP Equitable Bank B2B Bank Optimum Street Capital Other Twitter Linkedin (ex: linkedin.com/company/bridgewater-bank): Facebook (ex: facebook.com/bridgewater-bank): Page 2 of 3

3 Broker Service Level Agreement RECORD KEEPING REQUIREMENTS: I/We agree to keep the following information on file for all customers purchasing Bridgewater Bank mortgages and to produce this information at any time on the request of an authorized representative of Bridgewater Bank. - Full legal name of the customer, as it appears on his/her identification* - Any short forms of the customer s name, nicknames, or other aliases commonly used by the customer (e.g. Robert-Bob, Richard-Dick, etc.) - of birth - Resident address - Occupation (if self-employed state nature of business) - Name and address of employer and type/nature of business - Copy of all cheques used for down payment - Original signed customer info and mortgage application * Please refer to the Bridgewater Website Broker Forms, for acceptable forms of Identification. CREDIT BUREAU AND SOCIAL INSURANCE NUMBER CONSENT: I/We agree to obtain written consent from each mortgage applicant to obtain credit bureau information/or credit information from creditors disclosed or subsequently identified/or as stated on the mortgage application. I/We also agree to inform the customer that they are not obliged to provide their SIN number on a credit application; however, the use of a SIN number may ensure a more accurate match between the customer s personal information and the customer s credit bureau information. I/We agree to meet with each customer personally to ensure the identity of each applicant and the accuracy of their information. I/We hereby certify and declare that the above information and attachments is/are true and accurate. Authorized Signatory Please submit your signed forms to your BDM: Southwestern Ontario Stephen Watton swatton@bridgewaterbank.ca Northern & eastern Ontario Matt Royston mroyston@bridgewaterbank.ca GTA & central Ontario John Oliverio joliverio@bridgewaterbank.ca Saskatchewan, Edmonton, central & northern Alberta Tania Melnyk tmelnyk@bridgewaterbank.ca Manitoba, Calgary & southern Alberta Sophia Jessa sjessa@bridgewaterbank.ca British Columbia Ut Yue uyue@bridgewaterbank.ca Manager, B2B Solutions Jason Provencher jprovencher@bridgewaterbank.ca Page 3 of 3

4 BROKER PRE-AUTHORIZED CREDIT (PAC) AGREEMENT This agreement allows Bridgewater Bank to credit your external bank account for payment of broker fees. Please read the terms & conditions and complete all sections. Sign and return this form and attach a blank personalized company cheque marked void or fill in your bank account information below and obtain a teller stamp from your financial institution. CUSTOMER INFORMATION Name of Brokerage: Address: Telephone Number: ( ) - Fax Number: ( ) - Contact Name: First Name Last Name TYPE OF SERVICE: Direct Deposit of Broker Fee Payments EXTERNAL BANK ACCOUNT INFORMATION Name of Financial Institution: Teller stamp required if void cheque is not attached. Address of Financial Institution: Account Number: Branch Transit Number (5 digits): Bank Number (3 digits): PRE-AUTHORIZED CREDIT TERMS & CONDITIONS In this agreement, I, me and my refers to each account holder who signs below and is a party to this agreement: 1. I/We authorize Bridgewater Bank to credit the bank account identified above for payment of broker fees due to our office for all eligible mortgages funded at Bridgewater Bank. 2. I acknowledge that in order to change the external bank account information contained in this agreement, I must notify Bridgewater Bank in writing OR complete a new Bridgewater Bank Broker Pre-Authorized Credit Agreement. I understand that such notification must be received by Bridgewater Bank at least ten (10) days prior to my next scheduled credit. 3. I have attached a personalized company void cheque OR provided my bank account information above with a teller stamp from my financial institution. 4. I certify that ALL PERSONS whose signatures are required to sign on the external bank account identified in this agreement have signed the authorization below. #4003 (04-SEP-12) bridgewaterbank.ca CAAPAD09

5 Signature of Bank Account Holder Name (please print) Signature of Bank Account Holder Name (please print) When you have completed and signed this agreement, please mail with your void cheque or confirmation from your financial institution of the account ownership, to the address below. Please keep a copy of this agreement for your records. If you have any questions or wish to obtain further information regarding this agreement, please contact Denise Janzen at: Bridgewater Bank Funding Department 150, 926-5th Avenue SW Calgary, Alberta T2P 0N7 Telephone: djanzen@bridgewaterbank.ca #4003 (04-SEP-12) bridgewaterbank.ca PAYM001

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