BRANCH: / Acct. Officer Code: / NEG FEES: / DATE (YYYY/MM/DD):
AMT OF LOAN REQ.: / PURPOSE OF LOAN:
VISA ACCT NO.: / CUSTOMER MASTER NO.: / NATIONAL INSURANCE NO./NATIONAL I.D.: / MASTERCARD ACCT NO.:
DRIVER’S LICENSE NO.: / EXPIRY DATE (YYYY/MM/DD): / PASSPORT NO.: / EXPIRY DATE (YYYY/MM/DD):
personal information
NAME (PLEASE PRINT) / DATE OF BIRTH (YYYY/MM/DD) / AGE / MARTIAL STATUS
SingleMarriedSeparatedDivorcedWidowWidower / NO. OF DEPENDENTS
(INCL SPOUSE)
HOME ADDRESS – NUMBER, STREET, CITY / POSTAL BOX / SINCE (YEAR) / TELEPHONE NUMBERS
Home:Cell:
Work: / SPOUSE’S NAME / DATE OF BIRTH (YYYY/MM/DD)
NAME & ADDRESS OF LANDLORD (IF RENTING) / PREVIOUS ADDRESS / YEARS THERE
NAME OF PERSONAL REFERENCE – IMMEDIATE FAMILY PREFERRED / ADDRESS – STREET, CITY, P.O. BOX / TELEPHONE NUMBERS
Home:Cell:
Work: / RELATIONSHIP
NAME OF PERSONAL REFERENCE – IMMEDIATE FAMILY PREFERRED / ADDRESS – STREET, CITY, P.O. BOX / TELEPHONE NUMBERS
Home:Cell:
Work: / RELATIONSHIP
NAME OF BANK OR FINANCIAL INSTITUTION / HAVE YOU ANY JUDGEMENTS OR LEGAL PROCEEDINGS AGAINST YOU? / YES
NO / IF YES, SEE PAGE 2FOR DETAILS / INDIRECT LIABILITIES (GUARANTEES OR ENDORSEMENTS FOR OTHERS) / YES
NO
HAVE YOU EVER BORROWED BEFORE FROM ANY SOURCE?
YES NO / IF YES, WHERE AND WHEN / AMOUNT / HAVE YOU HAD ANY PREVIOUS LOANS FROM THE ROYAL BANK?
YES NO / IF YES, WHERE AND WHEN / AMOUNT
employment information
NAME & ADDRESS OF EMPLOYER / TELEPHONE / EMPLOYMENT DATE (yyyy/mm/dd) / PRESENT ANNUAL SALARY OR WAGES
OCCUPATION / POSITION / EMPLOYEE NO. / RENT: 50% 75%
PREVIOUS EMPLOYER / EMPLOYMENT DATE (yyyy/mm/dd) / other income / (source)
NAME & ADDRESS OF SPOUSE’S EMPLOYER / TELEPHONE / EMPLOYMENT DATE (yyyy/mm/dd) / SPOUSE’S ANNUAL SALARY OR WAGES
OCCUPATION / POSITION / EMPLOYEE NO. / TOTAL ANNUAL INCOME / $ 0.00
PREVIOUS EMPLOYER / EMPLOYMENT DATE (yyyy/mm/dd) / TOTAL MONTHLY INCOME / $ 0.00
financial information
asset / amount / liabilities / amount / monthly pmt
CASH (ROYAL BANK) / (loans, mortgages, credit cards. all other debts)
CASH (OTHER) / MORTGAGE / RENEWAL DATE (YYYY/MM/DD)
LIQUID INVESTMENTS (STOCKS, BONDS, ETC.) / BANK LOANS – ROYAL
BANK LOANS – OTHER
LIFE INSURANCE – / LOANS – CREDIT UNION
FACE AMOUNT / PAYABLE TO / csv / LOANS – INSURANCE CO.
OTHER LIQUID ASSETS (SPECIFY) / CREDIT CARDS – VISA ROYAL – LIMIT $
CREDIT CARDS – OTHER – LIMIT $
REAL ESTATE / OTHER DEBTS (SPECIFY)
AUTOMOBILE
year and make
year and make
FURNITURE
OTHER / MONTHLY RENT (IF APPLICABLE)
OTHER / SUBTOTAL / $ 0.00
OTHER / SURPLUS / $ 0.00
TOTAL / $ 0.00 / TOTAL / $ 0.00 / $ 0.00
REAL ESTATE OWNED - LOCATION / REGISTERED - OWNER / YR PURCHASED / PURCHASE PRICE / VALUE / EQUITY / FIRE INS
APPLICABLE LOAN TYPE
Variable RateFixed RatePersonal/DemandEndorser/GuarantorOther / INTEREST RATE VALID UNTIL
/ / / ROYAL BANK PRIME PLUS %
ROYAL BANK PERSONAL LOAN BASE RATE PLUS%
FIXED % / PAYMENT
WeeklyBi-WeeklyMonthlyInterest Only / TERM / AMORTIZATION
I/We warrant and confirm the information given herein is true and correct and I/We understand it is being used to determine My/Our credit responsibility. I/We further confirm that no information, which might affect the Bank's decision to make the loan, has been withheld. I/We hereby authorize and consent to the Bank receiving and exchanging any financial and other information which it may have in it's possession about Me/Us with any of it's subsidiaries, agents, third party assignees, other financial institutions, Credit Bureaus or other person of Corporation or with whom I/We may have or propose to have financial dealings from time to time. I/We indemnify the Bank against any loss, claims, damages, liabilities, actions and proceedings, legal and or other expense which may be directly and reasonably incurred as a consequence of the disclosure of the financial information. My/Our deposit account may be charged with the monthly payments as they mature and I/We agree to pay your customary assessment for any notices of overdue installments. / PAYMENT IN MONTHLY INSTALLMENTS
BEGINNING ONE MONTH FROM DATE OF NOTE / AGREEMENT
BEGINNING - //
MATURITY DATE - /
APPLICANT’S SIGNATURE / CO-SIGNOR (SPOUSE ONLY)
SOURCE OF BUSINESS
NEW
MAIL DROP / REFINANCE
DIRECT MAIL / FORMER
WALK IN / NEWSPAPER
SIGN / RADIO
STAFF REFERRAL / TV
CLIENT REFERRAL / OTHER (SPECIFY)
JUDGEMENTS OR LEGAL PROCEEDINGS (PARTICULARS)
INDIRECT LIABILITIES (PARTICULARS)
investigation
EMPLOYER CONFIRMS
POSITION INCOME SERVICE / SALARY VERIFICATION/CONFIRMATION DETAILS:
PREVIOUS EMPLOYER CONFIRMS
POSITION INCOME SERVICE
SPOUSE’S EMPLOYER CONFIRMS
POSITION INCOME SERVICE
LANDLORD / MORTGAGE HOLDER
MO. PAYMENT YEARS THERE PAYING HABITS – GOOD / SLOW
LIFE INSURANCE APPRAISAL
existing creditors (Verify standing of account with all creditors.)
NAME OF COMPANY / BANK / TELEPHONE / DATE ACCT OPENED / HIGH CREDIT / TERMS / BALANCE / RATING / OTHER INFORMATION OBTAINED
/
/
record particulars of last check completed
GENERALINFORMATION / CONFIRMATION / REFERENCE CHECKED / DATE ACCT OPENED / HIGH CREDIT / TERMS / PRESENT BALANCE / RATING
YES / NO
AGE / / /
ADDRESS / //
EMPLOYER / / /
SALARY / /
INVESTIGATOR’S REMARKS / NO. OF YEARS RBC CUSTOMER
COLLATERAL SECURITY
HELD TO BE OBTAINED BEING SENT
SHOW FULL PARTICULARS FORM NO. AND DESCRIPTION OF SECURITY. / } / INITIALS
ENDORSEMENT(S) AND/OR CO-SIGNER(S) (ATTACHED S.O.A.)
INSERT NAME(S) AND THE DEGREE OF PROTECTION AFFORDED SUCH AS NET WORTH, ETC. / }
TOTAL DEBT SERVICE RATIO
(SPOUSE MUST CO-SIGN IF INCOME BEING USED) / TOTAL MONTHLY PAYMENTS INCLUDING NEW LOAN
GROSS MONTHLY INCOME / X 100 = % (should not exceed 40%)
INFORMATION CHECK LIST / AUTOMOBILE INSURANCE VERIFIED
CHATTEL MORTGAGE ON MOTOR VEHICLE TAKEN / BILL OF SALE ON MOTOR VEHICLE TAKEN / REGISTERED CHATTEL MORTGAGE
SPOUSE’S COVENANT HELD / SALARY ASSIGNMENT
SALARY DEDUCTION - AutomaticManual
REFINANCE LOAN #TRANSIT #: LOAN NOTE DATE - / / LOAN #TRANSIT #:
CREDIT A/C #TRANSIT #: / DEBIT A/C #TRANSIT #:
CREDIT BUREAU RESULTS:
APPROVING OFFICER
CREDIT POLICY EXCEPTIONS / NAME AND SIGNATURE
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