Personal Information

You are currently applying for the Personal Loan Application.

Information about your Source of Income

Fill in the details to the best of your ability

Details About Your Credit

  • Tell Us about yourself
  • Employer Information
  • References + Homeownership
  • Credit Check

Tell Us About Yourself:

Full Name


Phone Number

Date of Birth

Drivers License:

SIN Number (Optional)

Home Address (Including Postal Code)

Time at Address (Years & Months)

Primary Residence Type

Name and Address of Landlord or Mortgage Holder

Rent or Mortgage Payment

Home Ownership

Are you behind in Rent or Mortgage?

Employer Information

Are you Currently Employeed?

Employer Name

Employer Address


Type of Business

Length of Employment

Employer Phone Number

Employer's Name and Address

Monthly Income

Income Type

Creditor Information

1) Creditors Name and Address

1) Creditors Account #


Unpaid Balance

Instalment Amount

2) Creditors Name and Address

2) Creditors Account #


Unpaid Balance

Instalment Amount

3) Creditors Name and Address

3) Creditors Account #


Unpaid Balance

Instalment Amount

Previous Leasing Experience

Monthly Payment

Two Personal Reference

Reference #1 (Name, Address and Phone Nuimber)

Reference #2 (Name, Address and Phone Nuimber)

Own Your Home?

Purchase Price

Down Payment

Balance of Mortgage

Today's Market Value

I/We grant our irrevocable permission to release our confidential information to Realcor Capital Inc (‘Realcor”) and iCapital Financial Services Corp (“iCapital”). I/We understand this information is being used for credit underwriting purposes only. Permission is also granted to contact any business past, present or future that we may deal with including banks, landlords we currently use or will use in the future. Each person signing below consents to RealCor Capital Inc and iCapital obtaining credit, financial and related personal or business information (including a credit information report) about the undersigned from any credit Bureau or credit reporting agency in connection with this application. Each person also consents to the collection, use and disclosure of personal information as further detailed in the privacy policy published on

Credit Check

Permission to check credit

E-Signature of Application

Today's Date