First Name
Last Name
Company
Phone#
area code:
ext.#
E-mail Address
Location of Project
City:
Province:
Select
AB
BC
MB
NB
NL
NT
NS
NU
ON
PE
QC
SK
YT
Type of Property
Type of Mortgage Required
RESIDENTIAL PROPERTY
Apartment & Townhouse Rental Projects
Apartment & Townhouse Condominiums
Construction Mortgage
Permanent Mortgage
Both
COMMERCIAL/INDUSTRIAL
Shopping/Retail Centres
Industrial Buildings - owned or leased
Office Buildings - owned or leased
Construction Mortgage
Permanent Mortgage
Both
HEALTH CARE PROPERTY
Long Term Care
Retirement Facilities
Other
Construction Mortgage
Permanent Mortgage
Both
Mortgage Request
CDN
Existing Debt
Amount
Rate
%
Lender
Maturity Date
5 Year
10 Year
15 Year
20 Year
25 Year
30 Year
If you were referred to IC Funding please complete
Name
Company