Mortgage Lender Intake Form

Kindly complete all fields below and upload required documentation.

First name

Last name

Birthdate

Year

Month

Day

Phone number with country code (cellular)

Please click the flag icon to select your country code.

Phone number with country code (home)

Please click the flag icon to select your country code.

Spousal status

Your current address

Client complete address

Country/Region

Address

Address - line 2

City

Zip / Postal code

Employment status

Are you a Canadian citizen or Permanent Resident?

Please provide one type of ID with a government photo ID (No provincial health cards)

How did you hear about Huza Law Office?

Do you have any accessibility or mobility needs that would make it difficult to meet with our legal team on the second floor of our office?

I agree that the sending of any questions or information to Huza Law Office, through the form herein, does not form any solicitor-client relationship between myself and Huza Law Office. I further agree and understand that the sending of the foregoing information will be unencrypted and although the risks are minimal, Huza Law Office cannot guarantee the inadvertent interception or unauthorized access, disclosure or viewing of the information or documents sent through this platform.

Mortgage Lender Intake Form

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