Client Financial Assessment Form – The Bahamas Mortgage Corporation

MORTGAGES

CLIENT FINANCIAL ASSESSMENT

Today's Date

General Information

Name

Date of Birth

Age

NIB #

Marital Status

Number of Dependents

Country of Citizenship

Address (Street Address)

PO Box

Island

Telephone

Employment Information

Are you self-employed?

Occupation

Employer

Employment Date

Present Annual Full-Time Salary

Present Annual Part-Time Salary

Gratuity/Commission

Pay cycle

Financial Position

Loans & Credit Cards

Type of Loan

Financial Institution

Balance

Monthly Payment

Maturity Date

Type of Loan

Financial Institution

Balance

Monthly Payment

Maturity Date

Type of Loan

Financial Institution

Balance

Monthly Payment

Maturity Date

Type of Loan

Financial Institution

Balance

Monthly Payment

Maturity Date

Savings & Investments

Type of Asset

Financial Institution

Balance/Value

Type of Asset

Financial Institution

Balance/Value

Type of Asset

Financial Institution

Balance/Value

Type of Asset

Financial Institution

Balance/Value

I declare that the information provided to The Bahamas Mortgage Corporation is true, accurate, and presented to the best of my knowledge. I undertake to provide to The Bahamas Mortgage Corporation all the necessary due diligence and supporting documents as required by Bahamian Law and Corporation lending policies pertaining to anti-money laundering, countering the financing of terrorism, international tax compliance and credit exposure reporting.