Client First Name

Client Last Name

Client Phone *

Client Email *

Agent Name *

Brokerage Name & Information ( Address, Lic #, Phone Number)

Submission Notes ( Be detailed in what you need, also please put name of referral )

Requested Mortgage Amount

If you have any documents for this file upload them here.

Account Manager Document Upload For Submission

Submission Consent:

By signing below, I certify the information enclosed in the attached client file for CUU is accurate and true. I also confirm that I have taken all necessary steps and due diligence to ensure the validity and authenticity of the documents and supporting documents given to me by the borrowers, and submitted to the respective lender associated with this mortgage transaction. I agree to have taken all necessary steps to verify the identity of the borrowers of this mortgage transaction and have collected valid identification at the application stage of this transaction. I confirm I have abided by, and have not been in breach of any Regulations, or the Policies and Procedures of either the regulator or Citadel Mortgages, with respect to my involvement in this mortgage transaction.

Citadel Mortgages - 150 King Street West 2nd Floor, Toronto Ontario M5H 1J9

If you do not disclose properly on company lead then you will not be paid the commission on the deal and be removed from the lead program.