11833 MG-2021/10

Page 1 of 2

Customer Consent & Disclosure

1. Quebec residents only: It is the express wish of the parties that this document and any related documents be drawn up in English.
Les parties aux présentes ont expressément demandé que ce document et tous les documents s’y rattachant soient rédigés en anglais.
2. Borrower Acknowledgement and Consent: I agree that if the loan is granted in whole or in part, or if Canada Mortgage and
Housing Corporation (CMHC) or another mortgage insurer pre-qualifies the loan or agrees to insure the loan: a) the granting,
pre-qualification or insurance is not confirmation that I and any co-applicant(s) have the ability to pay the loan, or confirmation of the
value or condition of the property (even if an appraisal or inspection was performed), and b) all information obtained from or about me
and any co-applicant(s) in connection with approving the loan, including credit bureau information, will be accessible to and may be
used by the mortgage insurer for any purpose related to the provision of mortgage insurance generally. Any information retained by
the mortgage insurer in that regard will be subject to federal access to information and privacy legislation.
3. For Mortgage Loan Customers: I understand if I enter into a mortgage loan agreement with CIBC, I have the right to receive a
disclosure statement that provides details about the mortgage loan and the cost of borrowing. I can choose when to receive the
disclosure statement; when I sign the mortgage loan agreement, or at least two business days before I sign the mortgage loan
agreement. By signing below I agree to receive the disclosure statement no later than the time I sign the mortgage loan agreement. If
I wish to receive the disclosure statement at least two business days before I sign the mortgage loan agreement, I will contact CIBC at
1 888 264 6843. I also understand that in some cases this may delay my mortgage loan closing date.
4. Referral Sources: I authorize CIBC to notify the referral source involved in this transaction, if any, whether my application has been
approved, of any conditional financing requirements and the amount. I acknowledge that CIBC has advised me of and I consent to,
payment of a referral fee or the awarding of loyalty points redeemable for rewards, where permitted and applicable, to the referral
source(s) including but are not limited to a real estate brokerage, builder or developer.
Quebec residents only: If the referral source (if any) is a mortgage brokerage, I authorize CIBC to provide the brokerage with
documentation related to my mortgage application, including the mortgage loan and related disclosure documents, as needed for the
brokerage to fulfill its legal and regulatory obligations relating to this transaction.
5. Electronic Document Regulation: By checking the “Yes” box below, I agree to receive documents electronically via CIBC secure
email. These documents may include information that the Bank Act or other regulation requires be provided in writing. Depending on
the product I select, the documents may include Borrower Acknowledgement, Disclosure Statement (including Schedule of Non-Interest
Charges), Application for Creditor Insurance, Certificate of Creditor Insurance, Refinance/Replacement Statement and Line of Credit
Fees and Services. I will retain copies of these documents and this consent for my records. CIBC will retain all of these documents for
seven years after my loan is paid off. This consent takes effect immediately. I am responsible for advising CIBC of any changes to my
email address. I may cancel this consent at any time by contacting my Mortgage Advisor.
6. Credit Bureau Consent and Privacy Authorization: By providing CIBC with my personal information in this application, or in
connection with my existing CIBC products and services, I consent to the collection, use, and sharing of my personal information as
described in CIBC’s privacy policy called Your Privacy is Protected, which is available at any banking centre or www.cibc.com.
I also consent to CIBC, its agents and service providers obtaining my credit report from a credit or consumer reporting agency. During
the course of our relationship, I acknowledge that CIBC, its agents and service providers will also collect my credit, financial and related
personal or business information. CIBC may obtain this information from credit or consumer reporting agencies, or any third party with
whom I have had, or may have, a financial relationship, and CIBC may share that information with these parties. This information may
be used or shared for the following purposes: credit determination and monitoring, product and service qualification, identification,
servicing and fraud protection, product and service updates or promotions and complying with laws. My consent is valid for as long as
I have a product or service with CIBC and for a reasonable time after that. CIBC can provide me with the contact information of the
credit or consumer reporting agency upon request. “Service provider” includes a person or entity that has been engaged in connection
with a) the servicing, origination, insurance, maintenance, collection or operation of the loan, or b) the provision of services or benefits
to me, including loyalty programs.
Including a Social Insurance Number (SIN) in a credit bureau request is the best way to make sure credit bureau information accurately
refers to the right person. However, this is completely voluntary, and I understand that if I choose not to give permission, this by itself
will not prevent me from continuing the application. By checking the “Yes” box below, I give my consent to include my SIN in a credit
bureau request.
 11833 MG-2021/10
Page 2 of 2

Customer Consent & Disclosure

Applicant 1
Social Insurance Number
I give my consent to include my SIN in a credit bureau request, as outlined in section 6. X Yes No

checkbox
checkbox
Electronic Document Delivery
I agree to receive documents electronically via CIBC secure email, as outlined in section 5. X Yes No

checkbox
checkbox
Marketing
I agree to receive marketing communications from CIBC. I may withdraw consent at any time by X Yes No

checkbox
checkbox
contacting CIBC at 1 800 465-CIBC (2422). I will not be refused products or services just because I
choose not to receive marketing.

E-SIGNED by Jonathan Cristancho Diaz

Nov/30/2021 Jonathan Cristancho Diaz
X
Date (mmm/dd/yyyy) Name of Applicant 1 Signature of Applicant 1 (sign within box)

Applicant 2
Social Insurance Number
I give my consent to include my SIN in a credit bureau request, as outlined in section 6. Yes No

checkbox
checkbox
Electronic Document Delivery
I agree to receive documents electronically via CIBC secure email, as outlined in section 5. Yes No

checkbox
checkbox
Marketing
I agree to receive marketing communications from CIBC. I may withdraw consent at any time by Yes No

checkbox
checkbox
contacting CIBC at 1 800 465-CIBC (2422). I will not be refused products or services just because I
choose not to receive marketing.

Evaristo Cristancho Garcia

X
Date (mmm/dd/yyyy) Name of Applicant 2 Signature of Applicant 2 (sign within box)

CIBC Head Office, Commerce Court, Toronto, Ontario, Canada M5L 1A2; www.cibc.com