Common Questions KYC

[Timothy Ross]

Javascript must be enabled in order to complete this form

Mr/Ms
First Name *
Last Name *
Household *
Address Line 1 *
Address Line 2 *
City / Town *
State / County / Province *
Zip / Postal Code *
Country
Phone *
Phone 2 *
Phone 3
Email *
Date of Birth *
SIN *
Marital StatusCommon LawDivorcedEngagedLiving Common LawMarriedSeparatedSingleWidowed*
# of Children *
Spouse's Full Name *
Spouse's Employer Information *
Employer *
Type of Business *
Employer Address *
Occupation *
Position *
Start Date
Bank Name
Bank Transit / Institution #
Account #
Bank Address
Trading AuthorizationDeclinedNoYes
Single, Trust or JointJointSingleTrust
Salary *
Bonus
Commission *
Investment Income
Dividend
CPP-OAS-QPP *
Retirement income *
Child Support *
Other
Cash-Chequing Acct *
Savings Acct *
RSP *
RIF *
LIRA *
TFSA *
RESP *
DPSP *
Other Liquid Assets
Home (Market Value) *
Business *
Real Estate *
Rental Properties *
Insurance cash value *
Jewelry-Collectibles *
Boat *
Cottage *
Vehicle *
Land *
Other Fixed Assets *
Principle residence *
Business *
Real Estate *
Rental property *
Vehicle *
Personal line of credit *
Auto loan *
Car lease *
Credit Card *
Tax owing *
Other Liabilities *
Total Liquid Assets
Total Fixed Assets
Total Liabilities
Objective - Income % *
Objective - Growth % *
Objective - Aggressive % *
Risk - Low *
Risk - Medium *
Risk - High *
Investment time frameLongMediumShort*
Investment KnowledgeGoodLimitedPoorSophisticated*
Referred by *
Have you met face to face?YesNo*
How long have you known the client? *
Is the advisor registered in client's province of residence?YesNo
Joint tenants with rights of survivorship and not as tenant in commonYesNo
Tenants in common without the right of survivorshipYesNo
Are you a snr officer or director of a public trading company?YesNo
Do you, alone or as part of a group, hold or control any such company?YesNo
Have you authorized anyone to use discretion in handling your account?YesNo
Regulatory\Anyone else have any authority over the acct?YesNo
Anyone else have any financial interest in the acct?YesNo
Anyone else guarantee this acct?YesNo
Is this acct used by or on behalf of a 3rd party?YesNo
Do you have direct or indirect interest in the acct other than commission?YesNo
Are you or spouse employee,Dir,Prtnr or Offcr of a dealer,StockExch or IIROC?YesNo
Do you trade or intend to trade with other investment firms?YesNo
Do you have any other accounts with our firm?YesNo
Are you or someone close a Head of State, Ambassador, etc. for a foreign State?YesNo
Margin & Leverage disclosure form completed & signedYesNo
Leverage approval templateYesNo
Leverage risk disclosure formYesNo
Has money been borrowed to investYesNo
How much money has been borrowed to invest
Date of loan
ID #1 - TypeBank CardBirth CertificateCitizenship CertificateDebit CardDriver's LicenseEmployment IDHealth Insurance CardOtherPassportSSN
ID #1 - ID Number
ID #1 - Place of Issuance
ID #1 - Expiry Date
ID #2 - TypeBank CardBirth CertificateCitizenship CertificateDebit CardDriver's LicenseEmployment IDHealth Insurance CardOtherPassportSSN
ID #2 - ID Number
ID #2 - Place of Issuance
ID #2 - Expiry Date
Account Application Information & KYC\Account #1 Profile\Account #
Account Application Information & KYC\Account #1 Profile\Account TypeCash CDNCash USDAP CDNDAP USFamily RESPGICGroup RSPGroup SP RSPHedge CDNHedge USIndividual RESPIPP/RCALeveragedLIF/LRIFLIRA/LRSPMargin CDNMargin USOpenOption CDNOption USPRIFQASP/SMERIFRLSPRRSPRSPSEGSShort CDNShort USSP RSPSPRIFTFSA CDNTFSA US
Account Application Information & KYC\Account #2 Profile\Account #
Account Application Information & KYC\Account #2 Profile\Account TypeCash CDNCash USDAP CDNDAP USFamily RESPGICGroup RSPGroup SP RSPHedge CDNHedge USIndividual RESPIPP/RCALeveragedLIF/LRIFLIRA/LRSPMargin CDNMargin USOpenOption CDNOption USPRIFQASP/SMERIFRLSPRRSPRSPSEGSShort CDNShort USSP RSPSPRIFTFSA CDNTFSA US
Account Application Information & KYC\Account #2 Profile\Objective\Objective - Income %
Account Application Information & KYC\Account #2 Profile\Objective\Objective - Growth %
Account Application Information & KYC\Account #2 Profile\Objective\Objective - Aggressive %
Account Application Information & KYC\Account #2 Profile\Risk Tolerance\Risk - Low %
Account Application Information & KYC\Account #2 Profile\Risk Tolerance\Risk - Medium %
Account Application Information & KYC\Account #2 Profile\Risk Tolerance\Risk - High %
Account Application Information & KYC\Account #2 Profile\Investment Time Frame\Investment Time FrameLongMediumShort
Account Application Information & KYC\Account #2 Profile\Investment Time Frame\Investment KnowledgeGoodLimitedPoorSophisticated
Account Application Information & KYC\Account #3 Profile\Account #
Account Application Information & KYC\Account #3 Profile\Account TypeCash CDNCash USDAP CDNDAP USFamily RESPGICGroup RSPGroup SP RSPHedge CDNHedge USIndividual RESPIPP/RCALeveragedLIF/LRIFLIRA/LRSPMargin CDNMargin USOpenOption CDNOption USPRIFQASP/SMERIFRLSPRRSPRSPSEGSShort CDNShort USSP RSPSPRIFTFSA CDNTFSA US
Account Application Information & KYC\Account #3 Profile\Objective\Objective - Income %
Account Application Information & KYC\Account #3 Profile\Objective\Objective - Growth %
Account Application Information & KYC\Account #3 Profile\Objective\Objective - Aggressive %
Account Application Information & KYC\Account #3 Profile\Risk Tolerance\Risk - Low %
Account Application Information & KYC\Account #3 Profile\Risk Tolerance\Risk - Medium %
Account Application Information & KYC\Account #3 Profile\Risk Tolerance\Risk - High %
Account Application Information & KYC\Account #3 Profile\Investment Time Frame\Investment Time FrameLongMediumShort
Account Application Information & KYC\Account #3 Profile\Investment Time Frame\Investment KnowledgeGoodLimitedPoorSophisticated
WME_Client Information\Primary AdvisorD. JohnsonK. Lasky
WME_Client Information\IA CodeA1213A2956
WM_KYC etc.\Balance Sheet\Liquid\Open
WM_KYC etc.\Balance Sheet\Fixed\RSP Spousal
WM_KYC etc.\Account #2\Leverage\Has money been borrowed to investYesNo
WM_KYC etc.\Account #2\Leverage\How much money has been borrowed to invest
WM_KYC etc.\Account #2\Leverage\Date of Loan
WM_KYC etc.\Account #3\Leverage\Has money been borrowed to investYesNo
WM_KYC etc.\Account #3\Leverage\How much money have been borrowed to invest
WM_KYC etc.\Account #3\Leverage\Date of Loan

All fields marked with a * must have a value in order to complete this form