Know Your Client Info Form

Are you a new client of Wellington-Altus/Tower Wealth?

Yes
No

PERSONAL INFORMATION

Full Name or Corporate Name: *

Has any of your personal information below changed in the past year? *

Address
Employment
Income
ID expired? Upload you ID here.

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Employment:

Income:

ID expiration date:

Attach Photo ID:

Click or drag a file to this area to upload.

Trusted Contact

Would you like to appoint a Trusted Contact? *

Yes
No

This is someone your advisor can reach out to if he or she is concerned you are being financially exploited.

Name of Trusted Contact:

Relationship:

Trusted Contact Information:

Liquidity Requirements

Do you require any lump sums from your portfolio in the next 1 to 3 years? *

Yes
No

How much?

Approximate Date:

Account Specific Information – Assets

Cash and Cash Equivalents: *

Cash, in common language, means money (currency) in physical form.
Cash equivalents are any highly secure financial asset that is liquid, i.e. can be readily converted into cash, such as
high-interest savings accounts, short-term Guaranteed Investment Certificate (GICs), money market funds,
treasury bills (T-bills), and other debt instruments with less than a year to maturity.

Fixed Income Securities: *

Fixed income refers to any type of investment that is not equity, which obligates the borrower/issuer to make payments on a
fixed schedule, even if the number of the payments may be variable A common type of fixed income investment is a bond.
Other common types are savings bonds, such as Canada Savings Bonds, and guaranteed investment certificates (GICs) issued by
a variety of financial institutions.

Equities: *

An equity is a stock or any other security representing an ownership interest.
The following are various classes of equities held individually or through a mutual fund: Common shares, Preferred shares,
Hybrid Securities, Real estate investment trust, Split share corporation, Debenture, US equities, International equities,
Emerging markets, Hedge funds, Flow-through shares, Warrants and Right, offerings, Limited Partnerships

Alternative Securities: *

An alternative investment is a financial asset that does not fit into the conventional equity/income/cash categories.
Private equity or venture capital, hedge funds, real property, commodities, and tangible assets are all examples of alternative investments.

Fixed Assets and Real Estate: *

Assets like homes, land, vehicles, recreational vehicles

Account Specific Information – Liabilities

Personal Loans & Credit Card Balances: *

These are loans that are not secured by Assets

Lines of Credit: *

Typically, a Line of Credit is secured against an asset such as a HELOC (Home Equity Line of Credit.

Mortgages: *

A loan against a property

Other (please specify): *

Debts owed to non-institutional entities * open field is required

Estimated Total Net Worth: *

*For an existing client this number will change if Wellington-Altus/Tower Wealth Assets were excluded

Full account information & Profile

Full Name *

First

Last

Client Birthdate *

Client Address *

Address Line 1

City

State / Province / Region

Postal Code

Country

Email *

Client Home Phone

Client Cell Phone

Client Work Phone

Drivers License/Passport # *

Drivers License/Passport Expiry Date *

Attach Photo ID *

Click or drag a file to this area to upload.

Drivers License/Passport

SIN Number *

Social Insurance Number

Void Cheque *

Click or drag a file to this area to upload.

Number of Dependants *

Dependant(s) Information

First Name / Last Name / D.O.B / SIN # / Relationship / Male or Female

Employer's Name: *

(If retired or unemployed, must list past employment)

Job Type: *

Position: *

Employment Address: *

Annual Income *

Spousal Information

Is your spouse a current client

Yes
No

Spouse Name *

First

Last

Spouse Birthdate:

Employers Name:

(If retired or unemployed, must list past employment)

Employers Address:

Spouse Job Type:

Occupation:

Spouse Annual Income

Spouse Liquid Fixed Assets ($)

Spouse Fixed Assets ($)

Spouse Drivers License/Passport #

Spouse Drivers License/Passport Expiry Date

Attach ID (Spouse)

Click or drag a file to this area to upload.

Trusted Contact

Would you like to appoint a Trusted Contact? *

Yes
No

This is someone your advisor can reach out to if he or she is concerned you are being financially exploited.

Name of Trusted Contact:

Relationship:

Trusted Contact Information:

Liquidity Requirements

Do you require any lump sums from your portfolio in the next 1 to 3 years? *

Yes
No

How much?

Approximate Date:

Account Specific Information – Assets

Cash and Cash Equivalents: *

Cash, in common language, means money (currency) in physical form.
Cash equivalents are any highly secure financial asset that is liquid, i.e. can be readily converted into cash, such as
high-interest savings accounts, short-term Guaranteed Investment Certificate (GICs), money market funds,
treasury bills (T-bills), and other debt instruments with less than a year to maturity.

Fixed Income Securities: *

Fixed income refers to any type of investment that is not equity, which obligates the borrower/issuer to make payments on a
fixed schedule, even if the number of the payments may be variable A common type of fixed income investment is a bond.
Other common types are savings bonds, such as Canada Savings Bonds, and guaranteed investment certificates (GICs) issued by
a variety of financial institutions.

Equities: *

An equity is a stock or any other security representing an ownership interest.
The following are various classes of equities held individually or through a mutual fund: Common shares, Preferred shares,
Hybrid Securities, Real estate investment trust, Split share corporation, Debenture, US equities, International equities,
Emerging markets, Hedge funds, Flow-through shares, Warrants and Right, offerings, Limited Partnerships

Alternative Securities: *

An alternative investment is a financial asset that does not fit into the conventional equity/income/cash categories.
Private equity or venture capital, hedge funds, real property, commodities, and tangible assets are all examples of alternative investments.

Fixed Assets and Real Estate: *

Assets like homes, land, vehicles, recreational vehicles

Account Specific Information – Liabilities

Personal Loans & Credit Card Balances: *

These are loans that are not secured by Assets

Lines of Credit: *

Typically, a Line of Credit is secured against an asset such as a HELOC (Home Equity Line of Credit.

Mortgages: *

A loan against a property

Other (please specify): *

Debts owed to non-institutional entities * open field is required

Estimated Total Net Worth: *

*For an existing client this number will change if Wellington-Altus/Tower Wealth Assets were excluded

Know Your Client

PERSONAL INFORMATION

Trusted Contact

Liquidity Requirements

Account Specific Information – Assets

Account Specific Information – Liabilities

Full account information & Profile

Spousal Information

Trusted Contact

Liquidity Requirements

Account Specific Information – Assets

Account Specific Information – Liabilities

“We provide comprehensive wealth advisory solutions for affluent individuals, professionals & corporations using our unique Wealth Navigation Process.”

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Contact Us

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1524 91 St SW., Suite 212 Edmonton, Alberta T6X 1M5