KYC Info Form - New Clients (ID #230054)We are updating our Know Your Client information in order to ensure we have the proper information for each client. Many have changed employers and have different incomes. In preparing paperwork we need to ensure we have the most up to date information for securities regulations.Please enable JavaScript in your browser to complete this form.Know your client information formYou are an existing clientYou are a new clientHas Your Personal Information Changed?YesNo(Address/Contact Details/Email/Photo ID)PERSONAL INFORMATIONClient Name *FirstLastClient Birthdate *Client Address *Address Line 1CityState / Province / RegionPostal CodeAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryEmail *Client Home PhoneClient Cell PhoneClient Work PhoneDrivers License/Passport # *Drivers License/Passport Expiry Date *Attach Photo ID * Click or drag a file to this area to upload. Drivers License/PassportSIN Number *Social Insurance NumberVoid Cheque * Click or drag a file to this area to upload. Number of Dependants *Dependant(s) InformationFirst Name / Last Name / D.O.B / SIN # / Relationship / Male or FemaleEmployment StatusHas Your Employment Status Changed?YesNoEmployer's Name: *(If retired or unemployed, must list past employment)Job Type: *Position: *Employment Address: *Annual Income *Your Personal Net WorthHas Your Personal Net Worth Changed?YesNoa. Cash and Cash Equivalents *b. Fixed Income Securities *c. Equities *d. Alternative Securities *e. Net Liquid Assets *+ Fixed Assets and Real Estate *+ Net Fixed Assets *(Fixed assets less liabilites against Fixed Assets)- Personal Loans & Credit Card Balances *- Lines of Credit *- Mortgages *- Other (specify) *Estimated Total Net Worth *Liquidity Requirements *None, (No funds Required in the Short Term)Funds May Be Required on Short NoticeIf required, notes regarding amount and approximate date(s) when money required: *Trusted ContactWould you like to add a trusted contact to the account?YesNoIf yes, include the 'Trusted Contact Form'Download the Trusted Contact FormSpousal InformationIs your spouse a current clientYesNoHas your spouse information changed?YesNoSpouse Name *FirstLastSpouse Birthdate:Employers Name:(If retired or unemployed, must list past employment)Employers Address:Spouse Job Type:Occupation:Spouse Annual IncomeSpouse Liquid Fixed Assets ($)Spouse Fixed Assets ($) Spouse Drivers License/Passport # Spouse Drivers License/Passport Expiry DateAttach ID (Spouse) Click or drag a file to this area to upload. Submit