COMPLETION INSTRUCTIONS
(Individual)
Please meet with the Borrower(s), Guarantor(s) and/or Beneficial Owner(s) (each a “signatory”) and complete the
Agent Examination of Identification Form. Please be sure to obtain the signature of each signatory in the space
provided on the form.
You must obtain two (2) pieces of identification for each signatory.
At least one piece of identification obtained must contain a photograph and must be from List A. The other can be
from either List A or List B. See attached Agent Examination of Identification Form for List A and List B.
You must confirm that none of the identification provided has expired.
Each borrower must complete the Third Party Certificate attached to the Agent Examination Form as Appendix B.
Please contact First National if there are any questions surrounding the completion of the Agent
Examination of Identification Form. A copy of this form must be provided to First National before funds
will be advanced.
Do not provide copies of identification to First National. Legible copies of all identification obtained by
you are to be kept on file and made available to First National upon request, if necessary.
May 21, 2015
Page 1 of 6
Doc 354v5
AGENT EXAMINATION OF IDENTIFICATION FORM
(Individual Borrower/Guarantor)
FIRST NATIONAL LOAN NO.:
CLIENT NAME:
PROPERTY ADDRESS:
I, the undersigned, attest that (i) I understand and accept that I am acting as an agent on behalf of the mortgagee and
its successors, assigns and co-lenders for the purpose of ascertaining the identity of the Borrower, Guarantor and/or
Signing Officer, and/or such other relevant parties listed below; (ii) I am currently in good standing and entitled to
practice law without any restrictions; (iii) I have personally met with each individual; and (iv) I have examined two
valid and current original identification documents from the lists in Appendix A as recorded below, one of which
includes a photograph of the individual and is from List A, and have been verified by me in accordance with the
Proceeds of Crime (Money Laundering) and Terrorist Financing Regulations of Canada.
(choose ALL THAT APPLY)
Borrower
Guarantor
LAST NAME
Beneficial Owner
FIRST NAME
SECOND NAME
DATE OF BIRTH
(e.g. August 1, 1975)
OCCUPATION & SPECIFIC
FIELD OF WORK 1
ID TYPE2
ID NUMBER
EXPIRY
PLACE OF ISSUANCE
ID TYPE2
ID NUMBER
EXPIRY
PLACE OF ISSUANCE
POLITICALLY EXPOSED PERSON (PEP) OFFICIAL CERTIFICATION: (check appropriate box)
I hereby certify that I or members of my family are:
□
NOT a Politically Exposed Person
as defined in Appendix “A”.
OR
□
a Politically Exposed Person,
as defined in Appendix “A”.
CLIENT SIGNATURE:
1
2
Vague description such as “Business-for-Self”, “self-employed”, “consultant”, “investor”, “business owner”, “businessman”, “entrepreneur”
or “Signing Officer” is not acceptable. The occupation must clearly reflect the nature of the work and the industry in which it is performed.
The Country of Origin to be specified for any Passport used (i.e. Canadian Passport).
May 21, 2015
Page 2 of 6
Doc 354v5
I hereby certify that the identification provided by the individual is valid and has not expired and I have
verified that the person shown in the photo ID is the person who appeared before me.
I further certify that each of the above individuals is one and the same person named in the identification
provided by that individual and is one and the same person as noted in the Commitment Letter and CMHC
Special Conditions (if applicable).
I confirm that I have retained in my files a photocopy of both sides of each identification document reviewed
by me.
Signature of Notary or Solicitor (acting as an agent)
Name (please print)
Date:
May 21, 2015
Page 3 of 6
Doc 354v5
APPENDIX A - LIST OF ACCEPTABLE IDENTIFICATION DOCUMENTS
Obtain two pieces of identification, at least one of which contains a photograph and is from List A. The other one can be from
either List A or List B.
NOTE: All Identification must be original, valid, legible and in good condition
PLEASE READ NOTES BELOW
















List A
Driver’s License issued in Canada (except Quebec)1
Passport
Certificate of Canadian Citizenship/Certification of Naturalization
Permanent Resident Card or Citizenship and Immigration Canada Form IMM5292, IMM1000 or IMM1442
Unexpired Firearms Acquisition Certificate (FAC) or a license — either a Possession Only or a Possession and
Acquisition License (PAL) — issued by the Canadian Federal government under the Firearms Act.
Armed Forces ID issued by the Government of Canada
FAST Express Card2/NEXUS Card
A document or card with the individual’s signature and photograph on it issued by any of the following:
ServiceOntario (Ontario Photo Card)
The Insurance Corporation of British Columbia
Alberta Registries
Saskatchewan Government Insurance
The Department of Service Nova Scotia and Municipal Relations
The Department of Transportation and Public Works of the Province of Prince Edward Island
Service New Brunswick
The Department of Government Services and Lands of the Province of Newfoundland and Labrador
The Department of Transportation of the Northwest Territories
The Department of Community Government and Transportation of the Territory of Nunavut
List B
Birth certificate issued in Canada (must be issued by a provincial, territorial or federal government)
Provincial health insurance card (except for Ontario, Prince Edward Island, Nova Scotia, Manitoba, and Quebec3)
Certificate of Indian Status issued by the Government of Canada
Old Age Security card issued by the Government of Canada
Signed credit card issued by a member of the Canadian Payments Association4 (corporate credit cards are not
acceptable)
Signed Canadian Institute for the Blind (CNIB) client card with a photograph
Record of Landing
Social Insurance Number (SIN) card issued by the Government of Canada 5
NOTES:
Valid foreign ID, if equivalent to an acceptable type of Canadian identification document, is acceptable.
1
In Quebec, driver’s license may not be requested but can be used if offered.
2
The card, issued by the Canadian Board Agency, is used to expedite the delivery of goods back and forth between
Canada and the U.S. It includes the borrower’s name, date of birth, gender, citizenship, a photo, expiry date and
a unique identifier number, and is issued for a five year period.
3
In Quebec, provincial health card may not be requested but can be used if offered.
4
For a list of CPA members, refer to www.cdnpay.ca. Name of financial institution issuing credit card to be noted
on Agent Examination of Identification Form.
5
The Social Insurance Number card may not be requested but can be used if offered.
May 21, 2015
Page 4 of 6
Doc 354v5
Out-of-Country Attestations
Where the individual is not physically present in Canada, a third party (e.g., lawyer, notary public, commissioner of
oaths or similar person) who is attesting to the individual’s identity on our behalf has to be properly instructed in
writing to act as our agent and has to complete and sign the Agent Examination of ID Form. In addition, the lawyer,
notary public, commissioner of oaths or similar person’s standing should be confirmed directly or through the
Canadian consulate or embassy in that country. Alternatively, the individual can attend the closest Canadian
consulate or embassy and have his/her identification attested to. In such a case, the officer at the consulate or embassy
would have to complete and sign the Agent Examination of ID Form.
Power of Attorney
Where an individual under a power of attorney will be executing documentation on behalf of a borrower, guarantor,
beneficial owner or other covenantor, the Agent must collect the appropriate identification and complete an Agent
Examination of ID Form for each of the attorney and the person who granted the power of attorney (the “Donor”).
Further, the Agent must also verify with the Donor that the power of attorney continues to be valid, is in full force
and effect and was granted by the Donor.
Politically Exposed Person (PEP):
A PEP is a person who is a “senior political figure”, any member of a senior political figure’s “immediate family”, and any
“close associate” of a senior political figure.
A senior political figure is an individual who holds or has ever held in the past, one of the following offices or positions in
or behalf of Canada or a foreign country:
o
o
o
o
a head of state or government;
a member of the executive council of
government or member of a legislature;
a deputy minister (or equivalent);
an ambassador or an ambassador’s attaché or
counselor;
o
o
o
o
o
a military general (or higher rank);
a president of a state owned company or bank;
a head of government agency;
a judge; or
a leader or president of a political party in a
legislature.
PEP also includes the immediate family members of any individual described below:
o
spouse or common law partner;
o
mother or father; or
o
child, brother, sister, half-brother or half-sister;
o
spouse’s or common-law partner’s mother or
father.
May 21, 2015
Page 5 of 6
Doc 354v5
APPENDIX B to Agent Examination of Identification Form
BORROWER CERTIFICATE RE THIRD PARTIES
TO:
FIRST NATIONAL FINANCIAL LP (the “Lender”)
RE:
Loan (the “Loan”) from the Lender to  (the “Borrower”) secured by a mortgage on  (the
“Property”)
I,
hereby certify as follows.
1.
, of the City of
, in the Province of
I will be the registered and beneficial owner of the Property on closing.
OR (select one and delete the other)
The beneficial owner of the Property on closing will be
2.
.
I am not acting in this transaction on the instructions of any undisclosed third party other than any beneficial
owner described herein.
DATED this
Witness
day of
,
)
)
)
)
.

May 21, 2015
Page 6 of 6
Doc 354v5