Account Application ACCOUNT APPLICATION Step 1 of 6 16% Account Holder InformationLegal Name* First Last Primary Phone (Cell)*Other PhoneEmail (Used for electronic document delivery, must be different from spouse.)* Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Add Spouse No Yes Spouse's InformationSpouse Legal Name First Last Spouse Primary Phone (Cell)Spouse Other PhoneSpouse Email (Used for electronic document delivery, must be different from spouse.) Personal InformationDate of Birth MM slash DD slash YYYY Gender at Birth Male Female Social Insurance NumberMarital Status Single Married Divorced Separated Common Law Citizenship Canadian United States Tax Status: To What Countries do you remit taxes to? Canada United States Employer Occupation / Title (Previous if Retired) Annual Income (All Sources)Beneficiary Name, Birthdate and % (Estate, Spouse, Children, etc.) Spouse Personal InformationSpouse Date of Birth MM slash DD slash YYYY Spouse Gender at Birth Male Female Spouse Social Insurance NumberSpouse Citizenship Canadian United States Spouse Tax Status: To What Countries do you remit taxes to? Canada United States Spouse Employer Spouse Occupation / Title (Previous if Retired) Spouse Annual Income (All Sources)Spouse Beneficiary Name, Birthdate and % (Estate, Spouse, Children, etc.) Children and DependentsName First Last AgeDependent Yes No Name First Last AgeDependent Yes No Name First Last AgeDependent Yes No Name First Last AgeDependent Yes No AssetsPrimary ResidenceRRSP, LIRA, RRIF, LIFCurrent Monthly RRSP SavingsTFSACurrent Monthly TFSA SavingsPension PlanNon-RegisteredCurrent Monthly SavingsGroup Plan Life Insurance AmountExisting Life InsuranceOther 1Other 2Other 3Spouse AssetsSpouse - RRSP, LIRA, RRIF, LIFSpouse - Current Monthly RRSP SavingsSpouse - TFSASpouse - Current Monthly TFSA SavingsSpouse - Pension PlanSpouse - Non-RegisteredSpouse - Current Monthly SavingsSpouse - Group Plan Life Insurance AmountSpouse - Existing Life InsuranceSpouse - Other 1Spouse - Other 2Spouse - Other 3 LiabilitesMortgage AmountMortgage Payment AmountMortgage Interest RateMortgage Maturity MM slash DD slash YYYY VehiclesPersonal LoansCredit Cards / Line of CreditsOther 1Other 2Other 3Spouse LiabilitiesSpouse VehiclesSpouse Personal LoansSpouse Credit Cards / Line of CreditsSpouse Other 1Spouse Other 2Spouse Other 3 HiddenNet WorthHiddenTotal AssetsHiddenTotal LiabilitiesHiddenTotal Net WorthNotes and Other InformationNotes and Other Information Return to New Form We Stand Beside You. 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