Section 1 Client Information

Section 1 – Plan Registration
Individual Individual-ITF Joint-ITF Joint-JWROS Joint-JTIC Corporate Estate Formal Trust
Section 3 – General Information
Source (Referral, etc.) / Occupation / Employer’s Name / Known Client Since
Source (Referral, etc.) / Occupation / Employer’s Name / Known Client Since

New Client  Update

Section 2 – Client Information
First Name / Last Name / Date of Birth / SIN Number
First Name (Joint Applicant) / Last Name (Joint Applicant) / Date of Birth / SIN Number
Home Number / Work Number
Mailing Address
Email Address
Section 4 – Know Your Client Information
Approximate Income
 Under $30,000
 $30,001 - $75,000
 $75,001 - $150,000
 Over $150,000 / Investment Knowledge
 Excellent
 Good
 Fair
 Poor / Nil / Investment Objective
 High Risk (100% Equity)
 Long Term Growth
 Income / Risk Tolerance:
____ Low Risk
____ Medium Risk
____ High Risk
(Split % can be used) / Time Horizon
 1 – 3 Years
 4 – 9 Years
 10+ Years
PLAN TYPESelf Directed Name ______
Non-Registered Spousal RRSPLIRA RESP RRSP RRIFLIFTFSASelf Directed Acct. ______
Approximate Net Worth $ ______
I/We confirm that the noted KYC information applies to the plan type(s) selected in this section. / X______ / X______
Clients Initials / Joint Applicant Initials
Section 5 – Client Acknowledgement or Consent
The Proceeds of Crime (Money Laundering) and Terrorist Financing Act obligates BridgeForce Financial Group to verify the identity of any person(s) involved with an investment account. This includes any person authorized to give instructions on the account. The identity of a corporate applicant must be ascertained by verifying, in the same manner, the identity of the individual (officer) who is signing the KYC on behalf of the corporate client.
Approved Documentation: Driver’s License Birth Certificate  Passport  Other (Specify) ______
Document Number: ______2nd Document Number: ______
I/We hereby declare that I/we have provided original documentation to our rep in order to verify my/our identity and the above information is correct.
Are you opening this account on behalf of a third party? Yes  No If yes, complete the Identity and Third Party Determination Form and attach copy of the Power of Attorney, if applicable.
I/we have read and fully understand the “Your Personal Information” section on the reverse and acknowledge and consent to the collection, use, and disclosure of my/our personal information by BridgeForce Financial Group for the purposes identified in therein. Your consent relating to the use of your personal information to provide you with details about other insurance and financial services and products is optional. If you do not wish your personal information to be used for this optional purpose, check here ____ or you can write us at BridgeForce Financial Group,2550 Matheson Blvd. East, Suite 130, Mississauga, ON L4W 4Z1.
3444
Dealer # / Rep # / Rep Print Name / Client Signature / Date
Branch Manager Approval / Date / Rep Signature / Client Signature (Joint) / Date

DEALER COMPENSATION DISCLOSURE STATEMENT

BridgeForce Financial Group is an independent Segregated fund dealer authorized to solicit and place purchase orders for segregated funds sponsored by many different fund organizations. In performing our services on your behalf, we may be eligible to receive compensation from one or more sources. Your sales representative can give you a complete explanation of the compensation he or she will receive if you buy securities of a particular segregated fund.

RESPONSIBILITY

I/we will not hold BridgeForce Financial Group liable for any loss or any failure to obtain any profit which is caused directly or indirectly by government restrictions, exchange or market rulings, suspension of trading, unavailability of any Electronic Service to allow for maintenance, updates or other reasonable cause, wars, strikes or other conditions beyond its control, or any errors or omissions in connection with or in the handling of orders relating to the purchase, sale, execution or expiration of any trades or any related matter, unless BridgeForce Financial Group was grossly negligent. If BridgeForce Financial Group was grossly negligent, I will not hold BridgeForce Financial Group liable for any indirect, special or consequential damages.

If BridgeForce Financial Group acts on verbal or electronic instructions from me then I agree to indemnify BridgeForce Financial Group for any loss, liability or expense including legal costs which may arise as a result of BridgeForce Financial Group compliance with such instructions.

BridgeForce Financial Group hereby guarantees repayment of any monetary loss that is incurred by the applicant as the result of a sale of segregated funds shares or units contemplated by this client application form, provided such loss is directly attributable to fraud, theft or negligence on the part of BridgeForce Financial Group or an employee thereof.

“YOUR PERSONAL INFORMATION”

BridgeForce Financial Group is committed to protecting the privacy of all client personal information that is being collected, used and disclosed in the course of carrying out business with you. Upon receipt of this application, BridgeForce Financial Group will establish a file in which will be placed personal information about you concerning (a) this application, (b) any other form, application, authorization, trade ticket or other document you complete in relation to this application or to your investment account with us, and (c) other documents or information relating to the servicing and administration of this application or your investment account with us. We collect personal information about you from this application and any supplementary forms, and from our advisors, agents and representatives. We collect and use your personal information for the purposes of assessing and implementing your investment objectives and instructions, providing you with investment advice, servicing and administering this application and your investment account with us, and for such other purposes as are outlined in this application. Your information may be disclosed to your dealer representative for the purposes identified above. Your Social Insurance Number will be used for income reporting purposes. Your banking information will be disclosed to the financial institution(s) processing your investment deposits and withdrawals. You represent and warrant that you are authorized to provide the personal information of a referring third party as requested in this application.

From time to time BridgeForce Financial Group may use your personal information to determine which other financial or insurance products and services may meet your needs and to offer them to you. Your consent for this use of your personal information is optional. If you do not wish your personal information to be used for this optional purpose, please make the appropriate selection on the front of this form.

Employees or authorized representatives of BridgeForce Financial Group who will be responsible for functions relevant to the purposes identified above, and other persons authorized by you or by law, will have access to the personal information contained in your file. Subject to exceptions set out in applicable legislation, you may access your file and request corrections to your personal information by sending a written request to BridgeForce Financial Group, Attn: Privacy Officer, 2550 Matheson Blvd. East, Mississauga, ON L4W 4Z1.

By completing and signing this application, you acknowledge and agree that you have provided personal and financial information that is true and accurate and you consent to the collection, use and disclosure of your personal information as described herein or at the time of collection, and as required or permitted by law.

CLIENT COMPLAINT INFORMATION

Clients of a segregated fund dealer who are not satisfied with a financial product or service have a right to make a complaint and to seek resolution of the problem. If you have a complaint, these are some of the steps you can take.

Your complaint should first be explained to your financial advisor. The person who sold you the product or service will solve most problems quickly.

Contact your segregated fund dealer.

Some problems are easily solved by a phone call. Some matters can be resolved through the Branch Manager.The dealer’s Compliance Department will investigate any complaint that you initiate in writing and respond back to you with the results of their investigation.