Ontario Securities Commission Bulletin

Issue 44/05s1 - February 04, 2021

Ont. Sec. Bull. Issue 44/05s1

Table of Contents

CSA Notice and Request for Comment Proposed Amendments to National Instrument 33-109 Registration Information and Changes to Companion Policy 33-109CP Registration Information and Related Amendments to National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations and Changes to Companion Policy 31-103CP Registration Requirements, Exemptions and Ongoing Registrant Obligations Modernizing Registration Information Requirements, Clarifying Outside Activity Reporting & Updating Filing Deadlines

Annex A -- Proposed Amendments to NI 33-109

Annex B -- Blackline Showing Proposed Changes to NI 33-109

Annex C -- Proposed Changes to 33-109CP

Annex D -- Blackline Showing Proposed Changes to 33-109CP

Annex E -- Proposed Amendments to NI 31-103

Annex F -- Proposed Changes to 31-103CP

Annex G -- Local Matters

Schedule 1

Schedule 2

Schedule 3

Schedule 4

Schedule 5

 

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CSA Notice and Request for Comment Proposed Amendments to National Instrument 33-109 Registration Information and Changes to Companion Policy 33-109CP Registration Information and Related Amendments to National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations and Changes to Companion Policy 31-103CP Registration Requirements, Exemptions and Ongoing Registrant Obligations Modernizing Registration Information Requirements, Clarifying Outside Activity Reporting & Updating Filing Deadlines

CSA Notice and Request for Comment Proposed Amendments to National Instrument 33-109 Registration Information and Changes to Companion Policy 33-109CP Registration Information and Related Amendments to National Instrument 31-103Registration Requirements, Exemptions and Ongoing Registrant Obligations and Changes to Companion Policy 31-103CPRegistration Requirements, Exemptions and Ongoing Registrant Obligations Modernizing Registration Information Requirements, Clarifying Outside Activity Reporting & Updating Filing Deadlines

February 4, 2021

Executive Summary

The Canadian Securities Administrators (the CSA or we) uses registration information to assess whether an individual or firm is or remains suitable for registration, with regards to their proficiency, integrity and solvency. While registered firms are responsible for the oversight of their registered individuals and permitted individuals{1} (collectively,Individual Registrants), registration is an important gatekeeper requirement in securities legislation.{2} Investor harm may arise if individuals and entities are inappropriately registered and carry on securities business. In this regard, we require accurate, complete and timely registration information to effectively carry out our regulatory functions.

We are proposing targeted changes to registration information requirements to provide greater clarity on the information to be submitted, to help individuals and firms (collectively, Regulated Persons) provide complete and accurate registration information, and to reduce the regulatory burden of doing so, while allowing the CSA to receive the information necessary to carry out its regulatory roles. These proposed targeted changes address issues identified by CSA staff and respond to concerns raised by Regulated Persons.

The targeted changes proposed by the CSA include the following:

• Establishing a new reporting framework for reporting activities carried on by Individual Registrants outside of their sponsoring firms (Outside Activities previously referred to as "outside business activities"),

• Implementing a new rule that will replace the existing practice of imposing terms and conditions which restrict the client base of Individual Registrants whose Outside Activities are positions of influence (referred to as "restricted client terms and conditions"){3},

• Extending the deadline to report changes in registration information,

• Modifying or clarifying certain registration information requirements to adjust the burden of collection with the intended purpose of collecting that information, such as reporting changes to percentage ownership in ownership charts, reporting a change in the annual expiry date of insurance policies, and reporting changes in litigation status,

• Implementing a new rule to reduce multiple filings of the same information by corporate groups by allowing registered firms to delegate to an affiliated registered firm the requirement to notify the regulator of changes in certain registration information where the reporting and filing firms have the same principal regulator,

• Amending certain registration information requirements to provide greater clarity on the information asked for and reduce common errors, such as making clear that the following registration information is required to be disclosed:

• allegations of non-compliance with standards of conduct, such as a firm's policies and procedures, that existed at the time of resignation or termination from the firm (whether or not they were the reason for the resignation or termination),

• non-compliance with securities laws, SRO rules or bylaws, or standards of conduct (e.g., the sponsoring firm's policies and procedures or the standards of conduct of an authority exercising jurisdiction over specific business activities or professions), and other detrimental information that existed at the time of resignation or termination (whether or not they were the reason for registration or termination),

• criminal offences under any foreign law,

• bankruptcy, consumer proposals and other insolvency events, regardless of how long ago they occurred, and

• all non-securities licenses, including medical licenses,

• Clarifying that Form 33-109F7 Reinstatement of Registered Individuals and Permitted Individuals (Reinstatement Form) may only be used if, among other requirements, the individual's registration information was up-to-date at the time the individual previously ceased to be registered or to be a permitted individual,

• Clarifying when certain forms should be used, such as which forms a permitted individual may be required to submit, to reduce the number of forms returned,

• Consolidating where information is provided on relevant securities experience in the forms and clarifying that only education and course information required for registration needs to be disclosed,

• Moving the certification to the front of each form and creating a single certification standard to underscore and clarify the standard of care expected of Regulated Persons when completing the forms,

• Updating and improving the readability of the privacy notice to provide greater clarity on how personal information is collected and used by the CSA and self-regulatory organizations (SROs), and

• Implementing a new requirement to collect the professional titles used by Individual Registrants.

The proposed targeted changes are not intended to change the nature of the registration process, the requirement to register or the assessment of suitability for registration.

At this time, we are not proposing new forms or enabling Form 33-109F6 Firm Registration (Firm Registration Form) to be submitted in the National Registration Database{4} (NRD). Any amendments to the registration information requirements will require changes to the NRD and NRD is currently anticipated to be replaced by SEDAR+{5} in 2023. The proposed targeted changes are intended to provide the most benefit to Regulated Persons and regulators, given the costs to make changes in NRD and considering that NRD will eventually be replaced by SEDAR+.

To seek feedback on these proposed targeted changes, we are publishing, for a 90-day comment period:

• Proposed amendments to National Instrument 33-109 Registration Information (NI 33-109), including its related forms (the Registration Forms), and changes to Companion Policy 33-109CP Registration Information (33-109CP), and

• Related proposed amendments to National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations (NI 31-103) and changes to Companion Policy 31-103CP Registration Requirements, Exemptions and Ongoing Registrant Obligations (31-103CP).

We refer to the proposed amendments to NI 33-109 and NI 31-103 and changes to 33-109CP and 31-103CP collectively as the Proposed Revisions.

Background

A Regulated Person submits registration information to regulators and is required to keep this information up-to-date. There are seven Registration Forms, the primary forms being Form 33-109F4 Registration of Individuals and Review of Permitted Individuals (Individual Registration Form) and the Firm Registration Form. The registration information collected includes, among other things, criminal history, financial information (such as consumer proposals, bankruptcy and other insolvency events), and lawsuits. For an individual, it also includes information about the individual's education and work experience, and their Outside Activities.

Based on this information, we consider whether a Regulated Person is able to carry out their obligations under securities legislation. High standards of fitness and business conduct, as well as a demonstrated commitment to compliance with securities laws must be met to be registered. If individuals and entities are inappropriately registered and carry on securities business, investor harm may arise. In this regard, registration protects investors from unfair, improper or fraudulent practices and fosters fair and efficient capital markets and confidence in capital markets.

The submission of registration information represents an important touchpoint between regulators and Regulated Persons. The number of registration information filings submitted in Canada in the calendar year 2019 was more than 180,000.

Areas of concern and Proposed Revisions

The Proposed Revisions may be grouped into several areas and below we discuss each area and the changes we propose to make.

(i) Outside Activities and positions of influence

Individual Registrants are currently required to disclose "any employment and business activities outside the sponsoring firm", all director and officer and other equivalent positions, and all positions of influence. The high volume of submissions we receive for these types of filings reflects the broad scope of these requirements. Over the last three years, Individual Registrants submitted on average 58,896 filings annually to us pertaining to updates on Outside Activities.

CSA staff have commonly found instances where Regulated Persons have failed to disclose, or were late in disclosing, Outside Activities. These findings raise concerns that registered firms may not be aware of and are not able to address, or address in a timely manner, the risks and conflicts from their Individual Registrants' Outside Activities.

We understand that Regulated Persons may sometimes struggle to comply with reporting Outside Activities to us. Regulated Persons have raised the following concerns to us about reporting on Outside Activities:

• Some Regulated Persons are of the view that the requirement is broad and unclear. It requires the disclosure of "any employment and business activities outside the sponsoring firm", but this information must be provided, whether or not any such position is business-related.

• Registered firms do not find the 10-day deadline to be a sufficient amount of time for an Individual Registrant to report an Outside Activity to the firm and for the firm to review and assess if the firm should approve the Outside Activity and whether the Outside Activity is reportable.

• The disclosure requirement captures some Outside Activities that, in their view, do not raise conflicts of interest or provide information relevant to regulators to assess suitability for registration.

Regulated Persons have indicated that they would like a clearer, more consistent, and principles-based approach to reporting Outside Activities among the CSA and SROs.

In addition, restricted client terms and conditions are imposed on registrations of individuals who are in a position of influence (e.g., clergy, doctor, nurse, caregiver, professor) on a case-by-case basis when they are reported to us. These terms and conditions restrict the client base of a person who is in a position of influence (i.e., the registered individual may not deal with or advise investors who are subject to their influence). These restricted client terms and conditions are imposed to protect investors and are necessary for the sponsoring firm to adequately supervise the Outside Activity. However, Regulated Persons have raised the concern that it is unclear which Outside Activities are positions of influence, as "position of influence" is not defined. As of October 8, 2019, 354 registered individuals' registrations had restricted client terms and conditions.

Each CSA jurisdiction has communicated their concerns with Regulated Persons' compliance with reporting Outside Activities. Additionally, CSA Staff Notice 31-326 Outside Business Activities was published in July 2011 and subsequently incorporated into 31-103CP to provide additional guidance on Outside Activities.

Proposed revisions

Concerns

Proposed Revisions to Address Concerns

 

Regulated Persons have difficulty understanding what Outside Activities must be reported to regulators.

Establish 6 categories of Outside Activities that are reportable to us:

 

1.

Activities with another registered firm

 

2.

Activities with an entity that receives compensation from another registered firm for the Regulated Person's registrable activity

 

3.

Other securities related activities

 

4.

Provision of financial or financial-related services

 

5.

Positions of influence

 

6.

Specified activities

 

by amending Item 10 of the Individual Registration Form and Item 7 of the Reinstatement Form.

 

Regulated Persons would like a clearer, more consistent and principles-based approach to reporting Outside Activities to CSA and SROs.

Add guidance on the categories of Reportable Outside Activities in 33-109CP.

 

Regulated Persons are of the view that certain Outside Activities do not raise conflicts of interest or provide information relevant to regulators in assessing suitability for registration.

Update guidance on our expectations relating to registered firms' oversight of their Individual Registrants' Outside Activities in 31-103CP.

 

Regulated Persons find "outside business activities" to be unclear.

Refer to activities outside the sponsoring firm as "outside activities".

 

The deadline to report new Outside Activities and changes in Outside Activities is insufficient.

Extend the deadline for reporting new Outside Activities or changes in Outside Activities to 30 days by amending subsection 4.1(1) of NI 33-109.

 

It is unclear what Outside Activities are positions of influence.

Introduce in subsection 13.4.3(1) of NI 31-103, a definition of positions of influence.

 

Provide guidance on positions of influence in 31-103CP.

 

Restrictions on the client base of a registered individual who is in a position of influence are imposed on a case-by-case basis by applying restricted client terms and conditions.

Introduce in subsections 13.4.3(3) and (4) of NI 31-103, a new rule that codifies the restriction of the client base of a registered individual who is in a position of influence.

Registered firms have and will continue to have the primary responsibility for the oversight of their Individual Registrants. This includes addressing the risks of their Individual Registrants' Outside Activities (including where the individual is in a position of influence) and the conflicts of interest that may arise. We propose updating 31-103CP to provide more guidance on our expectations relating to Regulated Persons' obligations to supervise and monitor their Individual Registrants' Outside Activities.

We acknowledge that many Regulated Persons find the obligation to report Outside Activities to be broad and that it creates a regulatory burden. The proposed framework for the reporting of Outside Activities is intended to narrow the Outside Activities that are reportable to us and provide clarity on the requirements. At the same time, we will continue to receive information about Outside Activities that we consider relevant for assessing suitability for registration and to provide compliance oversight of Regulated Persons using a risk-based approach.

The introduction of reportable categories of Outside Activities might require Regulated Persons to make changes to certain policies and procedures. Our intention is to provide greater clarity to Regulated Persons in this area and we expect these changes will result in a reduction of Outside Activities reported to us.

Under the Proposed Revisions, only specific Outside Activities will be reportable to us. Some Outside Activities are reportable to us whenever they are undertaken (such as activities that involve securities, financial services or positions of influence). Other Outside Activities are generally only reportable to us if the total amount of time spent by the individual on all Outside Activities (including activities that involve securities, financial and financial-related services or positions of influence) exceeds a cumulative minimum time threshold.

Uncompensated activities, such as volunteer or community work, that do not involve securities or financial services or are not a position of influence would no longer be reportable to us. In addition, some employment or business activities, such as involvement with non-active entities (e.g., personal holding companies) or acting as a landlord, may no longer be reportable if in combination with all other Outside Activities, those activities do not exceed the cumulative minimum time threshold.

The proposed new rule on positions of influence codifies the existing case-by-case practice, which is to impose restricted client terms and conditions on individuals' registrations. We also propose guidance on what a position of influence is. This new rule and guidance allow registered firms to continue to manage their Individual Registrants' Outside Activities. We expect the new rule and guidance will also provide transparency and consistency relating to the treatment of Outside Activities that are positions of influence.

Questions for comment

1. Are there other categories of Outside Activities that should be reportable to regulators? If so, please describe what categories of Outside Activities should be reportable to regulators.

2. Considering the proposed framework for reporting of Outside Activities, are there categories of Outside Activities that should not be reportable to regulators? If so, please describe what categories of Outside Activities should not be reportable to regulators.

3. Are there any challenges that Regulated Persons may face to administer the proposed reporting regime for Outside Activities? If so, please explain the challenges.

4. Is 7 years an appropriate amount of time to report on past Outside Activities that involved raising money for an entity through the issuance of securities or derivatives or promoting the sale of an entity's securities or derivatives? Please explain your view.

5. Is 30 hours per month (based upon 7.5 hours per week for four weeks) an appropriate cumulative minimum time threshold for reporting all Outside Activities? Please explain your view.

6. Will Regulated Persons have sufficient time to report Outside Activities given the Proposed Revisions? If not, please explain the challenge in reporting Outside Activities within the proposed revised deadline.

7. Are there other positions that should be considered positions of influence? If so, please describe these positions and explain why they should be positions of influence.

8. Is "susceptibility" the appropriate term to describe the impact of the influence on the individual subject to the influence? If not, please explain why not and propose alternative language.

9. Are there any aspects of the new rule on positions of influence that you expect will be difficult to administer? If so, please describe the difficulty.

(ii) Reporting deadlines

Regulated Persons are generally required to inform regulators of changes to registration information previously provided in the Individual Registration Form and in the Firm Registration Form within 10 calendar days of the change. The exceptions are changes to citizenship and previous employment information in the Individual Registration Form and changes to business history in the Firm Registration Form, which may be reported within 30 calendar days.

Many firms have a strong desire to meet filing requirements and make use of compliance and registration staff and in-house legal counsel to meet reporting deadline requirements. Regulated Persons have informed us that providing changes in a majority of areas within 10 days is challenging, especially for larger firms with numerous Individual Registrants. If multiple changes occur within a short timeframe, Regulated Persons may be required to file multiple notices of change.

Proposed revisions

Concern

Proposed Revisions to Address Concern

 

Regulated Persons find reporting changes in certain registration information within 10 days challenging.

Extend the reporting deadlines from 10 days to 15 days by amending Parts 3 and 4 of NI 33-109.

 

Extend the reporting deadline from 10 days to 30 days for changes in the following information:

 

An Individual Registrant's current and previous residential address;

 

An Individual Registrant's mailing address;

 

Outside Activities;

 

A registered firm's securities registration;

 

A registered firm's auditor;

 

Whether and where a registered firm holds client assets; and

 

A registered firm's conflicts of interest

 

by amending Parts 3 and 4 of NI 33-109.

Generally, we have maintained two reporting deadlines for changes in registration information. Multiple reporting deadlines will increase complexity. We are concerned that any additional deadlines would increase the potential for a Regulated Person to identify the wrong deadline and fail to report on a timely basis. Similarly, we are concerned that longer reporting deadlines may result in more late filings, and late filings being filed even later.

We will require forms relating to a change in an individual's status, such as becoming a permitted individual or ceasing to be a registered individual or a permitted individual, to be submitted within 10 days of the change in registration status.

Questions for comment

10. Do you see any challenges in reporting updates to registration information by the proposed deadlines? If so, please identify the registration information that this would be challenging for and explain the challenges.

(iii) Regulatory burden of certain reporting requirements

We have heard from stakeholders that some specific registration information requirements may create a disproportionate reporting burden relative to their original purpose. For example, a registered firm is required to provide a chart showing the registered firm's structure and ownership, including the percentage ownership of the registered firm's voting securities, and to report changes in this ownership chart. We receive numerous filings reporting small changes to percentage ownership. Many of these small changes in percentage ownership are not material.

In addition, where multiple entities of a corporate group are registered, each registered firm often notifies the regulator of the same changes to the ownership chart. We have identified other areas where affiliated registered firms often submit the same information.

Reporting the expiry date of an insurance policy is another example. Since insurance policies are generally renewed annually, registered firms are required to report this change annually, even if there has otherwise been no change in the insurance policy.

In other cases, additional guidance is required to help Regulated Persons provide the necessary information. For example, currently registered firms are required to disclose outstanding litigation, including the "current state" of the litigation. We routinely receive non-material updates (e.g., adjournments) from registered firms striving to comply with this requirement.

We have reviewed these and other similar areas, and have considered whether the requirements may be amended or clarified to reduce regulatory burden without impacting our receipt of information necessary to carry out our regulatory role.

Proposed revisions

Concerns

Proposed Revisions to Address Concerns

 

Regulators receive numerous filings of small changes in percentage ownership.

Reduce the requirement for reporting changes in percentage ownership on an ownership chart to when the percentage ownership exceeds or falls below 10%, 20%, or 50% by adding paragraph 3.1(3)(f) of NI 33-109.

 

Affiliated registered firms of a corporate group notify the regulator of the same changes in certain registration information.

Provide a mechanism for a registered firm to delegate to another registered firm the requirement to notify the regulator of changes in certain registration information by adding subsection 3.1(2.1) of NI 33-109.

 

It is burdensome to annually report the renewal of an insurance policy.

Remove the requirement to report a change in the expiry date of a registered firm's insurance policy where the insurance policy has not lapsed and there have been no other changes to the insurance policy by adding subsection 3.1(3)(e) of NI 33-109.

 

It is unclear what information on change in status of a litigation is required.

Provide additional guidance on changes in litigation to be reported in 33-109CP.

 

Of the Registration Forms, only the Firm Registration Form is required to be witnessed by a notary or lawyer.

Remove the requirement that the Firm Registration Form be witnessed.

We believe these Proposed Revisions will reduce the burden on Regulated Persons, without impacting regulators' ability to oversee Regulated Persons.

Reporting changes in ownership charts is a high-volume area. We expect that reporting changes in percentage ownership only where a person or company's percentage of ownership crosses certain thresholds will reduce the number of filings, while providing regulators with relevant information about the ownership of the registered firm.

Providing a mechanism for one authorized affiliate to notify the regulator of changes in certain registration information for itself and its affiliates who have the same principal regulator is intended to reduce the burden of multiple filings of the same information by different registered affiliated entities.

As many insurance policies are renewed annually, we have removed the requirement to report a change in the expiry date of a registered firm's insurance policy when the policy is merely renewed. This should reduce the burden where there is otherwise no change to the insurance policy. We continue to expect registered firms to report where there are changes to the insurance policy or coverage (other than its expiry date) and when the insurance policy has lapsed.

Questions for comment

11. Are there any other thresholds where a change in percentage ownership in the ownership chart should be reported or any thresholds where changes should not be reported? If so, please explain what other thresholds should be included or what thresholds should not be reported.

12. Do you see any legal, operational or other challenges for a registered firm to delegate to another affiliated registered firm the requirement to notify the regulator of changes in certain registration information? If so, please explain the challenges.

13. Are there circumstances where a notice of change in registration information should not be delegated to an affiliate? Please describe.

14. Are there other circumstances where a notice of change in registration information may be delegated to an affiliate? Please describe.

15. In a legal action, are there changes other than documentary disclosures and adjournments that could significantly affect the firm, its business or the outcome of the legal action but should not be reported for other reasons or would be captured in reporting elsewhere?

(iv) Common errors and updated certification requirements

Each Registration Form requires an attestation from the Regulated Person who is completing and submitting the form that the information provided to regulators is true and complete. However, we consistently receive Registration Forms which are incomplete and inaccurate.

Incomplete or inaccurate information, or even information that is not provided in a clear manner, increases the regulatory burden on Regulated Persons as they must spend additional time and resources to respond to our inquiries. At the same time, it hinders our ability to reach prompt and appropriate determinations on suitability for registration. CSA staff spend time and resources to resolve these issues including to determine whether inaccurate or incomplete information arises because

• the registration information requirement is unclear,

• despite the certification requirement, the Regulated Person is not carefully completing the Registration Forms,

• the Regulated Person does not understand the registration information requirements,

• the sponsoring firm, who is required to have discussed the Registration Form with the Individual Registrants, is not providing adequate support, and/or

• the Regulated Person is not being forthright.

Certain areas of the Individual Registration Form are also more likely to be filled out incorrectly.

For example, the following information has not always been disclosed:

• allegations of non-compliance with standards of conduct, such as a firm's policies and procedures, that existed at the time of resignation or termination from the firm (whether or not they were the reason for resignation or termination);

• non-compliance with securities laws, SRO rules or bylaws, or standards of conduct (e.g., the sponsoring firm's policies and the standards of conduct of an authority exercising jurisdiction over specific business activities or professions), and other detrimental information that existed at the time of resignation or termination (regardless of whether they were the reason for resignation or termination);

• criminal offences under foreign laws; and

• past consumer proposals, bankruptcy and other insolvency events, particularly where they are over seven years old, despite the registration information requirements not having a time limit.

In addition, we do not always receive sufficiently detailed information on an individual's securities experience relevant to the registration category.

The CSA routinely communicates with Regulated Persons on ways to facilitate and expedite registration applications, as well as on the errors in registration information that has been provided. These communications include publishing guidance that describe common deficiencies from applications and from updates provided on changes to registration information, and holding in-person meetings with compliance staff at registered firms.

The CSA also published CSA Staff Notice 33-320 The Requirement for True and Complete Applications for Registration in July 2017 to alert stakeholders to the serious problem of false or misleading applications for registration, to caution them about the potential consequences of submitting such applications, and to provide guidance regarding the completion of the Registration Forms.

Proposed revisions

Concern

Proposed Revision to Address Concern

 

There are issues which arise from inaccurate and incomplete information.

Clarify that the following registration information is required to be disclosed in the Individual Registration Form:

 

allegations of non-compliance with standards of conduct, such as a firm's policies and procedures, that existed at the time of resignation or termination, whether or not they were the reason for resignation or termination, by amending Item 12;

 

non-compliance with securities laws, SRO rules or bylaws, or standards of conduct (e.g., the sponsoring firm's policies and procedures or the standards of conduct of an authority exercising jurisdiction over specific business activities or professions), and other detrimental information that existed at the time of resignation or termination, whether or not they were the reason for resignation or termination, by amending Item 12;

 

criminal offences under any foreign law by amending Item 14;

 

bankruptcy, consumer proposals and other insolvency events, regardless of how long ago they occurred, by amending Item 16; and

 

all non-securities licenses, including medical licenses, by amending Item 13(3)(a).

 

Clarify that, among other requirements, if an Individual Registrant's registration information was up-to-date at the time the Individual Registrant previously ceased to be registered or to be a permitted individual, the Individual Registrant may request a reinstatement using the Reinstatement Form (rather than submitting a new Individual Registration Form) by amending section 2.3 of NI 33-109.

 

Clarify that only education and course information required for registration should be disclosed (and not all education and courses obtained) by amending Item 8(1) of the Individual Registration Form.

 

Clarify that individuals submitting applications to be a permitted individual must select all jurisdictions that the firm is registered or seeking registration in (and not just the jurisdiction where the individual resides) by amending Item 5(2) of the Individual Registration Form and Item 2(2) of the Reinstatement Form.

 

Clarify which Registration Forms a permitted individual is required to submit (e.g., when removing a subcategory of permitted individual, when ceasing to be a permitted individual) by amending section 4.1 of NI 33-109.

 

Clarify that a registered firm is to submit an executed Schedule B whenever there is a change in either the agent for service or the address for the agent for service by amending subsection 3.1(4) of NI 33-109.

 

Amend the Registration Forms for appropriate and consistent use of "firm", "sponsoring firm", and "entity".

 

Regulators received incomplete registration information.

Clarify that "termination" does not mean only when an individual is "fired" but rather when the individual ceases to be a registered individual or permitted individual for their sponsoring firm by replacing "termination" and "terminate" with "cessation" and "cease" in the Registration Forms where appropriate.

 

Consolidate where information is provided on relevant securities experience to Item 8 and Schedule F of the Individual Registration Form and add guidance on the details required in 33-109CP.

 

Regulated Persons may need to be reminded of their obligations to provide accurate and complete information prior to completing the form.

Move the certification to the front of each Registration Form.

 

Create a single certification standard that requires Regulated Persons to certify that the information provided is: "true and complete to the best of their knowledge, after reasonable inquiry" in each Registration Form.

 

Make formatting changes to improve the readability of the certification.

The amendments to the registration information requirements are intended to enhance the clarity of the registration information sought, which may:

• Help firms and applicants complete the Registration Forms more efficiently, and

• Reduce the number of inaccurate and incomplete forms received by regulators and reduce the additional time required by Regulated Persons and regulators to resolve these issues.

We expect that creating a single certification standard will provide clarity and consistency on regulatory expectations concerning the submission of information and the amount of diligence required by Regulated Persons.

Questions for comment

16. Do the Proposed Revisions offer sufficient clarity to the registration information requirements? If not, please explain which registration information requirement remains unclear and why.

17. Are there any circumstances where the certification standard may not be met or be applicable? If so, please describe the circumstances.

(v) Privacy notice and consent

Personal information is collected by the CSA to administer and enforce securities laws, and by the SROs to administer and enforce the rules of the SROs. This includes using the information collected to assess a Regulated Person's suitability for registration. As regulatory organizations, we are required to abide by the provisions of applicable privacy and securities laws in the collection, use and disclosure of personal information. The privacy notices we rely on to meet these obligations should be reviewed and updated to reflect our data practices and meet the latest requirements provided by law.

Proposed revisions

Concerns

Proposed Revisions to Address Concerns

 

Privacy notices should be routinely reviewed and updated and should be easy to understand.

Update the notice of use and collection of personal information in each of the Registration Forms and improve readability.

We have updated the privacy notice and made it clearer to read so that Regulated Persons can easily understand what personal information is being collected, why it is being collected, and when and how it is being collected. For example, we collect personal information at any time, not just at application, but periodically throughout the time the person is registered and at termination or resignation. Personal information may also be collected from a variety of sources. For example, when conducting background checks for the initial application, we may review social media and request information from previous employers.

(vi) Collecting information on professional titles

Professional titles are often used to convey the functions of the person providing the service. Currently, the Individual Registration Form requires Individual Registrants to disclose the name and title of their immediate supervisor, but not the Individual Registrant's own titles at their sponsoring firm.

Without information about the titles used by Individuals Registrants, regulators have incomplete information on what titles are being used, the services being provided under those titles, and whether the titles properly reflect the Individual Registrant's ability and registration categories.

In addition, from reviews of applications, we have identified individuals who are not yet registered and who are using titles in social media, and in some cases, on the sponsoring firm's website, that imply that they are registered, or are registered in a specific category, when they are not.

Proposed revisions

Concern

Proposed Revision to Address Concern

 

CSA does not have information on the professional title(s) Individual Registrants use.

Amend Schedule G of the Individual Registration Form and Schedule D of the Reinstatement Form to collect the title(s) Individual Registrants use.

We expect Individual Registrants to know the professional title(s) that they use or will be using. We do not anticipate the disclosure of this information to be a material burden for Individual Registrants. Receiving this information will enhance the regulator's ability to effectively carry out its mandate.

Questions for comment

18. Do you see any challenges in reporting the title(s) used by Individual Registrants? If so, please explain.

Proposed Transition

Subject to the nature of comments we receive and the time to make the changes to NRD, as well as any applicable regulatory requirements (including Ministerial approval), we are proposing that if approved, the proposed amendments to NI 33-109 and to NI 31-103 are expected to come into force at the end of 2021 (the Proposed Effective Date).

Where after the Proposed Effective Date there is a change to the registration information that was previously reported, we expect Regulated Persons will update the registration information for that change and will review and update any other registration information that is not complete or accurate in light of the Proposed Revisions.

With respect to the proposed amendments to NI 31-103 relating to positions of influence, we anticipate that there will be a six-month transition period for registered firms. Firms will need to identify registered individuals holding positions of influence that have not previously been reported and to implement policies and procedures where they do not have such policies and procedures in place. Any existing registered individual who holds a position of influence but is not already subject to restricted client terms and conditions will be able to use the transition period to transfer their affected clients to another registered individual.

For any existing registered individual who is subject to restricted client terms and conditions relating to a position of influence, regulators will lift those restricted client terms and conditions on the date that the 6-month transition period elapses so that only the restriction relating to positions of influence applicable to all registered firms and registered individuals under NI 31-103 will apply.

Questions for comment:

19. Registered firms are required to keep accurate records, including copies of forms submitted to the regulators. Are there any circumstances where an Individual Registrant will need to request a copy of their Individual Registration Form from the regulator to update information that is not complete or accurate? If so, please describe these circumstances.

20. What are your views on the transition plan for the proposed amendments to NI 31-103 relating to positions of influence?

21. Are there any significant operational changes that you need to make in order to implement the Proposed Revisions? If so, please describe these operational changes.

Stakeholder feedback

The CSA worked together with both staff of the Investment Industry Regulatory Organization of Canada (IIROC) and the Mutual Fund Dealers Association (MFDA) to develop the Proposed Revisions. We encourage all Regulated Persons, including IIROC and MFDA members, to provide their comments on the Proposed Revisions. At a later date, the SROs may propose conforming amendments, where necessary, to SRO rules consistent with the Proposed Revisions.

Additionally, the Proposed Revisions have been developed with input from the following:

Industry stakeholders

Comments and complaints relating to NI 33-109 and the Registration Forms from Regulated Persons received by CSA staff. For example, we considered comments received by staff of the Ontario Securities Commission (OSC) from the OSC's consultations with industry stakeholders on reducing regulatory burden in Ontario's capital markets and improving the investor experience, including roundtable discussions and comment letters received in response to OSC Staff Notice 11-784 Burden Reduction.

 

Consultations through CSA advisory committees and with industry groups.

 

Findings from compliance reviews

In its Annual Compliance Report Card -- 2018, staff of the British Columbia Securities Commission published findings from their review of whether firms met their requirement to update information about the firm and its Individual Registrants in the National Registration Database.

 

In September 2020, OSC staff reported on their findings from focused compliance reviews of seven registered firms across various dealer and adviser registration categories to assess their supervision of their Individual Registrants' Outside Activities. This included their supervision of any restricted client terms and conditions imposed on a registered individual's registration due to an Outside Activity that is a position of influence.

 

Regulators

Feedback from CSA staff including, among others, staff involved in day-to-day registrations and registrant conduct matters.

 

Past guidance issued by CSA staff on registration information requirements.

 

Subject matter experts

Consultations with a behavioural analyst on the structure and format of the Registration Forms.

 

Feedback from communications experts on the language used.

Contents of the notice

This notice contains the following annexes:

• Annex A -- Proposed amendments to NI 33-109

• Annex B -- Blackline showing proposed changes to NI 33-109

• Annex C -- Proposed changes to 33-109CP

• Annex D -- Blackline showing proposed changes to 33-109CP

• Annex E -- Proposed amendments to NI 31-103

• Annex F -- Proposed changes to 31-103CP

• Annex G -- Local matters

Annex G includes, where applicable, additional information that is relevant in a local jurisdiction only.

This notice will also be available on the following websites of CSA jurisdictions:

www.lautorite.qc.ca
www.albertasecurities.com
www.bcsc.bc.ca
www.fcnb.ca
nssc.novascotia.ca
www.osc.gov.on.ca
www.fcaa.gov.sk.ca
www.mbsecurities.ca

Request for Comments

We welcome your comments on the Proposed Revisions and the implementation plan, including the questions posed in the Notice.

Please submit your comments online using this [link] or in writing on or before May 5, 2021.

Address your submission to all of the CSA as follows:

• Alberta Securities Commission

• Autorité des marchés financiers

• British Columbia Securities Commission

• Manitoba Securities Commission

• Financial and Consumer Services Commission (New Brunswick)

• Nova Scotia Securities Commission

• Ontario Securities Commission

• Registrar of Securities, Northwest Territories

• Registrar of Securities, Yukon Territory

• Financial and Consumer Affairs Authority of Saskatchewan

• Securities Commission of Newfoundland and Labrador

• Superintendent of Securities, Department of Justice and Public Safety, Prince Edward Island

• Superintendent of Securities, Nunavut

If you are submitting your comments in writing, deliver your written comments only to the addresses below. Your comments will be distributed to the other participating CSA members. If you are not sending your comments by email, send a CD containing the submissions (in Microsoft Word format).

The Secretary
Me Philippe Lebel
Ontario Securities Commission
Corporate Secretary and Executive Director, Legal Affairs
20 Queen Street West, 22nd Floor
Autorité des marchés financiers
Toronto, Ontario M5H 3S8
Place de la Cité, tour Cominar
Fax: 416-593-2318
2640, boulevard Laurier, bureau 400
comments@osc.gov.on.ca
Québec (Québec) G1V 5C1
Fax: 514-864-8381
consultation-en-cours@lautorite.qc.ca

We cannot keep submissions confidential because securities legislation in certain provinces requires publication of the written comments received during the comment period. All comments received will be posted on the websites of each of the Alberta Securities Commission at www.albertasecurities.com, the Autorité des marchés financiers at www.lautorite.qc.ca and the Ontario Securities Commission at www.osc.gov.on.ca. Therefore, you should not include personal information directly in comments to be published. It is important that you state on whose behalf you are making the submission.

Questions

Please refer your questions to any of the following:

Alberta Securities Commission
 
Patricia Quinton-Campbell
Charmaine Coutinho
Team Lead, Registration
Legal Counsel
403.355.3899
403.592.4898
<<Patricia.Quinton-Campbell@asc.ca>>
<<Charmaine.Coutinho@asc.ca>>
 
Autorité des marchés financiers
 
Minh-Anh Nguyen
Martin Picard
Analyst
Senior Analyst
514.395.0337, ext. 4803
514.395.0337, ext. 4347
<<Minhanh.nguyen@lautorite.qc.ca>>
<<Martin.picard@lautorite.qc.ca>>
 
British Columbia Securities Commission
 
Anne Hamilton
Kent Waterfield
Senior Legal Counsel
Senior Registration Administrator
604.899.6716
604.899.6694
<<ahamilton@bcsc.bc.ca>>
<<kwaterfield@bcsc.bc.ca>>
 
Financial and Consumer Affairs Authority of Saskatchewan
 
Curtis Brezinski
Compliance Auditor, Capital Markets
Securities Division
306.787.5876
<<Curtis.brezinski@gov.sk.ca>>
 
Financial and Consumer Services Commission (New Brunswick)
 
Clayton Mitchell
Senior Securities Officer, Securities
506.658.5476
<<Clayton.mitchell@fcnb.ca>>
 
Manitoba Securities Commission
 
Sarah Hill
Legal Counsel
204.945.0605
<<Sarah.hill@gov.mb.ca>>
 
Securities NL (Newfoundland and Labrador)
Financial Services Regulation Division
Department of Government Services
 
Raymond Clarke
Registrations and Compliance Officer
709.729.4701
<<raymondclarke@gov.nl.ca>>
 
Ontario Securities Commission
 
Elizabeth King
Colin Yao
Deputy Director, Compliance and Registrant Regulation Branch
Legal Counsel, Compliance and Registrant Regulation Branch
416.204.8951
416.593.8059
<<eking@osc.gov.on.ca>>
<<cyao@osc.gov.on.ca>>
 
Gloria Tsang
Senior Legal Counsel, Compliance and Registrant Regulation Branch
416.593.8263
<<gtsang@osc.gov.on.ca>>

{1} Permitted individuals are reviewed by regulators due to their association with a registered firm but are not registered.

{2} As of September 30, 2020, there were more than 121,000 Individual Registrants and approximately 1,500 registered firms in Canada.

{3} The terms and conditions prohibit the registered individual from advising, or trading for, clients who they know from their position of influence.

{4} Registration information is submitted through NRD, with one exception. The Firm Registration Form and updates to information in the Firm Registration Form are submitted through each of the CSA's local electronic filing systems and not through NRD.

{5} SEDAR+ is the new records filing system that the CSA is currently in the process of developing, which will modernize and centralize existing national systems, including NRD and the various filings currently made in paper format or in each CSA's local electronic filing system.

 

Annex A -- Proposed Amendments to NI 33-109

ANNEX A

PROPOSED AMENDMENTS TO NATIONAL INSTRUMENT 33-109 REGISTRATION INFORMATION

1. National Instrument 33-109 Registration Information is amended by this Instrument.

2. Section 1.1 is amended

(a) in the definition of "cessation date" by deleting ", because of the end of, or a change in, the individual's employment, partnership or agency relationship with the firm", and

(b) by replacing the definition of "Form 33-109F1" with the following:

"Form 33-109F1" means Form 33-109F1 Notice of End of Individual Registration or Permitted Individual Status;.

3. Subsection 2.3(2) is amended

(a) by replacing paragraph (b) with the following:

(b) in the case of the individual resigning or the individual's relationship with the sponsoring firm being terminated, at the time of the resignation or termination there was no allegation against the individual, in Canada or in any foreign jurisdiction, relevant to an assessment whether the individual is not suitable for reinstatement of registration or the proposed reinstatement of registration is objectionable, including, for greater certainty, an allegation of any of the following:

(i) a crime;

(ii) a contravention of any statute, regulation, or order of a court or regulatory body;

(iii) a contravention of any rule or bylaw of an SRO, of an authority exercising jurisdiction over specific business activities or professions, or of a similar organization;

(iv) a failure to meet any standard of conduct of the sponsoring firm, of any industry association, or of any authority exercising jurisdiction over specific business activities or professions;, and

(b) by adding the following paragraph:

(b.1) on or before the cessation date, the individual notified, in accordance with section 4.1, the regulator or, in Québec, the securities regulatory authority of any change to the information previously submitted in the individual's Form 33-109F4;.

4. Subsection 2.5(2) is amended by replacing paragraph (c) with the following:

(c) the conditions described in paragraphs 2.3(2)(b), (b.1) and (c) are met..

5. Section 3.1 is amended

(a) by replacing subsection (1) with the following:

(1) In this section, "authorized affiliate" means, in respect of a registered firm, another registered firm that

(a) is an affiliate of the registered firm,

(b) has the same principal regulator as the registered firm.

(1.1) Subject to subsection (3) or (4), a registered firm must notify the regulator or, in Québec, the securities regulatory authority of a change to any information previously submitted in Form 33-109F6 or under this subsection, as follows:

(a) for a change to information previously submitted in relation to any of the following parts or items of Form 33-109F6, within 30 days of the change:

(i) part 3 [Business history and structure];

(ii) item 4.1 [Securities registration];

(iii) item 5.12 [Auditor];

(iv) item 6.1 [Client assets];

(v) item 6.2 [Conflicts of interest];

(b) for a change to information previously submitted in relation to any other part of Form 33-109F6, within 15 days of the change.,

(b) by adding the following subsection:

(2.1) A registered firm may delegate to an authorized affiliate the duty to notify the regulator or, in Québec, the securities regulatory authority under subsection (1.1) of a change to information previously submitted if all of the following apply:

(a) the change in information relates only to one or more of the following items or parts of Form 33-109F6:

(i) item 3.12 [Ownership chart];

(ii) item 4.1 [Securities registration];

(iii) item 4.3 [Membership of exchange or SRO];

(iv) item 4.5 [Refusal of registration, licensing or membership];

(v) item 4.6 [Registration for other financial products];

(vi) part 7 [Regulatory action];

(vii) part 8 [Legal action];

(b) the registered firm has filed a certificate, executed by the officer or partner authorized to certify and sign Form 33-109F5, with the registered firm's principal regulator, that confirms all of the following:

(i) the registered firm has delegated to the authorized affiliate the duty to notify the regulator, or in Québec, securities regulatory authority of a change to any information set out in paragraph (a), and

(ii) the full legal name and NRD number of the registered firm and the authorized affiliate, and

(iii) the following certification of the registered firm applies to each notice of change submitted by the authorized affiliate:

"I have read this form and understand all matters within this form, including the questions, and to the best of my knowledge and after reasonable inquiry, all of the information provided on this form is true and complete.",

(c) the registered firm directs the authorized affiliate, in each notice of change submitted by the authorized affiliate, to include the full legal name and NRD number of the registered firm and to state the following:

"The registered firm has delegated to the authorized affiliate the duty to notify the regulator, or in Québec, securities regulatory authority of a change to any of the following items or parts of Form 33-109F6:

(i) item 3.12 [Ownership chart];

(ii) item 4.1 [Securities registration];

(iii) item 4.3 [Membership of exchange or SRO];

(iv) item 4.5 [Refusal of registration, licensing or membership];

(v) item 4.6 [Registration for other financial products];

(vi) part 7 [Regulatory action];

(vii) part 8 [Legal action].",

(c) in subsection (3), by replacing "termination" with "cessation" in paragraph (b) and by adding the following paragraphs:

(e) a renewal of an insurance policy referred to in item 5.5 or in item 5.6 of Form 33-109F6, if the insurance policy has not lapsed and the only change is to extend the expiry date of the insurance policy for a period of at least one year;

(f) a change in a person or company's ownership of the firm's voting securities referred to in item 3.12 of Form 33-109F6, if the change did not result in the person or company's percentage of ownership falling below or exceeding 10%, 20% or 50% of the firm's voting securities., and

(d) in subsection (4) by replacing "a completed Schedule B" with "an executed Schedule B", adding "in" before "item 4", and replacing "10" with "15".

6. Section 3.2 is amended by replacing "10" with "15" wherever it appears.

7. Section 4.1 is amended

(a) by replacing subsection (1) with the following:

(1) Subject to subsection (2), a registered individual or permitted individual must notify the regulator or, in Québec, the securities regulatory authority of a change to any information previously submitted in respect of the individual's Form 33-109F4 as follows:

(a) for a change to information previously submitted in any of the following items, within 30 days of the change:

(i) item 2.1 [Current and previous residential address];

(ii) item 2.2 [Mailing address];

(iii) item 4 [Citizenship];

(iv) item 10 [Reportable activities];

(v) item 11 [Previous employment and other activities];

(b) for a change to information previously submitted in any other items of Form 33-109F4, within 15 days of the change.,

(b) by replacing subsection (2) with the following:

(2) A notice of change is not required under subsection (1) if the change only relates to any of the following:

(a) information previously submitted in item 3 [Personal information] of Form 33-109F4;

(b) the individual ceasing to have authority to act on behalf of the sponsoring firm as a registered individual or be a permitted individual of the sponsoring firm if a Form 33-109F1 is required to be submitted by the sponsoring firm under subsection 4.2(1)., and

(c) by replacing paragraph (4)(a) with the following:

(a) a change in a category of permitted activities of a permitted individual,.

8. Section 4.2 is amended by replacing subsection (1) with the following:

(1) A registered firm must notify the regulator if an individual ceases to have authority to act on behalf of the registered firm as a registered individual or be a permitted individual of the registered firm by submitting Form 33-109F1 to the regulator or, in Québec, the securities regulatory authority in accordance with National Instrument 31-102 National Registration Database with

(a) items 1 to 4 of the Form completed, and

(b) item 5 of the Form completed unless the reason for cessation under item 4 was death of the individual..

9. Form 33-109F1 Notice of Termination of Registered Individuals and Permitted Individuals (section 4.2) is amended

(a) by replacing the title with the following

"FORM 33-109F1 Notice of End of Individual Registration or Permitted Individual Status (Section 4.2)",

(b) by adding the following immediately before the heading "GENERAL INSTRUCTIONS":

WARNING -- It is an offence under securities legislation and derivatives legislation, including commodity futures legislation, to knowingly give false or misleading information to the regulator or securities regulatory authority.

CERTIFICATION

I certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where the firm is submitting this form and to any applicable self-regulatory authority (SRO) that

• I have read this form and understand all matters within this form, including the questions, and

• to the best of my knowledge and after reasonable inquiry, all of the information provided on this form is true and complete.

NRD format:

[ ] I am making this submission under authority delegated by the firm. By checking this box, I certify that the firm

(a) provided me with all of the information on this form, and

(b) makes the certification above.

Non-NRD format:

By signing below, I make the certification above.

Name of firm ____________________

Name of authorized signing officer or partner ____________________

Title of authorized signing officer or partner ____________________

Signature of authorized signing officer or partner ____________________

Date signed ____________________ (YYYY/MM/DD)

(c) by deleting the heading "Terms" and replacing the text between the heading "Terms" and "How to submit the form" with the following:

As set out in National Instrument 33-109 Registration Information, "cessation date" means the last day on which an individual had authority to act as a registered individual on behalf of their sponsoring firm or the last day on which an individual was a permitted individual of their sponsoring firm.,

(d) by replacing the text between the heading "When to submit the form" and "Item 1 Terminating firm" with the following:

As set out in National Instrument 33-109 Registration Information, you must submit the responses to Items 1, 2, 3 and 4 within 10 days of the cessation date.

If you are required to complete Item 5, you must submit those responses within 30 days of the cessation date. If you are submitting the responses to Item 5, in NRD format, after Items 1 to 4 have been submitted at NRD, use the NRD submission type called "Update/Correct Cessation Information" to complete Item 5 of this form.,

(e) in Item 1, by replacing in the heading "Terminating" with "Former sponsoring",

(f) in Item 2, by replacing in the heading "Terminated" with "Applicable",

(g) in Item 3, by replacing in the heading "terminated" with "applicable",

(h) by replacing Item 4 with the following:

Item 4 Date and reason for cessation

1. Cessation date ____________________ (YYYY/MM/DD)

The above date is the last day on which the individual had authority to act as a registered individual on behalf of the sponsoring firm, or the last day on which the individual was a permitted individual of the sponsoring firm.

2. Reason for cessation (check one):

Resigned -- voluntary

[ ]

Resigned -- at the firm's request

[ ]

Terminated in good standing

[ ]

Terminated for cause

[ ]

Completed temporary employment contract

[ ]

Retired

[ ]

Deceased

[ ]

Other

[ ]

If "Other", explain:

______________________________

(i) in Item 5, by replacing in the heading "termination" with "cessation" and by replacing the text between the heading and the sentence "Answer the following questions to the best of the firm's knowledge." with the following:

Complete Item 5 except in the case of an individual that is deceased. In the space below:

• state the reason(s) for the cessation and

• provide details if the answer to any of the following questions is "Yes".

[For NRD Format only:]

[ ] This information will be disclosed within 30 days of the cessation date

[ ] Not applicable: individual is deceased

(j) in Item 5, by replacing in question 7 "outside business activity" with "outside activity", and

(k) by repealing Items 7 and 8.

10. Form 33-109F2 Change or Surrender of Individual Categories (sections 2.2(2), 2.4, 2.6(2) or 4.1(4))is amended

(a) by adding the following text between the title Form 33-109F2 Change or Surrender of Individual Categories (sections 2.2(2), 2.4, 2.6(2) or 4.1(4))" and the heading "GENERAL INSTRUCTIONS":

WARNING -- It is an offence under securities legislation and derivatives legislation, including commodity futures legislation, to knowingly give false or misleading information to the regulator or securities regulatory authority.

CERTIFICATION

Individual

I certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where I am submitting this form and to any applicable self-regulatory organization (SRO) that

• I have read this form and understand all matters within this form, including the questions,

• I have discussed this form with an officer, partner, branch manager or supervisor of my sponsoring firm and that to the best of my knowledge, the officer, partner, branch manager or supervisor is satisfied that I understand the all matters within this form, including the questions,

• to the best of my knowledge and after reasonable inquiry, all of the information provided on this form is true and complete, and

• if applicable, I will limit my activities to those allowed by my category of registration and any SRO approval.

Firm

I certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where the firm is submitting this form and to any applicable SRO that

• the individual identified in this form will be engaged by the sponsoring firm as a registered individual or a permitted individual, and

• I have, or a branch manager, supervisor, officer or partner has, discussed this form with the individual. To the best of my knowledge, the individual understands the all matters within this form, including the questions.

NRD format:

[ ] I am making this submission under authority delegated by the firm and the individual identified in this form. By checking this box, I certify that

(a) the firm provided me with all of the information on this form and makes the firm certification above, and

(b) the individual provided the firm with all of the information on this form and makes the individual certification above.

Non-NRD format:

Individual

By signing below, I make the above individual certification.

Signature of individual ____________________

Date signed ____________________ (YYYY/MM/DD)

Firm

By signing below, I make the certification above.

Name of firm ____________________

Name of authorized signing officer or partner ____________________

Title of authorized signing officer or partner ____________________

Signature of authorized signing officer or partner ____________________

Date signed ____________________ (YYYY/MM/DD)

(b) in Item 4, by deleting "industry" in the subheading "3. Relevant securities industry experience" and by replacing the text between that subheading and "Item 5 Reason for surrender" with the following:

Do you have securities experience?

Yes [ ] No [ ] N/A [ ]

If you are an individual applying for IIROC approval, select "N/A".

If "Yes", complete Schedule A.

(c) by replacing Item 6 with the following:

Item 6 Collection and use of personal information

1. Notice of collection and use of personal information

Your personal information is collected by, or on behalf of, each securities regulatory authority and SRO set out in Schedule B. Any of the securities regulatory authorities or SROs set out in Schedule B may contact government or private bodies or agencies, individuals, corporations, employers, and other organizations, in Canada and in other countries, for information about you.

This personal information is being collected under the authority of the applicable securities legislation, derivatives legislation (including commodity futures legislation) or both of the securities regulatory authorities and pursuant to the SRO rules of an SRO set out in Schedule B. The collection, use and disclosure are done in accordance with applicable freedom of information and privacy legislation.

The principal purpose of this collection by the securities regulatory authorities is to administer, enforce, carry out their duties or exercise their powers under their respective securities legislation, derivatives legislation (including commodity futures legislation) or both, and by the SROs to administer and enforce the rules of the SROs.

The information submitted by you on this form with your consent, or collected indirectly with your authorization, may be collected

• at any time during your registration or while you are a permitted individual, or

• at the time the regulator or, in Québec, the securities regulatory authority, or SRO is informed by your sponsoring firm that you no longer have authority to act on behalf of the sponsoring firm or are not a permitted individual of the sponsoring firm.

If you have any questions about the collection, use and disclosure of this information, contact the securities regulatory authorities or SRO in any jurisdiction in which the required information is submitted. See Schedule B for details.

Note that certain information such as your name(s) (including aliases, trade names or some past names), your sponsoring firm, and other relevant registration information will be listed in a publicly available registry of registered individuals and, if applicable, on the Disciplined List.

Also note that certain securities regulatory authorities may provide or receive information to or from certain entities under separate provisions of their securities legislation or derivatives legislation (including commodity futures legislation) or both, and SROs may provide or receive information under the rules of the SROs. This consent and notice does not limit the authority, powers, obligations, or rights conferred on any of the securities regulatory authorities by legislation or regulations in effect in their jurisdiction.

2. Consent to collect and use personal information

By submitting this form, you consent to and authorize the collection, directly and indirectly, of personal information by each securities regulatory authority and SRO and to the use of your personal information as set out above.

The personal information that each securities regulatory authority or SRO collects, includes the following:

• the personal information provided in this form;

• the personal information provided by your sponsoring firm;

• registration or financial services licensing information;

• law enforcement records, including police records;

• credit records;

• bankruptcy or other insolvency records;

• employment records and information received from an employer;

• records and information received from entities you had or have an independent contractor or agency relationship with;

• personal information available online;

• records from government ministries and agencies, SROs or authorities exercising jurisdiction over specific business activities or professions; and

• records of, and used in, court proceedings, including any probation records.,

(d) by repealing Item 7,

(e) by repealing Item 8,

(f) by replacing Schedule A with the following:

Schedule A

Relevant securities experience (Item 4)

Instructions:

Some registration categories require a specified amount of experience to be obtained within specified timeframes. Please see National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligationsfor more information.

If you are applying to be an advising representative or an associate advising representative, provide details of the activities you performed for each experience that is relevant investment management experience. Such details may include the level of responsibility; value of accounts under direct supervision; number of years of experience in performing securities research and analysis for the purpose of portfolio securities selection, portfolio construction and analysis; number of years of experience collecting know-your-client information; or number of years of experience conducting suitability assessments.

1. If you are applying

• to be an advising representative or an associate advising representative of a portfolio manager, describe the relevant investment management experience that you have gained, or

• for any other category, describe the relevant securities industry experience that you have gained.

For each description of relevant experience, provide the following information:

(a) the name of the firm or entity with which you gained this experience;

(b) your title;

(c) the start and end dates of this position;

(d) the details of the activities you performed that are relevant for the category of registration that you are applying for;

(e) the percentage of your time in this position that was spent on activities relating to the experience.

______________________________

______________________________

______________________________

2. Indicate the continuing education activities in which you have participated during the last 36 months and that are relevant to the category of registration you are applying for:

______________________________

______________________________

______________________________

(g) in Schedule B, by replacing "Notice" in the title with "Consent and notice",

(h) in Schedule B in the portion of the form under the contact information for British Columbia, by replacing "Freedom of Information Officer" with "Registration staff" and adding "E-mail: Registration@bcsc.bc.ca" at the end,

(i) in Schedule B in the portion of the form under the contact information for Nova Scotia, by replacing "Deputy Director, Capital Markets" with "Registration",

(j) in Schedule B in the portion of the form under the contact information for Yukon, by adding "Office of the Yukon" before "Superintendent of Securities" and replacing "(867) 667-5314" with "(867) 667-5466", and

(k) in Schedule B in the portion of the form under the contact information for Northwest Territories, by deleting "Deputy" after "Attention:".

11. Form 33-109F3 Business Locations Other Than Head Office (section 3.2)is amended

(a) by adding the following text between the title "FORM 33-109F3Business Locations Other Than Head Office (section 3.2)" and "GENERAL INSTRUCTIONS":

WARNING -- It is an offence under securities legislation and derivatives legislation, including commodity futures legislation, to knowingly give false or misleading information to the regulator or securities regulatory authority.

CERTIFICATION

I certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where the firm is submitting this form and to any applicable self-regulatory organization (SRO) that

• I have read this form and understand all matters within this form, including the questions,

• if the business location specified in this form is a residence, the individual conducting business from that business location has completed a Form 33-506F4 Registration of Individuals and Review of Permitted Individuals certifying that they give their consent

• for the regulator or, in Québec, the securities regulatory authority in each jurisdiction where this form is submitted to enter the residence for the administration of securities legislation and derivatives legislation, including commodity futures legislation, and

• where applicable, for the SRO to enter the residence for the administration of the rules of the SRO, and

• to the best of my knowledge and after reasonable inquiry, all of the information provided on this form is true and complete.

NRD format:

[ ] I am making this submission under authority delegated by the firm and the individual identified in this form.

[ ] By checking this box, I certify that

(a) the firm provided me with all of the information on this form,

(b) the firm makes the certification above, and

(c) the firm provided me with the individual's consent

• for the regulator or, in Québec, the securities regulatory authority in each jurisdiction where this form is submitted to enter the residence for the administration of securities legislation and derivatives legislation, including commodity futures legislation; and

• where applicable, for the SRO to enter the residence for the administration of the rules of the SRO, where the individual is conducting business from the residence.

Non-NRD format:

By signing below, I make the certification above.

Name of firm ____________________

Name of authorized signing officer or partner ____________________

Title of authorized signing officer or partner ____________________

Signature of authorized signing officer or partner ____________________

Date signed ____________________ (YYYY/MM/DD)

(b) by repealing Item 4,

(c) by repealing Item 5,

(d) by repealing Item 6, and

(e) by repealing Schedule A.

12. Form 33-109F4 Registration of Individuals and Review Of Permitted Individuals (section 2.2)is amended

(a) by adding the following text between the title "Form 33-109F4Registration of Individuals and Review of Permitted Individuals (section 2.2)" and "GENERAL INSTRUCTIONS":

WARNING -- It is an offence under securities legislation and derivatives legislation, including commodity futures legislation, to knowingly give false or misleading information to the regulator or securities regulatory authority.

CERTIFICATION

Individual

I certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where I am submitting this form and to any applicable self-regulatory organization (SRO) that

• I have read this form and understand all matters within this form, including the questions,

• I have discussed this form with an officer, partner, branch manager or supervisor of my sponsoring firm and that to the best of my knowledge, the officer, partner, branch manager or supervisor is satisfied that I understand all matters within this form, including the questions,

• to the best of my knowledge and after reasonable inquiry, all of the information provided on this form is true and complete,

• if applicable, I will limit my activities to those allowed by my category of registration and any SRO approval, and

• if the business location specified in this form is a residence, I hereby give my consent

• for the regulator or, in Québec, the securities regulatory authority in each jurisdiction where I am submitting this form to enter that residence for the administration of securities legislation and derivatives legislation, including commodity futures legislation, and

• where applicable, for the SRO to enter that residence for the administration of the rules of the SRO.

Firm

I certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where the firm is submitting this form and to any applicable SRO that

• the individual identified in this form will be engaged by the sponsoring firm as a registered individual or a permitted individual, and

• I have, or a branch manager, supervisor, officer or partner has, discussed this form with the individual. To the best of my knowledge, the individual understands all matters within this form, including the questions.

NRD format:

[ ] I am making this submission under authority delegated by the firm and the individual identified in this form. By checking this box, I certify that

(a) the firm provided me with all of the information on this form and makes the firm certification above, and

(b) the individual provided the firm with all of the information on this form and makes the individual certification above.

Non-NRD format:

Individual

By signing below, I make the above individual certification.

Signature of individual ____________________

Date signed ____________________ (YYYY/MM/DD)

Firm

By signing below, I make the firm certification above.

Name of firm ____________________

Name of authorized signing officer or partner ____________________

Title of authorized signing officer or partner ____________________

Signature of authorized signing officer or partner ____________________

Date signed ____________________ (YYYY/MM/DD)

(b) in Item 5, by replacing the portion of the form in section 2 with the following:

2. Check each jurisdiction where you are seeking registration or, if you are seeking review as a permitted individual, check each jurisdiction where your sponsoring firm is registered:

[ ] All jurisdictions

[ ] Alberta

[ ] British Columbia

[ ] Manitoba

[ ] New Brunswick

[ ] Newfoundland and Labrador

[ ] Northwest Territories

[ ] Nova Scotia

[ ] Nunavut

[ ] Ontario

[ ] Prince Edward Island

[ ] Québec

[ ] Saskatchewan

[ ] Yukon

(c) in Item 8, by replacing the portion of the form after the subheading "1. Course, examination or designation information and other education" and before the subheading "2. Student numbers" with the following:

Complete Schedule E to state each course, examination and designation that

• is required for registration or approval, and

• you have successfully completed or, if you are an IIROC applicant, have been exempted from.

[ ] Check here if you are not required under securities legislation or derivatives legislation, or the rules of an SRO to satisfy any course, examination or designation requirements.,

(d) in Item 8, by deleting "industry" in the subheading "4. Relevant securities industry experience" and replacing the text between that subheading and "Item 9 Location of employment" with the following:

If you are an individual applying for IIROC approval, select "N/A".

Do you have relevant securities experience?

Yes [ ] No [ ] N/A [ ]

If "Yes", complete Schedule F.,

(e) by replacing Item 10 with the following:

Item 10 Reportable activities

1. Activities with your sponsoring firm

Instructions: Describe all of your roles and responsibilities with your sponsoring firm, whether these roles and responsibilities are securities related or not (e.g., sale of securities, review of marketing materials, IT helpdesk, negotiation of employment contracts, sales of banking and insurance products and services). Include any other information about your position with your sponsoring firm that is relevant for the regulator or, in Québec, the securities regulatory authority to know (e.g., if your role is specialized).

Complete a Schedule G with respect to your roles and responsibilities with your sponsoring firm.

2. Reportable outside activities

Instructions: Consider all of the activities that you participate in outside of your sponsoring firm, whether or not you receive compensation for such activities and whether or not any such activity is business related. If any of the categories below describes one or more activities that you participate in, complete a separate Schedule G for each activity or entity.

Category 1 -- Activities with another registered firm

Instructions: Report activities with registered firms, other than your sponsoring firm. All activities in this category are reportable, whether or not you receive compensation for such activities. Major shareholder means a shareholder who, in total, directly or indirectly owns voting securities carrying 10 percent or more of the votes carried by all outstanding voting securities.

If you are a director, officer, employee, contractor, consultant, agent, or service provider of a registered firm other than your sponsoring firm, or hold any other equivalent position with or for that registered firm, or are a major shareholder or partner of that registered firm, complete a separate Schedule G for the registered firm.

Category 2 -- Activities with an entity that receives compensation from a registered firm

If you are a director, officer, employee, contractor, consultant, or agent of a specified entity, or hold any other equivalent position with or for a specified entity, or are a shareholder or partner of a specified entity, complete a separate Schedule G for the specified entity.

For the purposes of this category, "specified entity" means an entity that receives compensation from a registered firm for activities that you provide for your sponsoring firm or another registered firm.

Category 3 -- Other securities related activities

Instructions: All activities in this category are reportable, whether or not you receive compensation for such activities.

If you have been at any time in the last 7 years directly involved in raising money for an entity through the issuance of securities or derivatives or promoting the sale of an entity's securities or derivatives outside of your activities with your sponsoring firm or another registered firm, complete a separate Schedule G for each entity for which you performed these activities.

Directors and officers of reporting issuers and of entities that have been at any time in the last 7 years raising money through the issuance of securities or derivatives are considered to be directly involved in raising money for that entity.

Category 4 -- Provision of financial or financial-related services

Instructions: All activities in this category are reportable, whether or not you receive compensation for such activities. Major shareholder means a shareholder who, in total, directly or indirectly owns voting securities carrying 10 percent or more of the votes carried by all outstanding voting securities.

Complete a separate Schedule G for each activity, as applicable, if you are

• an insurance broker or agent,

• providing loan or deposit products and services,

• carrying out a money service business,

• a mortgage broker, agent or administrator,

• preparing tax returns or providing tax advice,

• providing financial planning or financial advice, including estate planning,

• providing corporate finance services, including services provided in the capacity of a comptroller, treasurer and chief financial officer,

• advising on credit/debt restructuring,

• a pension consultant,

• providing advice on mergers and acquisitions services,

• providing accounting or bookkeeping services,

• providing oversight or independent review or expert opinion on the management of an entity's financial assets, or

• providing banking or insurance services.

Also complete a separate Schedule G for each activity, as applicable, if you are a director or officer, or hold any other equivalent position with or for, or are a major shareholder or active partner of, an entity that provides one or more of the services in the above list.

Category 5 -- Positions of influence

Instructions: All positions of influence (e.g., medical doctor, leader in a religious organization) are reportable, whether or not you receive compensation for such activities. For more information on positions of influence, see section 13.4.3 of National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations and section 13.4.3 of the Companion Policy to National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations.

Complete a separate Schedule G for each position of influence that you hold.

Category 6 -- Specified activities

Complete a separate Schedule G for activities not included in Categories 1 to 5 if the total time spent by you on specified activities exceeds, on average, 30 hours per month.

For this purpose, "specified activities" means all of the following:

• activities to which any of Categories 1 to 5 apply;

• activities for which you receive compensation or where you have a reasonable expectation of compensation;

• all other activities (whether or not you are compensated) for which you are a director or officer of, or hold an equivalent position with or for the entity, or are a partner or shareholder of the entity.;

(f) by replacing Item 12 with the following:

Item 12 Resignations and terminations

Instructions: Disclose any allegation that existed at the time of your termination or resignation, regardless of whether the allegation caused or contributed to your resignation or termination.

Have you ever resigned or been terminated from a position or contract when, at the time of your resignation or termination, there existed an allegation that you:

1. Contravened any statutes, regulations, orders of a court or regulatory body, rules or bylaws or failed to meet any standard of conduct of a sponsoring firm, of any industry association or of any authority exercising jurisdiction over specific business activities or professions?

Yes [ ] No [ ]

If "Yes", complete Schedule I, Item 12.1.

2. Failed to appropriately supervise compliance with any statutes, regulations, orders of a court or regulatory body, rules or bylaws or with any standard of conduct of a sponsoring firm, of any industry association, or of any authority exercising jurisdiction over specific business activities or professions?

Yes [ ] No [ ]

If "Yes", complete Schedule I, Item 12.2.

3. Committed a crime?

Yes [ ] No [ ]

If "Yes", complete Schedule I, Item 12.3.,

(g) in question 3(a) of Item 13, by adding ", doctor, mortgage broker or agent" after "teacher" and before ")",

(h) in question 3(c) of Item 13, by deleting "professional",

(i) in Item 14, by replacing the text between the heading "Item 14 Criminal disclosure" and the sentence "You are not required to disclose:" with the following:

You must disclose all offences, including:

• a criminal offence under the laws of Canada such as the Criminal Code (Canada), the Income Tax Act (Canada), the Competition Act (Canada), the Immigration and Refugee Protection Act (Canada) and theControlled Drugs and Substances Act (Canada), even if

• a record suspension has been ordered under the Criminal Records Act (Canada), or

• you have been granted an absolute or conditional discharge under the Criminal Code (Canada),

• a criminal offence under the laws of any foreign jurisdiction (such as U.S. federal and state criminal offences), and

• a criminal offence, with respect to questions 14.2 and 14.4,

• of which you or any entity when you were a partner, director, officer or major shareholder of that entity has been found guilty, or

• for which you or any entity when you were a partner, director, officer or major shareholder of that entity have participated in the alternative measures program, a diversion program, or any alternative resolution program within the previous three years, even if a record suspension has been ordered under the Criminal Records Act (Canada).,

(j) in question 3 of Item 14, by replacing "firm" with "entity",

(k) in question 4 of Item 14, by replacing "firm" with "entity",

(l) in Item 15, by replacing "a firm" with "an entity" wherever it appears,

(m) by replacing Item 16 with the following:

Item 16 Financial disclosure

By submitting this form you consent to the collection by the regulator or, in Québec, securities regulatory authority of your personal financial information through the use of bankruptcy and insolvency records and other means (See Item 20 -- Collection and use of personal information).

1. Bankruptcies, insolvencies, consumer proposals and creditor arrangements

Instructions: You must provide the following information even if the event occurred more than 7 years ago.

The information is required to be reported even if you or the entity has been discharged or released from bankruptcy.

A proceeding, arrangement or compromise with creditors includes the appointment of a receiver, receiver-manager, administrator or trustee.

Under the laws of any jurisdiction, including any foreign jurisdiction, have any of the following events ever occurred to you or to any entity when you were a partner, director, officer or major shareholder of the entity:

a) a bankruptcy, a filing for bankruptcy or a proceeding governing an event similar to a bankruptcy?

Yes [ ] No [ ]

If "Yes", complete Schedule M, Item 16.1(a).

b) a proposal, including a consumer proposal, under any legislation relating to bankruptcy or insolvency or any similar proceeding?

Yes [ ] No [ ]

If "Yes", complete Schedule M, Item 16.1(b).

c) proceedings under any legislation relating to the winding up or dissolution of the entity, or under the Companies' Creditors Arrangement Act (Canada)?

Yes [ ] No [ ]

If "Yes", complete Schedule M, Item 16.1(c).

d) any proceedings, arrangement or compromise with creditors?

Yes [ ] No [ ]

If "Yes", complete Schedule M, Item 16.1(d).

2. Debt obligations

During the past 10 years

• have you failed to meet a financial obligation of $10,000 or more as it came due, or

• to the best of your knowledge, has any entity, while you were a partner, director, officer or major shareholder of that entity, failed to meet any financial obligation of $10,000 or more as it came due?

Yes [ ] No [ ]

If "Yes", complete Schedule M, Item 16.2.

3. Surety bond or fidelity bond

Have you ever been refused for a surety or fidelity bond?

Yes [ ] No [ ]

If "Yes", complete Schedule M, Item 16.3.

4. Garnishments, unsatisfied judgments or directions to pay

Has any governmental authority or court, in any jurisdiction, ever issued any of the following against

• you regarding your indebtedness, or

• to the best of your knowledge, the indebtedness of an entity where you are or were a partner, director, officer or major shareholder:

Yes

No

 

Garnishment

[ ]

[ ]

Unsatisfied judgment

[ ]

[ ]

Direction to pay

[ ]

[ ]

If "Yes", complete Schedule M, Item 16.4.,

(n) by replacing Item 20 with the following:

Item 20 Collection and use of personal information

1. Notice of collection and use of personal information

Your personal information is collected by, or on behalf of, each securities regulatory authority and SRO set out in Schedule O. Any of the securities regulatory authorities or SROs set out in Schedule O may contact government or private bodies or agencies, individuals, corporations, employers, and other organizations, in Canada and in other countries, for information about you.

This personal information is being collected under the authority of the applicable securities legislation, derivatives legislation (including commodity futures legislation) or both of the securities regulatory authorities and pursuant to the SRO rules of an SRO set out in Schedule O. The collection, use and disclosure are done in accordance with applicable freedom of information and privacy legislation.

The principal purpose of this collection by the securities regulatory authorities is to administer, enforce, carry out their duties or exercise their powers under their respective securities legislation, derivatives legislation (including commodity futures legislation) or both, and by the SROs to administer and enforce the rules of the SROs.

The information submitted by you in this form with your consent, or collected indirectly with your authorization, may be collected

• at the time of your application,

• at any time during your registration or while you are a permitted individual, or

• at the time the regulator or, in Québec, the securities regulatory authority, or SRO is informed by your sponsoring firm that you no longer have authority to act on behalf of the sponsoring firm or are not a permitted individual of the sponsoring firm.

If you have any questions about the collection, use, and disclosure of this information, contact the securities regulatory authority or SRO in any jurisdiction in which the required information is submitted. See Schedule O for details.

Note that certain information such as your name(s) (including aliases, trade names or some past names), your sponsoring firm, and other relevant registration information will be listed in a publicly available registry of registered individuals and, if applicable, on the Disciplined List.

Also note that certain securities regulatory authorities may provide or receive information to or from certain entities under separate provisions of their securities legislation or derivatives legislation (including commodity futures legislation) or both, and SROs may provide or receive information under the rules of the SROs. This consent and notice does not limit the authority, powers, obligations, or rights conferred on any of the securities regulatory authorities by legislation or regulations in effect in their jurisdiction.

2. Consent to collect and use personal information

By submitting this form, you consent to and authorize the collection, directly and indirectly, of personal information by each securities regulatory authority and SRO and to the use of your personal information as set out above.

The personal information that each securities regulatory authority or SRO collects, includes the following:

• the personal information provided in this form;

• the personal information provided by your sponsoring firm;

• registration or financial services licensing information;

• law enforcement records, including police records;

• credit records;

• bankruptcy or other insolvency records;

• employment records and information received from an employer;

• records and information received from entities you had or have an independent contractor or agency relationship with;

• personal information available online;

• records from government ministries and agencies, SROs or authorities exercising jurisdiction over specific business activities or professions; and

• records of, and used in, court proceedings, including any probation records.,

(o) by repealing Item 21,

(p) by repealing Item 22,

(q) in Schedule C, by replacing the text between the subheading "Approval categories" and "Additional approval categories" with the following:

[ ] Executive

[ ] Director (Industry)

[ ] Director (Non-Industry)

[ ] Supervisor

[ ] Investor

[ ] Registered Representative

[ ] Investment Representative

[ ] Portfolio Manager

[ ] Associate Portfolio Manager

[ ] Trader,

(r) in Schedule E, by adding after the following text between the heading "Item 8.1 Course, examination or designation information and other education" and the table:

Below, state each course, examination and designation that:

• is required for registration or approval, and

• you have successfully completed.

*For IIROC applicants only -- If applicable, please indicate the date of any exemption granted for any course, examination, designation or other education required for approval.,

(s) in the table to Schedule E, by adding "*" at the end of "Date exempted" and by adding "*" at the end of "Regulator / securities regulatory authority granting the exemption",

(t) by replacing Item 8.4 in Schedule F with the following:

Item 8.4 Relevant securities experience

Instructions:

Some registration categories require a specified amount of experience be obtained within specified timeframes. Please see National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations for more information.

If you are applying to be an advising representative or an associate advising representative, provide details of the activities you performed for each experience that is relevant investment management experience. Such details may include the level of responsibility; value of accounts under direct supervision; number of years of experience in performing securities research and analysis for the purpose of portfolio securities selection, portfolio construction and analysis; number of years of experience collecting know-your-client information; or number of years of experience conducting suitability assessments.

1. If you are applying

• to be an advising representative or an associate advising representative of a portfolio manager, describe the relevant investment management experience that you have gained, or

• for any other category, describe the relevant securities industry experience that you have gained.

For each description of relevant experience, provide the following information:

(a) the name of the firm or entity with which you gained this experience;

(b) your title;

(c) the start and end dates of this experience;

(d) the details of the activities you performed that are relevant for the category of registration that you are applying for; and

(e) the percentage of your time in this position that was spent on activities relating to the experience.

______________________________

______________________________

______________________________

2. Indicate the continuing education activities in which you have participated during the last 36 months and that are relevant to the category of registration you are applying for:

______________________________

______________________________

______________________________

(u) by replacing Schedule G with the following:

Schedule G

Reportable activities (Item 10)

1. Start date ____________________ (YYYY/MM/DD)

2. Sponsoring firm or other entity information

[ ] Check here if the reportable activity is with your sponsoring firm.

If the reportable activity is with your sponsoring firm, you are not required to indicate the firm's name and address but are required to provide the name and title of your immediate supervisor. For all other types of reportable activity, enter all of the information below:

Name of business or employer: ____________________

Address of business or employer: ____________________ (number, street, city, province, territory or state, country)

Name and title of your immediate supervisor: ____________________

3. Description of the reportable activity and your roles and responsibilities

Instructions: If you are completing this schedule in relation to your activities with your sponsoring firm, for (e) below, provide the title(s) you will use once registered, and if you are already registered, provide the title(s) you use as of the date of this filing.

(a) Describe the entity that you carry on the activity with or for, including the nature of the entity's business.

(b) Is the entity listed on an exchange?

(c) Describe your relationship with the entity.

(d) Describe all of your roles and responsibilities relating to the activity.

______________________________

(e) Provide all title(s) you use for the activity.

______________________________

4. Number of work hours per month

How many hours per month do you spend on this activity? ____________________

5. Conflicts of interest

Instructions: Complete this section if you have reportable activity outside your sponsoring firm. Do not complete this section if your reportable activity is solely with your sponsoring firm.

Take into consideration existing and reasonably foreseeable material conflicts of interest and existing and potential client confusion.

(a) Does the activity give rise to any material conflicts of interest between the client and the sponsoring firm or you? Does the activity give rise to client confusion? If no material conflicts of interest or client confusion are expected, explain why.

______________________________

______________________________

______________________________

(b) Describe (i) the material conflicts of interest, and (ii) how these conflicts will be addressed in the best interest of the client.

______________________________

(c) Describe (i) the client confusion, and (ii) how the client confusion will be addressed.

______________________________

______________________________

______________________________

(d) Does your sponsoring firm and the entity have procedures for identifying and addressing material conflicts of interest? If so, confirm you are complying with both sets of procedures.

______________________________

(e) State the name and title of the individual at your sponsoring firm who has reviewed and approved the activity.

______________________________

______________________________

______________________________

(v) in Schedule H, by deleting "If you are seeking registration in a category of registration that requires specific experience, include details of that experience. Examples include level of responsibility, value of accounts under direct supervision, number of years of that experience and research experience, and percentage of time spent on each activity.",

(w) by replacing Schedule I with the following:

Schedule I

Resignations and terminations (Item 12)

Item 12.1

For each allegation of contravention of any statute, regulation, order of a court or regulatory body, rule or bylaw or failure to meet any standard of conduct of a sponsoring firm, of any industry association or of any authority exercising jurisdiction over specific business activities or professions, state below (1) the name of the firm from which you resigned or were terminated, (2) whether you resigned or were terminated, (3) the date you ceased to carry on duties, (4) the circumstances relating to your resignation or termination, (5) details of the allegation (regardless of whether the allegation caused or contributed to your resignation or termination), including the statutes, regulations, orders, rules or bylaws allegedly contravened or standards of conduct allegedly not met, (6) details of how the allegation was addressed, and (7) any details of the resignation, termination, or allegation relevant to the determination of your suitability for registration or whether your registration is otherwise objectionable.

______________________________

Item 12.2

For each allegation of failure to supervise compliance with any statute, regulation, order of a court or regulatory body, rule or bylaw or with any standard of conduct of a sponsoring firm, of any industry association or of any authority exercising jurisdiction over specific business activities or professions, state below, (1) the name of the firm from which you resigned or were terminated, (2) whether you resigned or were terminated, (3) the date you ceased to carry on duties, (4) the circumstances relating to your resignation or termination, (5) details of the allegation of failure to supervise (regardless of whether the allegation caused or contributed to your resignation or termination), (6) details of how the allegation was addressed, and (7) any details of the resignation, termination, or allegation relevant to the determination of your suitability for registration or whether your registration is otherwise objectionable.

______________________________

Item 12.3

For each allegation that you committed a crime, state below (1) the name of the firm from which you resigned or were terminated, (2) whether you resigned or were terminated, (3) the date you ceased to carry on duties, (4) the circumstances relating to your resignation or termination, (5) details of the allegation (regardless of whether the allegation caused or contributed to your resignation or termination), (6) details of how the allegation was addressed, and (7) any details of the resignation, termination, or allegation relevant to the determination of your suitability for registration or whether your registration is otherwise objectionable.

______________________________

(x) in Schedule J by replacing the portion of the form in part (c) after the heading "Item 13.2 SRO Regulation" with the following:

c) For each order or disciplinary proceeding, state below (1) the name of the firm, (2) the SRO that issued the order or that is, or was, conducting the proceeding, (3) the date any notice of proceeding was issued, (4) the date any order or settlement was made, (5) a summary of any notice, order or settlement, including any sanctions imposed, (6) whether you are or were a partner, director, officer or major shareholder of the firm and named individually in the order or disciplinary proceeding, and (7) any details of the order or disciplinary proceeding relevant to the determination of your suitability for registration or whether your registration is otherwise objectionable.

______________________________

(y) in Schedule J by replacing the portion of the form after the heading "Item 13.3 Non-securities regulation" with the following:

Item 13.3 Non-securities regulation

a) For each registration or licence, state below (1) the party who is, or was, registered or licensed, (2) if applicable, the employer or entity for whom you performed the registrable or licensable activity, (3) with which regulatory authority, or under what legislation, the party is, or was, registered or licensed, (4) the type or category of registration or licence, (5) the period that the party held the registration or licence, and (6) the licence number.

______________________________

b) For each registration or licence refused, state below (1) the party that was refused registration or licensing, (2) if applicable, the employer or entity for whom you performed the registrable or licensable activity, (3) with which regulatory authority, or under what legislation, the registration or licence was refused, (4) the type or category of registration or licence refused, (5) the date of the refusal, and (6) the reasons for the refusal.

______________________________

c) For each order or disciplinary proceeding, indicate below (1) the party against whom the order was made or the proceeding taken, (2) the regulatory authority that made the order or that is, or was, conducting the proceeding, or under what legislation the order was made or the proceeding is being, or was conducted, (3) the date any notice of proceeding was issued, (4) the date any order or settlement was made, (5) a summary of any notice, order or settlement (including any sanctions imposed), (6) whether you are or were a partner, director, officer or major shareholder of the entity and named individually in the order or disciplinary proceeding and (7) any details of the order or disciplinary proceeding relevant to the determination of your suitability for registration or whether your registration is otherwise objectionable.

______________________________

(z) in Schedule K, by replacing "firm" with "entity" wherever it occurs,

(aa) in Schedule L, by replacing "a firm" with "an entity" wherever it occurs,

(bb) by replacing Schedule M with the following:

Schedule M

Financial disclosure (Item 16)

Item 16.1 Bankruptcies, insolvencies, consumer proposals and creditor arrangements

Instructions: Proposals includes consumer proposals.

(a) For each event, state below (1) the date of your bankruptcy, filing for bankruptcy or a proceeding governing an event similar to a bankruptcy, (2) the person or entity about whom this disclosure is being made, (3) any amounts currently owing, (4) the creditors, (5) the status of the matter, (6) a summary of any disposition or settlement, (7) date of discharge or release, if applicable, and (8) any details of the bankruptcy, filing for bankruptcy or similar proceeding relevant to the determination of your suitability for registration or whether your registration is otherwise objectionable.

______________________________

(b) For each event, state below (1) the date of the proposal, (2) the person or firm about whom this disclosure is being made, (3) any amounts currently owing, (4) the creditors, (5) the status of the matter, (6) a summary of any disposition or settlement, and (7) any details of the proposal relevant to the determination of your suitability for registration or whether your registration is otherwise objectionable.

______________________________

(c) For each event, state below (1) the date of the proceeding, (2) the person or entity about whom this disclosure is being made, (3) any amounts currently owing, (4) the creditors, (5) the status of the matter, (6) a summary of any disposition or settlement, and (7) any details of the proceeding relevant to the determination of your suitability for registration or whether your registration is otherwise objectionable.

______________________________

(d) For each proceeding, arrangement or compromise with creditors, state below (1) the date of proceeding, arrangement or compromise, (2) the person or entity about whom this disclosure is being made, (3) any amounts currently owing, (4) the creditors, (5) the status of the matter, (6) a summary of any disposition or settlement, and (7) any details of the proceeding, arrangement or compromise relevant to the determination of your suitability for registration or whether your registration is otherwise objectionable.

______________________________

Item 16.2 Debt obligation

For each event, state below (1) the person or entity that failed to meet its financial obligation, (2) the amount that was owing at the time the person or entity failed to meet its financial obligation, (3) the person or entity to whom the amount is, or was, owing, (4) any relevant dates (for example, when payments are due or when final payment was made), (5) any amounts currently owing, and (6) any details of the debt obligation relevant to the determination of your suitability for registration or whether your registration is otherwise objectionable, including why the obligation has not been met/satisfied.

______________________________

Item 16.3 Surety bond or fidelity bond

For each bond refused, state below (1) the name of the bonding company, (2) the address of the bonding company, (3) the date of the refusal, and (4) the reasons for the refusal.

______________________________

Item 16.4 Garnishments, unsatisfied judgments or directions to pay

For each garnishment, unsatisfied judgment or direction to pay regarding your indebtedness or the indebtedness of an entity where you are or were a partner, director, officer or major shareholder, indicate below (1) the amount that was owing at the time the garnishment, judgment or direction to pay was rendered, (2) the person or entity to whom the amount is, or was, owing, (3) any relevant dates (for example, when payments are due or when final payment was made), (4) why the indebtedness has not been met or satisfied, (5) the percentage of earnings to be garnished or the amount to be paid, (6) any amounts currently owing, and (7) any details of the garnishment, unsatisfied judgement or direction to pay relevant to the determination of your suitability for registration or whether your registration is otherwise objectionable.

______________________________

(cc) in Schedule N, by replacing the text between the sentence "b) State the market value (approximate, if necessary) of any subordinated debentures or bonds of the firm to be held by you or any other subordinated loan to be made by you to the firm:" and the sentence "f) Is a person other than you the beneficial owner of the shares, bonds, debentures, partnership units or notes held by you?" with the following:

c) If another person or entity has provided you with funds to invest in the firm, provide the name of the person or entity and state the relationship between you and that person or entity:

______________________________

d) Is the payment of the funds to be invested (or proposed to be invested) guaranteed directly or indirectly by any person or entity?

Yes [ ] No [ ]

If "Yes", provide the name of the person or entity and state the relationship between you and that person or entity:

______________________________

e) Have you directly or indirectly given up any rights relating to these securities or this partnership interest, or do you, when you are registered or approved as a result of the review of this form, intend to give up any of these rights (including by hypothecation, pledging or depositing as collateral the securities or partnership interest with any entity or person)?

Yes [ ] No [ ]

If "Yes", provide the name of the person or entity, state the relationship between you and that person or entity and describe the rights that have been or will be given up:

______________________________

(dd) in Schedule O, by replacing "Notice" in the title with "Consent and notice",

(ee) in Schedule O in the portion of the form under the contact information for British Columbia, by replacing "Freedom of Information Officer" with "Registration staff" and adding "E-mail: Registration@bcsc.bc.ca" at the end,

(ff) in Schedule O in the portion of the form under the contact information for Nova Scotia, by replacing "Deputy Director, Capital Markets" with "Registration",

(gg) in Schedule O in the portion of the form under the contact information for Yukon, by adding "Office of the Yukon" before "Superintendent of Securities" and replacing "(867) 667-5314" with "(867) 667-5466", and

(hh) in Schedule O in the portion of the form under the contact information for Northwest Territories, by deleting "Deputy" after "Attention:".

13. Form 33-109F5 Change of Registration Information (sections 3.1 and 4.1)is amended

(a) by adding the following text between the title "Form 33-109F5Change of Registration Information (sections 3.1 and 4.1)" and "GENERAL INSTRUCTIONS":

WARNING -- It is an offence under securities legislation and derivatives legislation, including commodity futures legislation, to knowingly give false or misleading information to the regulator or securities regulatory authority.

CERTIFICATION

1. Form 33-109F4: Use the following certification when making changes to Form 33-109F4

Individual

I certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where I am submitting this form and to any applicable self-regulatory organization (SRO) that

• I have read this form,

• I have read Form 33-109F4 and understand all matters within this form, including its questions,

• I have discussed Form 33-109F4 with an officer, partner, branch manager or supervisor of my sponsoring firm and that to the best of my knowledge, the officer, partner, branch manager or supervisor is satisfied that I understand all matters within Form 33-109F4, including the questions in Form 33-109F4,

• to the best of my knowledge and after reasonable inquiry, all of the information provided on this form is true, complete and accurate, including information required to be disclosed by Form 33-109F4 that I am not changing with this form,

• if applicable, I will limit my activities to those allowed by my category of registration and any SRO approval, and

• if the business location specified in this form is a residence, I hereby give my consent

• for the regulator or, in Québec, the securities regulatory authority in each jurisdiction where I am submitting this form to enter that residence for the administration of securities legislation and derivatives legislation, including commodity futures legislation, and

• where applicable, for the SRO to enter that residence for the administration of the rules of the SRO.

Firm

I certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where the firm is submitting this form and to any applicable SRO that

• the individual identified in this form will be engaged by the sponsoring firm as a registered individual or a permitted individual, and

• I have, or a branch manager, supervisor, officer or partner has, discussed this form with the individual. To the best of my knowledge, the individual understands all matters within Form 33-109F4, including the questions.

NRD format:

[ ] I am making this submission under authority delegated by the firm and the individual identified in this form. By checking this box, I certify that

(a) the firm provided me with all of the information on this form and makes the firm certification above, and

(b) the individual provided the firm with all of the information on this form and makes the individual certification above.

Non-NRD format:

Individual

By signing below, I make the above individual certification.

Signature of individual ____________________

Date signed ____________________ (YYYY/MM/DD)

Firm

By signing below, I make the firm certification above.

Name of firm ____________________

Name of authorized signing officer or partner ____________________

Title of authorized signing officer or partner ____________________

Signature of authorized signing officer or partner ____________________

Date signed ____________________ (YYYY/MM/DD)

2. Form 33-109F6: Use the following certification when making changes to Form 33-109F6

By signing below, I certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where the firm is submitting this form and to any applicable SRO that

• I have read this form and understand all matters within this form, including the questions, and to the best of my knowledge and after reasonable inquiry, all of the information provided on this form is true and complete.

Name of firm ____________________

Name of authorized signing officer or partner ____________________

Title of authorized signing officer or partner ____________________

Signature of authorized signing officer or partner ____________________

Date signed ____________________ (YYYY/MM/DD)

(b) by replacing Item 3 with the following:

Item 3 Collection and use of personal information

1. Notice of collection and use of personal information

Your personal information is collected by, or on behalf of, each securities regulatory authority and SRO set out in Schedule A. Any of the securities regulatory authorities or SROs set out in Schedule A may contact government or private bodies or agencies, individuals, corporations, employers, and other organizations, in Canada and in other countries, for information about you.

This personal information is being collected under the authority of the applicable securities legislation, derivatives legislation (including commodity futures legislation) or both of the securities regulatory authorities and pursuant to the SRO rules of an SRO set out in Schedule A. The collection, use and disclosure are done in accordance with applicable freedom of information and privacy legislation.

The principal purpose of this collection by the securities regulatory authorities is to administer, enforce, carry out their duties or exercise their powers under their respective securities legislation, derivatives legislation (including commodity futures legislation) or both, and by the SROs to administer and enforce the rules of the SROs.

The information submitted by you in this form with your consent, or collected indirectly with your authorization, may be collected

• at any time during your registration or while you are a permitted individual, or

• at the time the regulator or, in Québec, the securities regulatory authority, or SRO is informed by your sponsoring firm that you no longer have authority to act on behalf of the sponsoring firm or are not a permitted individual of the sponsoring firm.

If you have any questions about the collection, use, and disclosure of this information, contact the securities regulatory authorities or SRO in any jurisdiction in which the required information is submitted. See Schedule A for details.

Note that certain information such as your name(s) (including aliases, trade names or some past names), your sponsoring firm, and other relevant registration information will be listed in a publicly available registry of registered individuals and, if applicable, on the Disciplined List.

Also note that certain securities regulatory authorities may provide or receive information to or from certain entities under separate provisions of their securities legislation or derivatives legislation (including commodity futures legislation) or both, and SROs may provide or receive information under the rules of the SROs. This consent and notice does not limit the authority, powers, obligations or rights conferred on any of the securities regulatory authorities by legislation or regulations in effect in their jurisdiction.

2. Consent to collect and use personal information

By submitting this form, you consent to and authorize the collection, directly and indirectly, of personal information by each securities regulatory authority and SRO and to the use of your personal information as set out above.

The personal information that each securities regulatory authority or SRO collects, includes the following:

• the personal information provided in this form;

• the personal information provided by your sponsoring firm;

• registration or financial services licensing information;

• law enforcement records, including police records;

• credit records;

• bankruptcy or other insolvency records;

• employment records and information received from an employer;

• records and information received from entities you had or have an independent contractor or agency relationship with;

• personal information available online;

• records from government ministries and agencies, SROs or authorities exercising jurisdiction over specific business activities or professions; and

• records of, and used in, court proceedings, including any probation records.,

(c) by repealing Item 4,

(d) by repealing Item 5,

(e) in Schedule A, by replacing "Notice" in the title with "Consent and notice",

(f) in Schedule A in the portion of the form under the contact information for British Columbia, by replacing "Freedom of Information Officer" with "Registration staff" and adding "E-mail: Registration@bcsc.bc.ca" at the end,

(g) in Schedule A in the portion of the form under the contact information for Nova Scotia, by replacing "Deputy Director, Capital Markets" with "Registration",

(h) in Schedule A in the portion of the form under the contact information for Yukon, by adding "Office of the Yukon" before "Superintendent of Securities" and replacing "(867) 667-5314" with "(867) 667-5466", and

(i) in Schedule A in the portion of the form under the contact information for Northwest Territories, by deleting "Deputy" after "Attention:".

14. Form 33-109F6 Firm Registration is amended

(a) by replacing the text between the heading "Contents of the form" and the sentence "You are also required to submit the following supporting documents with your completed form:" with the following:

This form consists of the following:

Certification

Part 1 -- Registration details

Part 2 -- Contact information

Part 3 -- Business history and structure

Part 4 -- Registration history

Part 5 -- Financial condition

Part 6 -- Client relationships

Part 7 -- Regulatory action

Part 8 -- Legal action

Part 9 -- [repealed]

Schedule A -- Contact information for consent and notice of collection and use of personal information

Schedule B -- Submission to jurisdiction and appointment of agent for service

Schedule C -- Form 31-103F1 Calculation of excess working capital;

(b) by replacing the text between the sentence "However, the questions in Part 4 -- Registration History and Part 7 -- Regulatory Action are to be answered in respect of any jurisdiction in the world." and the heading "Updating the information on the form" with the following:

It is an offence under securities legislation and derivatives legislation, including commodity futures legislation, to knowingly give false or misleading information to the regulator or securities regulatory authority.

(c) by replacing the text between the heading "Collection and use of personal information" and the heading "Part 1 -- Registration details" with the following:

In obtaining information about the firm, each securities regulatory authority and SRO set out in Appendix A may receive and collect personal information about individuals, if any, associated with the firm and its directors, officers, partners, employees, contractors and agents.

This may include the collection of

• the personal information provided in this form,

• registration or financial services licensing information,

• personal information available online,

• records from government ministries and agencies, SROs or authorities exercising jurisdiction over specific business activities or professions, or

• records of, and used in, court proceedings, including any probation records.

Any of the securities regulatory authorities or SROs set out in Schedule A may contact government or private bodies or agencies, individuals, corporations, employers, and other organizations, in Canada and in other countries, for information about the individual.

This personal information is being collected under the authority of the applicable securities legislation, derivatives legislation (including commodity futures legislation), or both of the securities regulatory authorities and pursuant to the SRO rules of an SRO set out in Schedule A. The collection, use and disclosure are done in accordance with applicable freedom of information and privacy legislation.

The principal purpose of this collection by the securities regulatory authorities is to administer, enforce, carry out their duties or exercise their powers under their respective securities legislation, derivatives legislation (including commodity futures legislation) or both, and for the SROs to administer and enforce the rules of the SROs.

The information may be collected

• at the time of the firm's application,

• at any time during the firm's registration, or

• at the time the regulator or, in Québec, the securities regulatory authority, or SRO is informed by the firm that it is surrendering its registration.

If you or anyone referred to in this form has any questions about the collection, use, and disclosure of this information, you or they can contact the regulator or, in Québec, the securities regulatory authority, or SRO in any jurisdiction in which the required information is submitted. See Schedule A for details.

Note that certain registration information about the firm and its registered individuals will be listed in a publicly available registry, including names used by the firm, the address of the firm's head office, whether the firm is on the Disciplined List, the jurisdictions and categories in which the firm is registered, and whether any terms and conditions have been imposed on the firm's registration, and the firm's registered individuals.

Also note that certain securities regulatory authorities may provide or receive information to or from certain entities under separate provisions of their securities legislation or derivatives legislation (including commodity futures legislation) or both, and SROs may provide or receive information under the rules of the SROs. This consent and notice does not limit the authority, powers, obligations, or rights conferred on any of the securities regulatory authorities by legislation or regulations in effect in their jurisdiction.

WARNING: It is an offence under securities legislation and derivatives legislation, including commodity futures legislation, to knowingly give false or misleading information to the regulator or securities regulatory authority.

CERTIFICATION

By signing this form, I

1. certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where the firm is submitting this form and to any applicable self-regulatory organization (SRO) that

• I have read this form,

• the firm has submitted and filed all information required to be submitted and filed under securities legislation and/or derivatives legislation in the principal jurisdiction of Canada where the firm is seeking registration, and

• to the best of my knowledge and after reasonable inquiry, all of the information provided on this form is true and complete,

2. authorize the principal regulator to give each non-principal regulator and, where applicable, SRO access to any information the firm has submitted or filed with the principal regulator under securities legislation or derivatives legislation or both in relation to the firm's registration in that jurisdiction,

3. acknowledge that the regulator or, in Québec, the securities regulatory authority, and SRO may collect and provide personal information about the individuals referred to in this form under Collection and Use of Personal Information, and

4. confirm that the individuals referred to in this form have been notified that their personal information is disclosed on this form, the legal reason for doing so, how it will be used and who to contact for more information.

Name of firm ____________________

Name of authorized signing officer or partner ____________________

Title of authorized signing officer or partner ____________________

Signature of authorized signing officer or partner ____________________

Date signed ____________________ (YYYY/MM/DD)

(d) in item 2.4, by replacing "a completed Schedule B" with "an executed Schedule B",

(e) by replacing item "3.10 Permitted individuals" with the following:

3.10 Permitted Individuals

List all permitted individuals of the firm.

State why the individual is considered a permitted individual (e.g., director, partner, officer, shareholder, or a permitted individual as described in paragraph (c) of the definition of "permitted individual" in section 1.1 of National Instrument 33-109 Registration Information).

Name

Type of Permitted Individual

NRD number, if applicable

 

__________

__________

__________

(f) by replacing item 3.12 with the following:

Attach a chart showing the firm's structure and ownership. Include all parents, specified affiliates and specified subsidiaries. Indicate which of the parents, specified affiliates and specified subsidiaries are registered under securities legislation in any jurisdiction of Canada and provide their NRD number.

Include the name of the person or company, and class, type, amount and percentage ownership of the firm's voting securities.,

(g) in item 4.6 by replacing the table after the sentence "If yes, provide the following information for each registration or licence:" with the following:

Name of entity

 

Type of licence or registration

 

Licence number

 

Regulator/organization

 

Date of registration (yyyy/mm/dd)

Expiry date, if applicable (yyyy/mm/dd)

 

Jurisdiction

(h) in item 5.13(b), by replacing "an interim financial report" with "interim financial information (as set out in subsection 12.11 of NI 31-103)",

(i) by repealing Part 9,

(j) in Schedule A in the portion of the form under the contact information for British Columbia, by replacing "Freedom of Information Officer" with "Registration staff" and adding "E-mail: Registration@bcsc.bc.ca" at the end,

(k) in Schedule A in the portion of the form under the contact information for Nova Scotia, by replacing "Deputy Director, Capital Markets" with "Registration",

(l) in Schedule A in the portion of the form under the contact information for Yukon, by adding "Office of the Yukon" before "Superintendent of Securities" and replacing "(867) 667-5314" with "(867) 667-5466",

(m) in Schedule A in the portion of the form under the contact information for Northwest Territories, by deleting "Deputy" after "Attention:",

(n) in Schedule B, by replacing the portion of the form in point 7 with the following:

7. Until six years after the Firm ceases to be registered, the Firm must file a new executed Submission to jurisdiction and appointment of agent for service in this form

a. no later than the 15th day after the date this Submission to jurisdiction and appointment of agent for service is terminated, and

b. no later than the 15th day after any change in the name or address of the Agent for Service., and

(o) in Schedule C, by replacing "CICA Handbook" with "CPA Canada Handbook".

15. Form 33-109F7 Reinstatement of Registered Individuals and Permitted Individuals (sections 2.3 and 2.5(2)) is amended

(a) by adding the following text between the title "Form 33-506F7Reinstatement of Registered Individuals and Permitted Individuals (sections 2.3 and 2.5(2))" and "GENERAL INSTRUCTIONS":

WARNING -- It is an offence under securities legislation and derivatives legislation, including commodity futures legislation, to knowingly give false or misleading information to the regulator or securities regulatory authority.

CERTIFICATION

Individual

I certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where I am submitting this form and to any applicable self-regulatory organization (SRO) that

• I have read this form and understand all matters within this form, including the questions,

• I have discussed this form with an officer, partner, branch manager or supervisor of my sponsoring firm and that to the best of my knowledge, the officer, partner, branch manager or supervisor is satisfied that I understand all matters within this form, including the questions,

• to the best of my knowledge and after reasonable inquiry, all of the information provided on this form is true and complete,

• if applicable, I will limit my activities to those allowed by my category of registration and any SRO approval,

• the new sponsoring firm understands that if the individual's reinstatement of registration was subject to any terms and conditions that were unsatisfied when the individual left the individual's former sponsoring firm, those terms and conditions remain in effect and the new sponsoring firm agrees to assume any ongoing obligations that apply to the sponsoring firm in respect of the individual under those terms and conditions, and

• if the business location specified in this form is a residence, I hereby give my consent

• for the regulator or, in Québec, the securities regulatory authority in each jurisdiction where I am submitting this form to enter that residence for the administration of securities legislation and derivatives legislation, including commodity futures legislation, and

• where applicable, for the SRO to enter that residence for the administration of the rules of the SRO.

Firm

I certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where the firm is submitting this form and to any applicable SRO that

• the individual identified in this form will be engaged by the new sponsoring firm as a registered individual or a permitted individual,

• I have, or a branch manager, supervisor, officer or partner has, discussed this form with the individual. To the best of my knowledge, the individual understands all matters within this form, including the questions, and

• the new sponsoring firm understands that if the individual's reinstatement of registration was subject to any undischarged terms and conditions when the individual left their former sponsoring firm, those terms and conditions remain in effect and agrees to assume any ongoing obligations that apply to the sponsoring firm in respect of the individual under those terms and conditions.

NRD format:

[ ] I am making this submission under authority delegated by the firm and the individual identified in this form. By checking this box, I certify that

(a) the firm provided me with all of the information on this form and makes the firm certification above, and

(b) the individual provided the firm with all of the information on this form and makes the individual certification above.

Non-NRD format:

Individual

By signing below, I make the above individual certification.

Signature of individual ____________________

Date signed ____________________ (YYYY/MM/DD)

Firm

By signing below, I make the firm certification above.

Name of firm ____________________

Name of authorized signing officer or partner ____________________

Title of authorized signing officer or partner ____________________

Signature of authorized signing officer or partner ____________________

Date signed ____________________ ,(YYYY/MM/DD)

(b) by replacing the General Instructions with the following:

GENERAL INSTRUCTIONS

Complete and submit this form to the relevant regulator(s) or, in Québec, the securities regulatory authority, or self-regulatory organization (SRO) if

• an individual has left a sponsoring firm and is seeking to reinstate their registration in one or more of the same categories or reinstate their same status of permitted individual as before with a sponsoring firm, and

• the new sponsoring firm is registered in the same category of registration in which the individual's former sponsoring firm was registered.

You only need to complete and submit one form regardless of the number of registration categories or permitted individual statuses you are seeking to be reinstated in.

An individual may reinstate the individual's registration or permitted individual status by submitting this form. This form must not be used unless all of the following apply:

1. this form is submitted on or before the 90th day after the cessation date of the individual's employment, partnership or agency relationship with the individual's former sponsoring firm;

2. the information in the individual's Form 33-109F4 was up-to-date as of the cessation date of the individual's employment, partnership or agency relationship with the individual's former sponsoring firm;

3. there have been no changes to the information previously submitted in respect of

• Item 13 (Regulatory Disclosure), other than changes to Item 13.3(a),

• Item 14 (Criminal Disclosure),

• Item 15 (Civil Disclosure), and

• Item 16 (Financial Disclosure)

of the individual's Form 33-109F4 since the individual left their former sponsoring firm; and

4. at the time of resignation or termination with the individual's former sponsoring firm, there were no allegations against the individual, in Canada or in any foreign jurisdiction, relevant to an assessment whether the individual is not suitable for reinstatement of registration or the proposed reinstatement of registration is objectionable, including, for greater certainty, an allegation against the individual of any of the following:

• a crime,

• a contravention of any statute, regulation, or order of a court or regulatory body,

• a contravention of any rule or bylaw of an SRO, of an authority exercising jurisdiction over specific business activities or professions, or of a similar organization, or

• a failure to meet any standard of conduct of the sponsoring firm, of any industry association or of any authority exercising jurisdiction over specific business activities or professions.

If you do not meet all of the above conditions, then you must apply for reinstatement by completing on NRD a Form 33-109F4 by making the NRD submission entitled "Reactivation of Registration".,

(c) in Item 2, by replacing the portion of the Form in section 2 with the following:

2. Check each province or territory in which you are seeking reinstatement of registration or, if you are seeking reinstatement as a permitted individual, check each province or territory where your sponsoring firm is registered:

[ ] All jurisdictions

[ ] Alberta

[ ] British Columbia

[ ] Manitoba

[ ] New Brunswick

[ ] Newfoundland and Labrador

[ ] Northwest Territories

[ ] Nova Scotia

[ ] Nunavut

[ ] Ontario

[ ] Prince Edward Island

[ ] Québec

[ ] Saskatchewan

[ ] Yukon

(d) by replacing Item 7 with the following:

Item 7 Reportable activities

Name of your new sponsoring firm:_____________________________________

1. Activities with your sponsoring firm

Instructions: Describe all of your roles and responsibilities with your sponsoring firm, whether these roles and responsibilities are securities related or not (e.g., sale of securities, review of marketing materials, IT helpdesk, negotiation of employment contracts, sales of banking and insurance products and services). Include any other information about your position with your sponsoring firm that is relevant for the regulator or, in Québec, the securities regulatory authority to know (e.g., if your role is specialized).

Complete a Schedule D with respect to your roles and responsibilities with your sponsoring firm.

2. Reportable outside activities

Instructions: Consider all of the activities that you participate in outside of your sponsoring firm, whether or not you receive compensation for such activities and whether or not any such activity is business related. If any of the categories below describes one or more activities that you participate in, complete a separate Schedule D for each activity or entity.

Category 1 -- Activities with another registered firm

Instructions: Report activities with registered firms, other than your sponsoring firm. All activities in this category are reportable, whether or not you receive compensation for such activities. Major shareholder means a shareholder who, in total, directly or indirectly owns voting securities carrying 10 percent or more of the votes carried by all outstanding voting securities.

If you are a director, officer, employee, contractor, consultant, agent, or a service provider of a registered firm other than your sponsoring firm, or hold any other equivalent position with or for that registered firm, or are a major shareholder or partner of that registered firm, complete a separate Schedule D for the registered firm.

Category 2 -- Activities with an entity that receives compensation from a registered firm

If you are a director, officer, employee, contractor, consultant, or agent of a specified entity, or hold any other equivalent position with or for a specified entity, or are a shareholder or partner of a specified entity, complete a separate Schedule D for the specified entity.

For the purposes of this category, "specified entity" means an entity that receives compensation from a registered firm for activities that you provide for your sponsoring firm or another registered firm.

Category 3 -- Other securities related activities

Instructions: All activities in this category are reportable, whether or not you receive compensation for such activities.

If you have been at any time in the last 7 years directly involved in raising money for an entity through the issuance of securities or derivatives or promoting the sale of an entity's securities or derivatives outside of your activities with your sponsoring firm or another registered firm, complete a separate Schedule D for each entity for which you performed these activities.

Directors and officers of reporting issuers and of entities that have been at any time in the last 7 years raising money through the issuance of securities or derivatives are considered to be directly involved in raising money for that entity.

Category 4 -- Provision of financial or financial-related services

Instructions: All activities in this category are reportable, whether or not you receive compensation for such activities. Major shareholder means a shareholder who, in total, directly or indirectly owns voting securities carrying 10 percent or more of the votes carried by all outstanding voting securities.

Complete a separate Schedule D for each activity, as applicable, if you are

• an insurance broker or agent,

• providing loan or deposit products and services,

• carrying out a money service business,

• a mortgage broker, agent or administrator,

• preparing tax returns or providing tax advice,

• providing financial planning or financial advice, including estate planning,

• providing corporate finance services, including services provided in the capacity of a comptroller, treasurer and chief financial officer,

• advising on credit/debt restructuring,

• a pension consultant,

• providing advice on mergers and acquisitions services,

• providing accounting or bookkeeping services,

• providing oversight or independent review or expert opinion on the management of an entity's financial assets, or

• providing banking or insurance services.

Also complete a separate Schedule D for each activity, as applicable, if you are a director or officer, or hold any other equivalent position with or for, or are a major shareholder or active partner of, an entity that provides one or more of the services in the above list.

Category 5 -- Positions of influence

Instructions: All positions of influence (e.g., medical doctor, leader in a religious organization) are reportable, whether or not you receive compensation for such activities. For more information on positions of influence, see section 13.4.3 of National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations and section 13.4.3 of the Companion Policy to National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations.

Complete a separate Schedule D for each position of influence that you hold.

Category 6 -- Specified activities

Complete a separate Schedule D for activities not included in Categories 1 to 5 if the total time spent by you on specified activities exceeds, on average, 30 hours per month.

For this purpose, "specified activities" means all of the following:

• activities to which any of Categories 1 to 5 apply;

• activities for which you receive compensation or where you have a reasonable expectation of compensation;

• all other activities (whether or not you are compensated) for which you are a director or officer of, or hold an equivalent position with or for the entity, or are a partner or shareholder of the entity.,

(e) in Item 9, by replacing section 2 with the following:

2. Check the box below -- I am eligible to file this Form 33-109F7, only if you satisfy all of the following conditions:

(a) the information in your Form 33-109F4 was up-to-date when you left your sponsoring firm;

(b) there are no changes to any of the disclosure items under Item 9.1 above; and

(c) at the time of your resignation or termination, there was no allegation against you, in Canada or in any foreign jurisdiction, relevant to an assessment whether you are not suitable for reinstatement of registration or your proposed reinstatement of registration is objectionable, including, for greater certainty, any allegations against you of

• a crime,

• a contravention of any statute, or regulation, or order of a court or regulatory body,

• a contravention of any rule or bylaw of an SRO, or an authority exercising jurisdiction over specific business activities or professions, or of a similar organization, or

• a failure to meet any standard of conduct of the sponsoring firm, of any industry association, or of any authority exercising jurisdiction over specific business activities or professions.

If you do not meet the above conditions for selecting the box 'I am eligible to file this Form 33-109F7', then you must apply for reinstatement by completing on NRD a Form 33-109F4 by making the NRD submission entitled "Reactivation of Registration". If you are submitting a Form 33-109F4 in a format other than NRD format you must complete the entire form.

[ ] I am eligible to file this Form 33-109F7.,

(f) by replacing Item 10 with the following:

Item 10 Submission to jurisdiction and collection and use of personal information

1. Submission to jurisdiction

By submitting this form, you agree to be subject to the securities legislation or derivatives legislation or both of each jurisdiction of Canada, and to the bylaws, regulations, rules, rulings and policies (collectively referred to as "rules" in this form) of the SROs to which you have submitted this form. This includes the jurisdiction of any tribunals or any proceedings that relate to your activities as a registrant or a partner, director or officer of a registrant under that securities legislation or derivatives legislation or both or as an approved person under SRO rules.

2. Notice of collection and use of personal information

Your personal information is collected by, or on behalf of, each securities regulatory authority and SRO set out in Schedule F. Any of the securities regulatory authorities or SROs set out in Schedule F may contact government or private bodies or agencies, individuals, corporations, employers, and other organizations, in Canada and in other countries, for information about you.

This personal information is being collected under the authority of the applicable securities legislation, derivatives legislation (including commodity futures legislation) or both of the securities regulatory authorities and pursuant to the SRO rules of an SRO set out in Schedule F. The collection, use and disclosure are done in accordance with applicable freedom of information and privacy legislation.

The principal purpose of this collection by the securities regulatory authorities is to administer, enforce, carry out their duties or exercise their powers under their respective securities legislation, derivatives legislation (including commodity futures legislation) or both, and by the SROs to administer and enforce the rules of the SROs.

The information submitted by you in this form with your consent, or collected indirectly with your authorization, may be collected

• at the time of your application,

• at any time during your registration or while you are a permitted individual, or

• at the time the regulator or, in Québec, the securities regulatory authority, or SRO is informed by your sponsoring firm that you no longer have authority to act on behalf of the sponsoring firm or are no longer a permitted individual of the sponsoring firm.

If you have any questions about the collection, use, and disclosure of this information, contact the securities regulatory authority or SRO in any jurisdiction in which the required information is submitted. See Schedule F for details.

Note that certain information such as your name(s) (including aliases, trade names or some past names), your sponsoring firm, and other relevant registration information will be listed in a publicly available registry of registered individuals and, if applicable, on the Disciplined List.

Also note that certain securities regulatory authorities may provide or receive information to or from certain entities under separate provisions of their securities legislation or derivatives legislation (including commodity futures legislation) or both, and SROs may provide or receive information under the rules of the SROs. This consent and notice does not limit the authority, powers, obligations or rights conferred on any of the securities regulatory authorities by legislation or regulations in effect in their jurisdiction.

3. Consent to collect and use personal information

By submitting this form, you consent to and authorize the collection, directly and indirectly, of personal information by each securities regulatory authority and SRO and to the use of your personal information as set out above.

The personal information that each securities regulatory authority or SRO collects, includes the following:

• the personal information provided in this form;

• the personal information provided by your sponsoring firm;

• registration or financial services licensing information;

• law enforcement records, including police records;

• credit records;

• bankruptcy or other insolvency records;

• employment records and information received from an employer;

• records and information received from entities you had or have an independent contractor or agency relationship with;

• personal information available online;

• records from government ministries and agencies, SROs or authorities exercising jurisdiction over specific business activities or professions; and

• records of, and used in, court proceedings, including any probation records.,

(g) by repealing Item 11,

(h) by repealing Item 12,

(i) in Schedule B, by replacing the text between the subheading "Approval categories" and "Additional approval categories" with the following:

[ ] Executive

[ ] Director (Industry)

[ ] Director (Non-Industry)

[ ] Supervisor

[ ] Investor

[ ] Registered Representative

[ ] Investment Representative

[ ] Portfolio Manager

[ ] Associate Portfolio Manager

[ ] Trader,

(j) by replacing Schedule D with the following:

Schedule D

Reportable activities (Item 7)

1. Start date ____________________ (YYYY/MM/DD)

2. Sponsoring firm or other entity information

[ ] Check here if the reportable activity is with your sponsoring firm.

If the reportable activity is with your sponsoring firm, you are not required to indicate the firm's name and address but are required to provide the name and title of your immediate supervisor. For all other types of reportable activity, enter all of the information below:

Name of business or employer: ____________________

Address of business or employer: ____________________ (number, street, city, province, territory or state, country)

Name and title of your immediate supervisor: ____________________

3. Description of the reportable activity and your roles and responsibilities

Instructions: If you are completing this schedule in relation to your activities with your sponsoring firm, for (e) below, provide the title(s) you will use once registered, and if you are already registered, provide the title(s) you use as of the date of this filing.

(a) Describe the entity that you carry on the activity with or for, including the nature of the entity's business.

(b) Is the entity listed on an exchange?

(c) Describe your relationship with the entity.

(d) Describe all of your roles and responsibilities relating to the activity.

______________________________

(e) Provide all title(s) you use for the activity.

______________________________

4. Number of work hours per month

How many hours per month do you spend on this activity? _____________

5. Conflicts of interest

Instructions: Complete this section if you have reportable activity outside your sponsoring firm. Do not complete this section if your reportable activity is solely with your sponsoring firm.

Take into consideration existing and reasonably foreseeable material conflicts of interest and existing and potential client confusion.

(a) Does the activity give rise to any material conflicts of interest between the client and the sponsoring firm or you? Does the activity give rise to client confusion? If no material conflicts of interest or client confusion are expected, explain why.

______________________________

______________________________

______________________________

(b) Describe (i) the material conflicts of interest, and (ii) how these conflicts will be addressed in the best interest of the client.

______________________________

(c) Describe (i) the client, and (ii) how the client confusion will be addressed.

______________________________

______________________________

______________________________

(d) Does your sponsoring firm and the entity have procedures for identifying and addressing material conflicts of interest? If so, confirm you are complying with both sets of procedures.

______________________________

(e) State the name and title of the individual at your sponsoring firm who has reviewed and approved the activity.

______________________________

______________________________

______________________________

(k) in Schedule E, by replacing the text between the sentence "b) State the market value (approximate, if necessary) of any subordinated debentures or bonds of the firm to be held by you or any other subordinated loan to be made by you to the firm:" and the sentence "f) Is a person other than you the beneficial owner of the shares, bonds, debentures, partnership units or notes held by you?" with the following:

c) If another person or entity has provided you with funds to invest in the firm, provide the name of the person or entity and state the relationship between you and that person or entity:

______________________________

d) Is the payment of the funds to be invested (or proposed to be invested) guaranteed directly or indirectly by any person or entity?

Yes [ ] No [ ]

If "Yes", provide the name of the person or entity and state the relationship between you and that person or entity:

______________________________

e) Have you directly or indirectly given up any rights relating to these securities or this partnership interest, or do you, when you are registered or approved as a result of the review of this form, intend to give up any of these rights (including by hypothecation, pledging or depositing as collateral the securities or partnership interest with any entity or person)?

Yes [ ] No [ ]

If "Yes", provide the name of the person or entity, state the relationship between you and that person or entity and describe the rights that have been or will be given up:

______________________________

(l) in Schedule F, by replacing "Notice" in the title with "Consent and notice",

(m) in Schedule F in the portion of the form under the contact information for British Columbia, by replacing "Freedom of Information Officer" with "Registration staff" and adding "E-mail: Registration@bcsc.bc.ca" at the end,

(n) in Schedule F in the portion of the form under the contact information for Nova Scotia, by replacing "Deputy Director, Capital Markets" with "Registration",

(o) in Schedule F in the portion of the form under the contact information for Yukon, by adding "Office of the Yukon" before "Superintendent of Securities" and replacing "(867) 667-5314" with "(867) 667-5466", and

(p) in Schedule F in the portion of the form under the contact information for Northwest Territories, by deleting "Deputy" after "Attention:".

16. This Instrument comes into force on •.

 

Annex B -- Blackline Showing Proposed Changes to NI 33-109

ANNEX B

BLACKLINE OF NATIONAL INSTRUMENT 33-109 REGISTRATION INFORMATION

Table of Contents

PART 1 -- DEFINITIONS AND INTERPRETATION

1.1

Definitions

1.2

Interpretation

 

PART 2 -- APPLICATION FOR REGISTRATION AND REVIEW OF PERMITTED INDIVIDUALS

2.1

Firm Registration

2.2

Individual Registration

2.3

Reinstatement

2.4

Application to Change or Surrender Individual Registration Categories

2.5

Permitted Individuals

2.6

Commodity Futures Act Registrants

 

PART 3 -- CHANGES TO REGISTERED FIRM INFORMATION

3.1

Notice of Change to a Firm's Information

3.2

Changes to Business Locations

 

PART 4 -- CHANGES TO REGISTERED INDIVIDUAL AND PERMITTED INDIVIDUAL INFORMATION

4.1

Notice of Change to an Individual's Information

4.2

Termination <<Cessation>> of Employment, Partnership or Agency Relationship

 

PART 5 -- DUE DILIGENCE AND RECORD-KEEPING

5.1

Sponsoring Firm Obligations

 

PART 6 -- [Lapsed]

 

PART 7 -- EXEMPTION

7.1

Exemption

 

PART 8 -EFFECTIVE DATE

8.1

[Lapsed]

8.2

Effective Date

 

FORM 33-109F1 NOTICE OF TERMINATION <<END>> OF REGISTERED INDIVIDUALS AND PERMITTED INDIVIDUALS <<STATUS>>

FORM 33-109F2 CHANGE OR SURRENDER OF INDIVIDUAL CATEGORIES

FORM 33-109F3 BUSINESS LOCATIONS OTHER THAN HEAD OFFICE

FORM 33-109F4 REGISTRATION OF INDIVIDUALS AND REVIEW OF PERMITTED INDIVIDUALS

FORM 33-109F5 CHANGE OF REGISTRATION INFORMATION

Form 33-109F6 Firm Registration

FORM 33-109F7 REINSTATEMENT OF REGISTERED INDIVIDUALS AND PERMITTED INDIVIDUALS

National Instrument 33-109 Registration Information

PART 1 -- DEFINITIONS AND INTERPRETATION

1.1 Definitions -- In this Instrument

"business location" means a location where the firm carries out an activity that requires registration, and includes a residence if regular and ongoing activity that requires registration is carried out from the residence or if records relating to an activity that requires registration are kept at the residence;

"cessation date" means the last day on which an individual had authority to act as a registered individual on behalf of their sponsoring firm or was a permitted individual of their sponsoring firm, because of the end of, or a change in, the individual's employment, partnership, or agency relationship with the firm;

"firm" means a person or company that is registered, or is seeking registration, as a dealer, adviser or investment fund manager;

"Form 33-109F1" means Form 33-109F1 Notice of Termination of Registered Individuals and Permitted Individuals;"Form 33-109F1" means Form 33-109F1 Notice of End of Individual Registration or Permitted Individual Status;

"Form 33-109F2" means Form 33-109F2 Change or Surrender of Individual Categories;

"Form 33-109F3" means Form 33-109F3 Business Locations other than Head Office;

"Form 33-109F4" means Form 33-109F4 Registration of Individuals and Review of Permitted Individuals;

"Form 33-109F5" means Form 33-109F5 Change of Registration Information;

"Form 33-109F6" means Form 33-109F6 Firm Registration;

"Form 33-109F7" means Form 33-109F7 Reinstatement of Registered Individuals and Permitted Individuals;

"former sponsoring firm" means the registered firm for which an individual most recently acted as a registered individual or permitted individual;

"NRD submission number" means the unique number generated by NRD to identify each NRD submission;

"permitted individual" means

(a) a director, chief executive officer, chief financial officer, or chief operating officer of a firm, or a functional equivalent of any of those positions,

(b) an individual who has beneficial ownership of, or direct or indirect control or direction over, 10 percent or more of the voting securities of a firm; or

(c) a trustee, executor, administrator or other personal or legal representative, that has direct or indirect control or direction over 10 percent or more of the voting securities of a firm;

"principal jurisdiction" means,

(a) for a firm, whose head office is in Canada, the jurisdiction of Canada in which the firm's head office is located,

(b) for an individual whose working office is in Canada, the jurisdiction of Canada in which the individual's working office is located,

(c) for a firm whose head office is outside Canada, the jurisdiction of the firm's principal regulator, as identified by the firm on its most recently submitted Form 33-109F5 or Form 33-109F6, and

(d) for an individual whose working office is outside Canada, the principal jurisdiction of the individual's sponsoring firm;

"principal regulator" means, for a person or company, the securities regulatory authority or regulator of the person or company's principal jurisdiction;

"registered firm" means a registered dealer, registered adviser or registered investment fund manager;

"registered individual" means an individual who is registered under securities legislation to do any of the following on behalf of a registered firm:

(a) act as a dealer, underwriter or adviser;

(b) act as a chief compliance officer;

(c) act as an ultimate designated person;

"sponsoring firm" means,

(a) for a registered individual, the registered firm on whose behalf the individual acts,

(b) for an individual applying for registration, the firm on whose behalf the individual will act if the individual's application is approved,

(c) for a permitted individual of a registered firm, the registered firm, and

(d) for a permitted individual of a firm that is applying for registration, the applicant firm.

1.2 Interpretation -- Terms used in this Instrument and that are defined in National Instrument 31-102 National Registration Database have the same meanings as in National Instrument 31-102 National Registration Database.

PART 2 -- APPLICATION FOR REGISTRATION AND REVIEW OF PERMITTED INDIVIDUALS

2.1 Firm Registration -- A firm that applies for registration as a dealer, adviser or investment fund manager must submit each of the following to the regulator:

(a) a completed Form 33-109F6;

(b) for each business location of the applicant in the local jurisdiction other than the applicant's head office, a completed Form 33-109F3 in accordance with National Instrument 31-102 National Registration Database.

2.2 Individual Registration

(1) Subject to subsection (2) and sections 2.4 and 2.6, an individual who applies for registration under securities legislation must submit a completed Form 33-109F4 to the regulator in accordance with National Instrument 31-102 National Registration Database.

(2) A permitted individual of a registered firm who applies to become a registered individual with the firm must submit a completed Form 33-109F2 to the regulator in accordance with National Instrument 31-102 National Registration Database.

2.3 Reinstatement

(1) An individual who applies for reinstatement of registration under securities legislation must submit a completed Form 33-109F4 to the regulator in accordance with National Instrument 31-102 National Registration Database, unless the individual submits a completed Form 33-109F7 in accordance with subsection (2).

(2) The registration of an individual suspended under section 6.1 [If an individual ceases to have authority to act for firm] of National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations is reinstated on the date the individual submits a completed Form 33-109F7 to the regulator in accordance with National Instrument 31-102 National Registration Database if all of the following apply:

(a) the Form 33-109F7 is submitted on or before the 90th day after the cessation date;

(b) the individual's employment, partnership or agency relationship with the former sponsoring firm did not end because the individual was asked by the firm to resign, resigned voluntarily or was dismissed, following an allegation against the individual of any of the following:

(i) criminal activity;

(ii) a breach of securities legislation;

(iii) a breach of a rule of an SRO;

(b) in the case of the individual resigning or the individual's relationship with the sponsoring firm being terminated, at the time of the resignation or termination there was no allegation against the individual, in Canada or in any foreign jurisdiction, relevant to an assessment whether the individual is not suitable for reinstatement of registration or the proposed reinstatement of registration is objectionable, including, for greater certainty, an allegation of any of the following:

(i) a crime;

(ii) a contravention of any statute, regulation, or order of a court or regulatory body;

(iii) a contravention of any rule or bylaw of an SRO, of an authority exercising jurisdiction over specific business activities or professions, or of a similar organization;

(iv) a failure to meet any standard of conduct of the sponsoring firm, of any industry association, or of any authority exercising jurisdiction over specific business activities or professions;

(b.1) on or before the cessation date, the individual notified, in accordance with section 4.1, the regulator or, in Québec, the securities regulatory authority of any change to the information previously submitted in the individual's Form 33-109F4;

(c) after the cessation date there have been no changes to the information previously submitted in respect of any of the following items of the individual's Form 33-109F4:

(i) item 13 [Regulatory disclosure] (other than Item 13.3(a));

(ii) item 14 [Criminal disclosure];

(iii) item 15 [Civil disclosure];

(iv) item 16 [Financial disclosure];

(d) the individual is seeking reinstatement with a sponsoring firm in one or more of the same categories of registration in which the individual was registered on the cessation date;

(e) the new sponsoring firm is registered in the same category of registration in which the individual's former sponsoring firm was registered.

2.4 Application to Change or Surrender Individual Registration Categories -- A registered individual who applies for registration in an additional category, or to surrender a registration category, must make the application by submitting a completed Form 33-109F2 to the regulator in accordance with National Instrument 31-102 National Registration Database.

2.5 Permitted Individuals

(1) A permitted individual must submit a completed Form 33-109F4 to the regulator, in accordance with National Instrument 31-102 National Registration Database, no more than 10 days after becoming a permitted individual, unless the individual submits a Form 33-109F7 in accordance with subsection (2).

(2) An individual who has ceased to be a permitted individual of a former sponsoring firm and becomes a permitted individual of a new sponsoring firm may submit a completed Form 33-109F7 to the regulator if all of the following apply:

(a) the Form 33-109F7 is submitted in accordance with National Instrument 31-102 National Registration Database

(i) no more than 10 days after becoming a permitted individual of the new sponsoring firm, and

(ii) no more than 90 days after the cessation date;

(b) the individual holds the same permitted individual status with the new sponsoring firm that they held with the former sponsoring firm;

(c) the conditions described in paragraphs (b) and (c) of subsection 2.3(2) are met.

(c) the conditions described in paragraphs 2.3(2)(b), (b.1) and (c) are met.

2.6 Commodity Futures Act Registrants

(1) In Manitoba and Ontario, despite paragraph 2.1(b), if a firm applies for registration under section 2.1 and is registered under the Commodity Futures Act, the applicant is not required to submit a completed Form 33-109F3 under section 3.2 for any business location of the applicant that is recorded on NRD.

(2) In Manitoba and Ontario, despite subsection 2.2(1), if an individual applies for registration under securities legislation and is recorded on NRD with his or her sponsoring firm as registered under the Commodity Futures Act, the individual must make the application by submitting a completed Form 33-109F2 to the regulator in accordance with National Instrument 31-102 National Registration Database.

PART 3 -- CHANGES TO REGISTERED FIRM INFORMATION

3.1 Notice of Change to a Firm's Information

(1) Subject to subsection (3) or (4), a registered firm must notify the regulator of a change to any information previously submitted in Form 33-109F6 or under this subsection, as follows:

(a) for a change previously submitted in relation to part 3 of Form 33-109F6, within 30 days of the change;

(b) for a change previously submitted in relation to any other part of Form 33-109F6, within 10 days of the change.

(1) In this section, "authorized affiliate" means, in respect of a registered firm, another registered firm that

(a) is an affiliate of the registered firm,

(b) has the same principal regulator as the registered firm.

(1.1) Subject to subsection (3) or (4), a registered firm must notify the regulator or, in Québec, the securities regulatory authority of a change to any information previously submitted in Form 33-109F6 or under this subsection, as follows:

(a) for a change to information previously submitted in relation to any of the following parts or items of Form 33-109F6, within 30 days of the change:

(i) part 3 [Business history and structure];

(ii) item 4.1 [Securities registration];

(iii) item 5.12 [Auditor];

(iv) item 6.1 [Client assets];

(v) item 6.2 [Conflicts of interest];

(b) for a change to information previously submitted in relation to any other part of Form 33-109F6, within 15 days of the change.

(2) A notice of change referred to in subsection (1) must be made by submitting a completed Form 33-109F5.

(2.1) A registered firm may delegate to an authorized affiliate the duty to notify the regulator or, in Québec, the securities regulatory authority under subsection (1.1) of a change to information previously submitted if all of the following apply:

(a) the change in information relates only to one or more of the following items or parts of Form 33-109F6:

(i) item 3.12 [Ownership chart];

(ii) item 4.1 [Securities registration];

(iii) item 4.3 [Membership of exchange or SRO];

(iv) item 4.5 [Refusal of registration, licensing or membership];

(v) item 4.6 [Registration for other financial products];

(vi) part 7 [Regulatory action];

(vii) part 8 [Legal action];

(b) the registered firm has filed a certificate, executed by the officer or partner authorized to certify and sign Form 33-109F5, with the registered firm's principal regulator which confirms all of the following:

(i) the registered firm has delegated to the authorized affiliate the duty to notify the regulator, or in Québec, securities regulatory authority of a change to any information set out in paragraph (a), and

(ii) the full legal name and NRD number of the registered firm and the authorized affiliate, and

(iii) the following certification of the registered firm applies to each notice of change submitted by the authorized affiliate:

"I have read this form and understand all matters within this form, including the questions, and to the best of my knowledge and after reasonable inquiry, all of the information provided on this form is true and complete."

(c) the registered firm directs the authorized affiliate, in each notice of change submitted by the authorized affiliate, to include the full legal name and NRD number of the registered firm and to state the following:

"The registered firm has delegated to the authorized affiliate the duty to notify the regulator, or in Québec, securities regulatory authority of a change to any of the following items or parts of Form 33-109F6

(i) item 3.12 [Ownership chart];

(ii) item 4.1 [Securities registration];

(iii) item 4.3 [Membership of exchange or SRO];

(iv) item 4.5 [Refusal of registration, licensing or membership];

(v) item 4.6 [Registration for other financial products];

(vi) part 7 [Regulatory action];

(vii) part 8 [Legal action]."

(3) A notice of change is not required under subsection (1) if the change relates to any of the following:

(a) a business location other than the head office of the firm if the firm submits a completed Form 33-109F3 under section 3.2;

(b) a terminationcessation, or a change, of a registered firm's employment, partnership or agency relationship with an officer, partner or director of the registered firm if the firm submits a completed Form 33-109F1 under subsection 4.2(1);

(c) the addition of an officer, partner, or director to the registered firm if that individual submits either of the following:

(i) a completed Form 33-109F4 under subsection 2.2(1) or 2.5(1);

(ii) a completed Form 33-109F7 under subsection 2.3(2) or 2.5(2);

(d) the information in the supporting documents referred to in any of the following items of Form 33-109F6:

(i) item 3.3 [Business documents];

(ii) item 5.1 [Calculation of excess working capital];

(iii) item 5.7 [Directors' resolution for insurance];

(iv) item 5.13 [Audited financial statements];

(v) item 5.14 [Letter of direction to auditors].

(e) a renewal of an insurance policy referred to in item 5.5 or in item 5.6 of Form 33-109F6, if the insurance policy has not lapsed and the only change is to extend the expiry date of the insurance policy for a period of at least one year;

(f) a change in a person or company's ownership of the firm's voting securities referred to in item 3.12 of Form 33-109F6, if the change did not result in the person or company's percentage of ownership falling below or exceeding 10%, 20% or 50% of the firm's voting securities.

(4) A person or company that submitted a completed Schedule B an executed Schedule B [Submission to jurisdiction and appointment of agent for service] to Form 33-109F6 must notify the regulator of a change to the information previously submitted in item 3 [Name of agent for service of process] or in item 4 [Address for service of process on the agent for service] of that schedule, by submitting a completed Schedule B no more than 1015 days after the change;

(5) Subsection (4) does not apply to a person or company after they have ceased to be registered for a period of 6 years or more.

(6) For the purpose of subsections (2) and (4), the person or company may give the notice by submitting it to the principal regulator.

3.2 Changes to Business Locations -- A registered firm must notify the regulator of the opening of a business location, other than a new head office, or of a change to any information previously submitted in Form 33-109F3, by submitting a completed Form 33-109F3 to the regulator in accordance with National Instrument 31-102 National Registration Database, within 1015 days of the opening of the business location or change.

PART 4 -- CHANGES TO REGISTERED INDIVIDUAL AND PERMITTED INDIVIDUAL INFORMATION

4.1 Notice of Change to an Individual's Information

(1) Subject to subsection (2), a registered individual or permitted individual must notify the regulator of a change to any information previously submitted in respect of the individual's Form 33-109F4 as follows:

(a) for a change of information previously submitted in items 4 [Citizenship] and 11 [Previous employment] of Form 33-109F4, within 30 days of the change;

(b) for a change of information previously submitted in any other items of Form 33-109F4, within 10 days of the change.

(1) Subject to subsection (2), a registered individual or permitted individual must notify the regulator or, in Québec, the securities regulatory authority of a change to any information previously submitted in respect of the individual's Form 33-109F4 as follows:

(a) for a change to information previously submitted in any of the following items, within 30 days of the change:

(i) item 2.1 [Current and previous residential address];

(ii) item 2.2 [Mailing address];

(iii) item 4 [Citizenship];

(iv) item 10 [Reportable activities];

(v) item 11 [Previous employment and other activities];

(b) for a change to information previously submitted in any other items of Form 33-109F4, within 15 days of the change.

(2) A notice of change is not required under subsection (1) if the change relates to information previously submitted in item 3 [Personal information] of Form 33-109F4.

(2) A notice of change is not required under subsection (1) if the change only relates to any of the following:

(a) information previously submitted in item 3 [Personal information] of Form 33-109F4;

(b) the individual ceasing to have authority to act on behalf of the sponsoring firm as a registered individual or be a permitted individual of the sponsoring firm if a Form 33-109F1 is required to be submitted by the sponsoring firm under subsection 4.2(1).

(3) A notice of change under subsection (1) must be made by submitting a completed Form 33-109F5 to the regulator in accordance with National Instrument 31-102 National Registration Database.

(4) Despite subsection (3), a notice of change referred to in subsection (1) must be made by submitting a completed Form 33-109F2 to the regulator in accordance with National Instrument 31-102 National Registration Database, if the change relates to

(a) an individual's status as a permitted individual of the sponsoring firm,

(a) a change in a category of permitted activities of a permitted individual,

(b) the removal or the addition of a category of registration,

(c) the surrender of registration in one or more non-principal jurisdictions, or

(d) any information on Schedule C of Form 33-109F4.

4.2 Termination Cessation of Employment, Partnership or Agency Relationship

(1) A registered firm must notify the regulator of the end of, or a change in, a sponsored individual's employment, partnership, or agency relationship with the firm if the individual ceases to have authority to act on behalf of the firm as a registered individual or permitted individual by submitting a Form 33-109F1 to the regulator in accordance with National Instrument 31-102 National Registration Database with

(a) items 1 through 4 completed, and

(b) item 5 completed unless the reason for termination under item 4 was death of the individual.

(1) A registered firm must notify the regulator if an individual ceases to have authority to act on behalf of the registered firm as a registered individual or be a permitted individual of the registered firm by submitting Form 33-109F1 to the regulator or, in Québec, the securities regulatory authority in accordance with National Instrument 31-102 National Registration Database with

(a) items 1 to 4 of the Form completed, and

(b) item 5 of the Form completed unless the reason for cessation under item 4 was death of the individual.

(2) A registered firm must submit to the regulator the information required under

(a) paragraph (1)(a), within 10 days of the cessation date, and

(b) paragraph (1)(b), within 30 days of the cessation date.

(3) A registered firm must, within 10 days of a request from an individual for whom the registered firm was the former sponsoring firm, provide to the individual a copy of the Form 33-109F1 that the registered firm submitted under subsection (1) in respect of that individual.

(4) If a registered firm completed and submitted the information in item 5 of a Form 33-109F1 in respect of an individual who made a request under subsection (3) and that information was not included in the initial copy provided to the individual, the registered firm must provide to that individual a further copy of the completed Form 33-109F1, including the information in item 5, within the later of

(a) 10 days after the request by the individual under subsection (3), and

(b) 10 days after the submission pursuant to paragraph (2)(b).

PART 5 -- DUE DILIGENCE AND RECORD-KEEPING

5.1 Sponsoring Firm Obligations

(1) A sponsoring firm must make reasonable efforts to ensure the truth and completeness of information that is submitted in accordance with this Instrument for any individual.

(2) A sponsoring firm must obtain from each individual who is registered to act on behalf of the firm, or who is a permitted individual of the firm, a copy of the Form 33-109F1 most recently submitted by the individual's former sponsoring firm in respect of that individual, if any, within 60 days of the firm becoming the individual's sponsoring firm.

(3) A sponsoring firm must retain all documents used by the firm to satisfy its obligation under subsection (1) as follows:

(a) in the case of a registered individual, for no less than 7 years after the individual ceases to be registered to act on behalf of the firm;

(b) in the case of an individual who applied for registration but whose registration was refused by the regulator, for no less than 7 years after the individual applied for registration; or

(c) in the case of a permitted individual, for no less than 7 years after the individual ceases to be a permitted individual with the firm.

(4) Without limiting subsection (3), if a registered individual, an individual applying for registration, or a permitted individual appoints an agent for service, the sponsoring firm must keep the original Appointment of Agent for Service executed by the individual for the period of time set out in paragraph (3)(b).

(5) A sponsoring firm that retains a document under subsection (3) or (4) in respect of an NRD submission must record the NRD submission number on the first page of the document.

PART 6 -- [Lapsed]

PART 7 -- EXEMPTION

7.1 Exemption

(1) The regulator or the securities regulatory authority may grant an exemption from this Instrument, in whole or in part, subject to such conditions or restrictions as may be imposed in the exemption.

(2) Despite subsection (1), in Ontario, only the regulator may grant such an exemption.

(3) Except in Alberta and Ontario, an exemption referred to in subsection (1) is granted under the statute referred to in Appendix B of National Instrument 14-101 Definitions, opposite the name of the local jurisdiction.

PART 8 -- REPEAL AND EFFECTIVE DATE

8.1 Repeal -- [Lapsed]

8.2 Effective Date -- This Instrument comes into force on the day National Instrument 31-103 Registration Requirements and Exemptions comes into force.

 

FORM 33-109F1 NOTICE OF TERMINATION OF REGISTERED INDIVIDUALS AND PERMITTED INDIVIDUALS (section 4.2)

FORM 33-109F1 NOTICE OF END OF INDIVIDUAL REGISTRATION OR PERMITTED INDIVIDUAL STATUS (section 4.2)

WARNING -- It is an offence under securities legislation and derivatives legislation, including commodity futures legislation, to knowingly give false or misleading information to the regulator or securities regulatory authority.

CERTIFICATION

I certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where the firm is submitting this form and to any applicable self-regulatory authority (SRO) that

I have read this form and understand all matters within this form, including the questions, and

to the best of my knowledge and after reasonable inquiry, all of the information provided on this form is true and complete.

NRD format:

[ ] I am making this submission under authority delegated by the firm. By checking this box, I certify that the firm

(a) provided me with all of the information on this form, and

(b) makes the certification above.

Non-NRD format:

By signing below, I make the certification above.

Name of firm ____________________

Name of authorized signing officer or partner ____________________

Title of authorized signing officer or partner ____________________

Signature of authorized signing officer or partner ____________________

Date signed ____________________ (YYYY/MM/DD)

GENERAL INSTRUCTIONS

Complete and submit this form to notify the relevant regulator(s) or, in Québec, the securities regulatory authority, or self-regulatory organization (SRO) that a registered individual or permitted individual has left their sponsoring firm or has ceased to act in a registerable capacity or as a permitted individual.

Terms

In this form, "cessation date" (or "effective date of termination") means the last day on which an individual had authority to act as a registered individual on behalf of their sponsoring firm or the last day on which an individual was a permitted individual of their sponsoring firm, because of the end of, or a change in, the individual's employment, partnership, or agency relationship with the firm.

As set out in National Instrument 33-109 Registration Information, "cessation date" means the last day on which an individual had authority to act as a registered individual on behalf of their sponsoring firm or the last day on which an individual was a permitted individual of their sponsoring firm.

How to submit the form

Submit this form at the National Registration Database (NRD) website in NRD format at www.nrd.ca.

If you are relying on the temporary hardship exemption in section 5.1 of National Instrument 31-102 National Registration Database, you may submit this form in a format other than NRD format.

When to submit the form

You must submit the responses to Item 1, Item 2, Item 3 and Item 4 within 10 days of the effective date of termination.

If you are required to complete Item 5, you must submit those responses within 30 days of the cessation date. If you are submitting the responses to Item 5, in NRD format, after Items 1 to 4 have been submitted at NRD, use the NRD submission type called "Update/Correct Termination Information" to complete Item 5 of this form.

As set out in National Instrument 33-109 Registration Information, you must submit the responses to Items 1, 2, 3 and 4 within 10 days of the cessation date.

If you are required to complete Item 5, you must submit those responses within 30 days of the cessation date. If you are submitting the responses to Item 5, in NRD format, after Items 1 to 4 have been submitted at NRD, use the NRD submission type called "Update/Correct Cessation Information" to complete Item 5 of this form.

Item 1 Terminating Former sponsoring firm

1. Name

2. NRD number

Item 2 Terminated Applicable individual

1. Name

2. NRD number

Item 3 Business location of the terminated applicable individual

1. Business location address ____________________

2. NRD number

Item 4 Date and reason for termination

1. Cessation date / Effective date of termination ____________________ (YYYY/MM/DD)

This is the last day that the individual had authority to act in a registerable capacity on behalf of the firm, or the last day that the individual was a permitted individual.

2. Reason for termination / cessation (check one):

Resigned -- voluntary

[ ]

Resigned -- at the firm's request

[ ]

Dismissed in good standing

[ ]

Dismissed for cause

[ ]

Completed temporary employment contract

[ ]

Retired

[ ]

Deceased

[ ]

Other

[ ]

If "Other", explain: ____________________

Item 4 Date and reason for cessation

1. Cessation date ____________________ (YYYY/MM/DD)

The above date is the last day on which the individual had authority to act as a registered individual on behalf of the sponsoring firm, or the last day on which the individual was a permitted individual of the sponsoring firm.

2. Reason for cessation (check one):

<<Resigned -- voluntary>>

<<[ ]>>

<<Resigned -- at the firm's request>>

<<[ ]>>

<<Terminated in good standing>>

<<[ ]>>

<<Terminated for cause>>

<<[ ]>>

<<Completed temporary employment contract>>

<<[ ]>>

<<Retired>>

<<[ ]>>

<<Deceased>>

<<[ ]>>

<<Other>>

<<[ ]>>

If "Other", explain: ____________________

Item 5 Details about the terminationcessation

Complete Item 5 except where the individual is deceased. In the space below:

state the reason(s) for the cessation / termination and

provide details if the answer to any of the following questions is "Yes".

[For NRD Format only:]

[ ] This information will be disclosed within 30 days of the effective date of termination

[ ] Not applicable: individual is deceased

Complete Item 5 except where the individual is deceased. In the space below:

state the reason(s) for the cessation and

provide details if the answer to any of the following questions is "Yes".

[For NRD Format only:]

[ ] This information will be disclosed within 30 days of the cessation date

[ ] Not applicable: individual is deceased

Answer the following questions to the best of the firm's knowledge.

In the past 12 months:

Yes

No

 

1.

Was the individual charged with any criminal offence?

[ ]

[ ]

 

2.

Was the individual the subject of any investigation by any securities or financial industry regulator?

[ ]

[ ]

 

3.

Was the individual subject to any significant internal disciplinary measures at the firm or at any affiliate of the firm related to the individual's activity as a registrant?

[ ]

[ ]

 

4.

Were there any written complaints, civil claims and/or arbitration notices filed against the individual or against the firm about the individual's securities-related activities that occurred while the individual was registered or a permitted individual authorized to act on behalf of the firm?

[ ]

[ ]

 

5.

Does the individual have any undischarged financial obligations to clients of the firm?

[ ]

[ ]

 

6.

Has the firm or any affiliate of the firm suffered significant monetary loss or harm to its reputation as a result of the individual's actions?

[ ]

[ ]

 

7.

Did the firm or any affiliate of the firm investigate the individual relating to possible material violations of fiduciary duties, regulatory requirements or the compliance policies and procedures of the firm or any affiliate of the firm? Examples include making unsuitable trades or investment recommendations, stealing or borrowing client money or securities, hiding losses from clients, forging client signatures, money laundering, deliberately making false representations and engaging in undisclosed outside business activity<<outside activity>>.

[ ]

[ ]

 

8.

Did the individual repeatedly or materially fail to follow compliance policies and procedures of the firm or any affiliate of the firm?

[ ]

[ ]

 

9.

Did the individual engage in discretionary management of client accounts or otherwise engage in registerable activity without appropriate registration or without the firm's authorization?

[ ]

[ ]

Reasons/Details: ____________________

Item 6 [repealed]

Item 7 Warning[repealed]

It is an offence under securities legislation and derivatives legislation, including commodity futures legislation, to give false or misleading information on this form.

Item 8 _____Certification[repealed]

Certification -- NRD format:

[ ] I am making this submission as agent for the firm. By checking this box, I certify that the firm provided me with all of the information on this form.

Certification -- Format other than NRD format:

By signing below I certify to the regulator or, in Québec, the securities regulatory authority, in each jurisdiction where I am submitting this form for the firm, either directly or through the principal regulator, that:

I have read this form and understand the questions, and

all of the information provided on this form is true and complete.

Name of firm ____________________

Name of authorized signing officer or partner ____________________

Title of authorized signing officer or partner ____________________

Signature of authorized signing officer or partner ____________________

Date signed ____________________ (YYYY/MM/DD)

 

Schedule A

[repealed]

 

FORM 33-109F2 CHANGE OR SURRENDER OF INDIVIDUAL CATEGORIES (section 2.2(2), 2.4, 2.6(2) or 4.1(4))

WARNING -- It is an offence under securities legislation and derivatives legislation, including commodity futures legislation, to knowingly give false or misleading information to the regulator or securities regulatory authority.

CERTIFICATION

Individual

I certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where I am submitting this form and to any applicable self-regulatory organization (SRO) that

I have read this form and understand all matters within this form, including the questions,

I have discussed this form with an officer, partner, branch manager or supervisor of my sponsoring firm and that to the best of my knowledge, the officer, partner, branch manager or supervisor is satisfied that I understand all matters within this form, including the questions,

to the best of my knowledge and after reasonable inquiry, all of the information provided on this form is true and complete, and

if applicable, I will limit my activities to those allowed by my category of registration and any SRO approval.

Firm

I certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where the firm is submitting this form and to any applicable SRO that

the individual identified in this form will be engaged by the sponsoring firm as a registered individual or a permitted individual, and

I have, or a branch manager, supervisor, officer or partner has, discussed this form with the individual. To the best of my knowledge, the individual understands all matters within this form, including the questions.

NRD format:

[ ] I am making this submission under authority delegated by the firm and the individual identified in this form. By checking this box, I certify that

(a) the firm provided me with all of the information on this form and makes the firm certification above, and

(b) the individual provided the firm with all of the information on this form and makes the individual certification above.

Non-NRD format:

Individual

By signing below, I make the above individual certification.

Signature of individual ____________________

Date signed ____________________ (YYYY/MM/DD)

Firm

By signing below, I make the certification above

Name of firm ____________________

Name of authorized signing officer or partner ____________________

Title of authorized signing officer or partner ____________________

Signature of authorized signing officer or partner ____________________

Date signed ____________________ (YYYY/MM/DD)

GENERAL INSTRUCTIONS

Complete and submit this form to notify the relevant regulator(s) or, in Québec, the securities regulatory authority, or self-regulatory organization (SRO) that a registered individual or permitted individual seeks to add and/or remove individual registration categories or permitted activities or provide notice of other changes to the information on Schedule C of Form 33-109F4.

Terms

In this form, "you", "your" and "individual" mean the registered individual or permitted individual who is seeking to add and/or remove registration categories or permitted activities.

How to submit this form

Submit this form at the National Registration Database (NRD) website in NRD format at www.nrd.ca.

If you are relying on the temporary hardship exemption in section 5.1 of National Instrument 31-102 National Registration Database, you may submit this form in a format other than NRD format.

Item 1 Individual

Name of individual ____________________

NRD number of individual ____________________

Item 2 Registration jurisdictions

1. Are you filing this form under the passport system / interface for registration?

Choose "No" if you are registered in:

(a) only one jurisdiction of Canada

(b) more than one jurisdiction of Canada and you are requesting a surrender in a non-principal jurisdiction or jurisdictions, but not in your principal jurisdiction, or

(c) more than one jurisdiction of Canada and you are requesting a change only in your principal jurisdiction.

Yes [ ] No [ ]

2. Check each jurisdiction where you are seeking the change or surrender.

[ ] Alberta

[ ] British Columbia

[ ] Manitoba

[ ] New Brunswick

[ ] Newfoundland and Labrador

[ ] Northwest Territories

[ ] Nova Scotia

[ ] Nunavut

[ ] Ontario

[ ] Prince Edward Island

[ ] Québec

[ ] Saskatchewan

[ ] Yukon

Item 3 Removing categories

What categories are you seeking to remove?

______________________________

Item 4 Adding categories

1. Categories

What categories are you seeking to add?

______________________________

2. Professional liability insurance (Québec mutual fund dealers and Québec scholarship plan dealers)

If you are seeking registration as a representative of a mutual fund dealer or of a scholarship plan dealer in Québec, are you covered by your sponsoring firm's professional liability insurance?

Yes [ ] No [ ]

If "No", state:

The name of your insurer ____________________

Your policy number ____________________

3. Relevant securities industry experience

If you have not been registered in the last 36 months and you passed the required examination more than 36 months ago, do you consider that you have gained 12 months of relevant securities industry experience during the 36-month period?

Yes [ ] No [ ] N/A [ ]

If you are an individual applying for IIROC approval, select "N/A".

If "Yes", complete Schedule A.

Do you have securities experience?

Yes [ ] No [ ] N/A [ ]

If you are an individual applying for IIROC approval, select "N/A".

If "Yes", complete Schedule A.

Item 5 Reason for surrender

If you are seeking to remove a registration category or permitted activity, state the reason for the surrender in the local jurisdiction.

______________________________

Item 6 Notice of collection and use of personal information

The personal information required under this form is collected on behalf of, and used by, the securities regulatory authorities in the jurisdictions set out in Schedule B to administer and enforce certain provisions of their securities legislation or derivatives legislation or both.

The personal information required under this form is also collected by and used by the SRO set out in Schedule B to administer and enforce its by-laws, regulations, rules, rulings and policies.

By submitting this form, the individual consents to the collection by the securities regulatory authorities or applicable SRO of this personal information, and any police records, records from other government or non-governmental regulators or SROs, credit records and employment records about the individual that the securities regulatory authorities or applicable SRO may need to complete their review of the information submitted in this form relating to the individual's continued fitness for registration or approval, if applicable, in accordance with the legal authority of the securities regulatory authorities while the individual is registered with or approved by it. Securities regulatory authorities or SROs may contact government and private bodies or agencies, individuals, corporations and other organizations for information about the individual.

If you have any questions about the collection and use of this information, contact the securities regulatory authorities or applicable SRO in any jurisdiction in which the required information is submitted. See Schedule B for details. In Québec, you can also contact the Commission d'accès à l'information at 1-888-528-7741 or visit its website at www.cai.gouv.qc.ca.

Item 6 Collection and use of personal information

1. Notice of collection and use of personal information

Your personal information is collected by, or on behalf of, each securities regulatory authority and SRO set out in Schedule B. Any of the securities regulatory authorities or SROs set out in Schedule B may contact government or private bodies or agencies, individuals, corporations, employers, and other organizations, in Canada and in other countries, for information about you.

This personal information is being collected under the authority of the applicable securities legislation, derivatives legislation (including commodity futures legislation) or both of the securities regulatory authorities and pursuant to the SRO rules of an SRO set out in Schedule B. The collection, use and disclosure are done in accordance with applicable freedom of information and privacy legislation.

The principal purpose of this collection by the securities regulatory authorities is to administer, enforce, carry out their duties or exercise their powers under their respective securities legislation, derivatives legislation (including commodity futures legislation) or both, and by the SROs to administer and enforce the rules of the SROs.

The information submitted by you on this form with your consent, or collected indirectly with your authorization, may be collected

at any time during your registration or while you are a permitted individual, or

at the time the regulator or, in Québec, the securities regulatory authority, or SRO is informed by your sponsoring firm that you no longer have authority to act on behalf of the sponsoring firm or are not a permitted individual of the sponsoring firm.

If you have any questions about the collection, use and disclosure of this information, contact the securities regulatory authorities or SRO in any jurisdiction in which the required information is submitted. See Schedule B for details.

Note that certain information such as your name(s) (including aliases, trade names or some past names), your sponsoring firm, and other relevant registration information will be listed in a publicly available registry of registered individuals and, if applicable, on the Disciplined List.

Also note that certain securities regulatory authorities may provide or receive information to or from certain entities under separate provisions of their securities legislation or derivatives legislation (including commodity futures legislation) or both, and SROs may provide or receive information under the rules of the SROs. This consent and notice does not limit the authority, powers, obligations, or rights conferred on any of the securities regulatory authorities by legislation or regulations in effect in their jurisdiction.

2. Consent to collect and use personal information

By submitting this form, you consent to and authorize the collection, directly and indirectly, of personal information by each securities regulatory authority and SRO and to the use of your personal information as set out above.

The personal information that each securities regulatory authority or SRO collects, includes the following:

the personal information provided in this form;

the personal information provided by your sponsoring firm;

registration or financial services licensing information;

law enforcement records, including police records;

credit records;

bankruptcy or other insolvency records;

employment records and information received from an employer;

records and information received from entities you had or have an independent contractor or agency relationship with;

personal information available online;

records from government ministries and agencies, SROs or authorities exercising jurisdiction over specific business activities or professions; and

records of, and used in, court proceedings, including any probation records.

Item 7 Warning[repealed]

It is an offence under securities legislation and derivatives legislation, including commodity futures legislation, to give false or misleading information on this form.

Item 8 Certification[repealed]

Certification -- NRD format:

I confirm I have discussed the questions in this form with an officer, branch manager or supervisor of my sponsoring firm. To the best of my knowledge and belief, the officer, branch manager or supervisor was satisfied that I fully understood the questions. I will limit my activities to those permitted by my category of registration.

[ ] I am making this submission as agent for the individual identified in this form. By checking this box, I certify that the individual provided me with all of the information on this form.

Certification -- Format other than NRD format:

By signing below:

1. I certify to the regulator or, in Québec, the securities regulatory authority, in each jurisdiction where I am submitting this form, either directly or through the principal regulator, that:

I have read this form and understand the questions, and

all of the information provided on this form is true, and complete.

2. I confirm I have discussed the questions in this form with an officer, branch manager or supervisor of my sponsoring firm. To the best of my knowledge and belief, the officer, branch manager or supervisor was satisfied that I fully understood the questions. I will limit my activities to those permitted by my category of registration.

Signature of individual ____________________

Date signed ____________________ (YYYY/MM/DD)

By signing below, I certify to the regulator or, in Québec, the securities regulatory authority, in each jurisdiction where I am submitting this form for the individual, either directly or through the principal regulator, that:

1. the individual identified in this form will be engaged by the firm as a registered individual, or a non registered individual, and

2. I have, or a branch manager or supervisor or another officer or partner has, discussed the questions set out in this form with the individual. To the best of my knowledge and belief, the individual fully understands the questions.

Name of firm ____________________

Name of authorized signing officer or partner

______________________________

Title of authorized signing officer or partner

______________________________

Signature of authorized signing officer or partner

______________________________

Date signed ____________________ (YYYY/MM/DD)

 

Schedule A

Relevant securities industry experience (Item 4)

Describe your responsibilities in areas relating to the category you are applying for, including the title(s) you have held, as well as start and end dates:

______________________________

______________________________

______________________________

What is the percentage of your time devoted to these activities?

_____ %

Indicate the continuing education activities in which you have participated during the last 36 months and that are relevant to the category of registration you are applying for:

______________________________

______________________________

______________________________

 

Schedule A

Relevant securities experience (Item 4)

Instructions:

Some registration categories require a specified amount of experience to be obtained within specified timeframes. Please see National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations for more information.

If you are applying to be an advising representative or an associate advising representative, provide details of the activities you performed for each experience that is relevant investment management experience. Such details may include the level of responsibility; value of accounts under direct supervision; number of years of experience in performing securities research and analysis for the purpose of portfolio securities selection, portfolio construction and analysis; number of years of experience collecting know-your-client information; or number of years of experience conducting suitability assessments.

1. If you are applying

to be an advising representative or an associate advising representative of a portfolio manager, describe the relevant investment management experience that you have gained, or

for any other category, describe the relevant securities industry experience that you have gained.

For each description of relevant experience, provide the following information:

(a) the name of the firm or entity with which you gained this experience;

(b) your title;

(c) the start and end dates of this position;

(d) the details of the activities you performed that are relevant for the category of registration that you are applying for;

(e) the percentage of your time in this position that was spent on activities relating to the experience.

______________________________

______________________________

______________________________

2. Indicate the continuing education activities in which you have participated during the last 36 months and that are relevant to the category of registration you are applying for:

______________________________

______________________________

______________________________

 

Schedule B

Contact information for Notice consent and notice of collection and use of personal information

Alberta
Nunavut
Alberta Securities Commission,
Government of Nunavut
Suite 600, 250-5th St. SW
Department of Justice
Calgary, AB T2P 0R4
P.O. Box 1000 Station 570
Attention: Information Officer
Iqaluit, NU X0A 0H0
Telephone: (403) 297-6454
Attention: Deputy Registrar of Securities
Telephone: (867) 975-6590
 
British Columbia
Ontario
British Columbia Securities Commission
Ontario Securities Commission
P.O. Box 10142, Pacific Centre
22[SUP]nd[/SUP] Floor
701 West Georgia Street
20 Queen Street West
Vancouver, BC V7Y 1L2
Toronto, ON M5H 3S8
Attention: Freedom of Information Officer<<Registration staff>>
Attention: Compliance and Registrant Regulation
Telephone: (604) 899-6500 or (800) 373-6393 (in Canada)
Telephone: (416) 593-8314
<<E-mail: Registration@bcsc.bc.ca>>
E-mail: registration@osc.gov.on.ca
 
Manitoba
Prince Edward Island
The Manitoba Securities Commission
Securities Office
500 -- 400 St. Mary Avenue
Department of Community Affairs and Attorney General
Winnipeg, MB R3C 4K5
P.O. Box 2000
Attention: Director of Registrations
Charlottetown, PE C1A 7N8
Telephone: (204) 945-2548
Attention: Deputy Registrar of Securities
Fax (204) 945-0330
Telephone: (902) 368-6288
 
New Brunswick
Québec
Financial and Consumer Services Commission of New Brunswick / Commission des services financiers et des services aux consommateurs du Nouveau-Brunswick
Autorité des marchés financiers
Suite 300, 85 Charlotte Street
800, square Victoria, 22e étage
Saint John, NB E2L 2J2
C.P. 246, tour de la Bourse
Attention: Director of Securities
Montréal (Québec) H4Z 1G3
Telephone: (506) 658-3060
Attention: Responsable de l'accès à l'information
Telephone: (514) 395-0337 or (877) 525-0337
 
Newfoundland and Labrador
Saskatchewan
Superintendent of Securities, Service NL
Financial and Consumer Affairs Authority of Saskatchewan
Government of Newfoundland and Labrador
Suite 601, 1919 Saskatchewan Drive
P.O. Box 8700
Regina, SK S4P 4H2
2nd Floor, West Block
Attention: Deputy Director, Capital Markets
Confederation Building
Telephone: (306) 787-5871
St. John's, NL A1B 4J6
Attention: Manager of Registrations
Telephone: (709) 729-5661
 
Nova Scotia
Yukon
Nova Scotia Securities Commission
Government of Yukon
Suite 400, 5251 Duke Street
<<Office of the Yukon>> Superintendent of Securities
Halifax, NS B3J 1P3
Department of Community Services
Attention: Deputy Director, Capital Markets<<Registration>>
P.O. Box 2703 C-6
Telephone: (902) 424-7768
Whitehorse, YT Y1A 2C6
Attention: Superintendent of Securities
Telephone: (867) 667-5314<<(867) 667-5466>>
 
Northwest Territories
Self-regulatory organization
Government of the Northwest Territories
Investment Industry Regulatory Organization of Canada
Department of Justice
121 King Street West, Suite 2000
1[SUP]st[/SUP] Floor Stuart M. Hodgson Building
Toronto, Ontario M5H 3T9
5009 -- 49[SUP]th[/SUP] Street
Attention: Privacy Officer
Yellowknife, NWT X1A 2L9
Telephone: (416) 364-6133
Attention: Deputy Superintendent of Securities
E-mail: PrivacyOfficer@iiroc.ca
Telephone: (867) 920-8984

 

FORM 33-109F3 BUSINESS LOCATIONS OTHER THAN HEAD OFFICE (section 3.2)

WARNING -- It is an offence under securities legislation and derivatives legislation, including commodity futures legislation, to knowingly give false or misleading information to the regulator or securities regulatory authority.

CERTIFICATION

I certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where the firm is submitting this form and to any applicable self-regulatory organization (SRO) that

I have read this form and understand all matters within this form, including the questions,

if the business location specified in this form is a residence, the individual conducting business from that business location has completed a Form 33-506F4 Registration of Individuals and Review of Permitted Individuals certifying that they give their consent

for the regulator or, in Québec, the securities regulatory authority in each jurisdiction where this form is submitted to enter the residence for the administration of securities legislation and derivatives legislation, including commodity futures legislation, and

where applicable, for the SRO to enter the residence for the administration of the rules of the SRO, and

to the best of my knowledge and after reasonable inquiry, all of the information provided on this form is true and complete.

NRD format:

[ ] I am making this submission under authority delegated by the firm and the individual identified in this form.

[ ] By checking this box, I certify that

(a) the firm provided me with all of the information on this form,

(b) the firm makes the certification above, and

(c) the firm has obtained the individual's consent

for the regulator or, in Québec, the securities regulatory authority in each jurisdiction where this form is submitted to enter the residence for the administration of securities legislation and derivatives legislation, including commodity futures legislation; and

where applicable, for the SRO to enter the residence for the administration of the rules of the SRO, where the individual is conducting business from the residence.

Non-NRD format:

By signing below, I make the certification above and have obtained the consent above.

Name of firm ____________________

Name of authorized signing officer or partner ____________________

Title of authorized signing officer or partner ____________________

Signature of authorized signing officer or partner ____________________

Date signed ____________________ (YYYY/MM/DD)

GENERAL INSTRUCTIONS

Complete and submit this form to notify the relevant regulator(s) or, in Québec, the securities regulatory authority, or self-regulatory organization (SRO) that a business location has opened or closed, or information about a business location has changed.

Check one of the following and complete the entire form:

[ ] Opening this business location

[ ] Closing this business location

[ ] Change to the information previously submitted about this business location. Clearly specify the information that has changed.

How to submit this form

Submit this form at the National Registration Database (NRD) website in NRD format at www.nrd.ca.

If you are relying on the temporary hardship exemption in section 5.1 of National Instrument 31-102National Registration Database, you may complete and submit this form in a format other than NRD format.

Item 1 Type of business location

Branch or business location

[ ]

Sub-branch (Mutual Fund Dealers Association of Canada members only)

[ ]

Item 2 Supervisor or branch manager

Name of designated supervisor or branch manager ____________________

NRD number of the designated supervisor or branch manager ____________________

Item 3 Business location information

Business location address ____________________ (a post office box is not a valid business location address)

Mailing address (if different from business location address) ____________________

Telephone number (_____) ____________________

Fax number (_____) ____________________

E-mail address ____________________

Item 4 Notice of collection and use of personal information[repealed]

The personal information required under this form is collected on behalf of, and used by, the securities regulatory authorities in the jurisdictions set out in Schedule A to administer and enforce certain provisions of their securities legislation or derivatives legislation or both.

The personal information required under this form is also collected by and used by the SRO set out in Schedule A to administer and enforce its by-laws, regulations, rules, rulings and policies.

By submitting this form, the individual consents to the collection by the securities regulatory authorities or applicable SRO of this personal information, and any police records, records from other government or non-governmental regulators or SROs, credit records and employment records about the individual that the securities regulatory authorities or applicable SRO may need to complete their review of the information submitted in this form relating to the individual's continued fitness for registration or approval, if applicable, in accordance with the legal authority of the securities regulatory authorities while the individual is registered with or approved by it. Securities regulatory authorities or SROs may contact government and private bodies or agencies, individuals, corporations and other organizations for information about the individual.

If you have any questions about the collection and use of this information, contact the securities regulatory authorities or applicable SRO in any jurisdiction in which the required information is submitted. See Schedule A for details. In Québec, you can also contact the Commission d'accès à l'information at 1-888-528-7741 or visit its website at www.cai.gouv.qc.ca.

Item 5 Warning[repealed]

It is an offence under securities legislation and derivatives legislation, including commodity futures legislation, to give false or misleading information on this form.

Item 6 Certification[repealed]

Certification -- NRD format:

[ ] I am making this submission as agent for the firm. By checking this box, I certify that the firm provided me with all of the information on this form.

[ ] If the business location is a residence, the individual conducting business from that business location has completed a Form 33-109F4 Registration of Individuals and Review of Permitted Individuals certifying that they give their consent for the regulator or, in Québec, the securities regulatory authority to enter the residence for the administration of securities legislation and derivatives legislation, including commodity futures legislation.

Certification -- Format other than NRD format:

By signing below, I certify to the securities regulator or, in Québec, the securities regulatory authority, in each jurisdiction where I am submitting this form for the firm, either directly or through the principal regulator, that:

I have read this form and understand the questions,

all of the information provided on this form is true, and complete, and

if the business location specified in this form is a residence, the individual conducting business from that business location has completed a Form 33-109F4 Registration of Individuals and Review of Permitted Individuals certifying that they give their consent for the regulator or, in Québec, the securities regulatory authority to enter the residence for the administration of securities legislation and derivatives legislation, including commodity futures legislation.

Name of firm ___________________

Name of authorized signing officer or partner ___________________

Title of authorized signing officer or partner ___________________

Signature of authorized signing officer or partner ___________________

Date signed _______________________ (YYYY/MM/DD)

 

Schedule A

[repealed]

Contact information for Notice of collection and use of personal information

Alberta
Nunavut
Alberta Securities Commission,
Government of Nunavut
Suite 600, 250-5th St. SW
Department of Justice
Calgary, AB T2P 0R4
P.O. Box 1000 Station 570
Attention: Information Officer
Iqaluit, NU X0A 0H0
Telephone: (403) 297-6454
Attention: Deputy Registrar of Securities
Telephone: (867) 975-6590
 
British Columbia
Ontario
British Columbia Securities Commission
Ontario Securities Commission
P.O. Box 10142, Pacific Centre
22[SUP]nd[/SUP] Floor
701 West Georgia Street
20 Queen Street West
Vancouver, BC V7Y 1L2
Toronto, ON M5H 3S8
Attention: Freedom of Information Officer
Attention: Compliance and Registrant Regulation
Telephone: (604) 899-6500 or (800) 373-6393 (in Canada)
Telephone: (416) 593-8314
e-mail: registration@osc.gov.on.ca
 
Manitoba
Prince Edward Island
The Manitoba Securities Commission
Securities Office
500 -- 400 St. Mary Avenue
Department of Community Affairs and Attorney General
Winnipeg, MB R3C 4K5
P.O. Box 2000
Attention: Director of Registrations
Charlottetown, PE C1A 7N8
Telephone: (204) 945-2548
Attention: Deputy Registrar of Securities
Fax (204) 945-0330
Telephone: (902) 368-6288
 
New Brunswick
Québec
Financial and Consumer Services Commission of New Brunswick / Commission des services financiers et des services aux consommateurs du Nouveau-Brunswick
Autorité des marchés financiers
Suite 300, 85 Charlotte Street
800, square Victoria, 22e étage
Saint John, NB E2L 2J2
C.P. 246, tour de la Bourse
Attention: Director of Securities
Montréal (Québec) H4Z 1G3
Telephone: (506) 658-3060
Attention: Responsable de l'accès à l'information
Telephone: (514) 395-0337 or (877) 525-0337
 
Newfoundland and Labrador
Saskatchewan
Superintendent of Securities, Service NL
Financial and Consumer Affairs Authority of Saskatchewan
Government of Newfoundland and Labrador
Suite 601, 1919 Saskatchewan Drive
P.O. Box 8700
Regina, SK S4P 4H2
2nd Floor, West Block
Attention: Deputy Director, Capital Markets
Confederation Building
Telephone: (306) 787-5871
St. John's, NL A1B 4J6
Attention: Manager of Registrations
Telephone: (709) 729-5661
 
Nova Scotia
Yukon
Nova Scotia Securities Commission
Government of Yukon
Suite 400, 5251 Duke Street
Superintendent of Securities
Halifax, NS B3J 1P3
Department of Community Services
Attention: Deputy Director, Capital Markets
P.O. Box 2703 C-6
Telephone: (902) 424-7768
Whitehorse, YT Y1A 2C6
Attention: Superintendent of Securities
Telephone: (867) 667-5314
 
Northwest Territories
Self-regulatory organization
Government of the Northwest Territories
Investment Industry Regulatory Organization of Canada
Department of Justice
121 King Street West, Suite 2000
1[SUP]st[/SUP] Floor Stuart M. Hodgson Building
Toronto, Ontario M5H 3T9
5009 -- 49[SUP]th[/SUP] Street
Attention: Privacy Officer
Yellowknife, NWT X1A 2L9
Telephone: (416) 364-6133
Attention: Deputy Superintendent of Securities
E-mail: PrivacyOfficer@iiroc.ca
Telephone: (867) 920-8984

 

FORM 33-109F4 REGISTRATION OF INDIVIDUALS AND REVIEW OF PERMITTED INDIVIDUALS (section 2.2)

WARNING -- It is an offence under securities legislation and derivatives legislation, including commodity futures legislation, to knowingly give false or misleading information to the regulator or securities regulatory authority.

CERTIFICATION

Individual

I certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where I am submitting this form and to any applicable self-regulatory organization (SRO) that

I have read this form and understand all matters within this form, including the questions,

I have discussed this form with an officer, partner, branch manager or supervisor of my sponsoring firm and that to the best of my knowledge, the officer, partner, branch manager or supervisor is satisfied that I understand all matters within this form, including the questions,

to the best of my knowledge and after reasonable inquiry, all of the information provided on this form is true and complete,

if applicable, I will limit my activities to those allowed by my category of registration and any SRO approval, and

if the business location specified in this form is a residence, I hereby give my consent

for the regulator or, in Québec, the securities regulatory authority in each jurisdiction where I am submitting this form to enter that residence for the administration of securities legislation and derivatives legislation, including commodity futures legislation, and

where applicable, for the SRO to enter that residence for the administration of the rules of the SRO.

Firm

I certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where the firm is submitting this form and to any applicable SRO that

the individual identified in this form will be engaged by the sponsoring firm as a registered individual or a permitted individual, and

I have, or a branch manager, supervisor, officer or partner has, discussed this form with the individual. To the best of my knowledge, the individual understands all matters within this form, including the questions.

NRD format:

[ ] I am making this submission under authority delegated by the firm and the individual identified in this form. By checking this box, I certify that

(a) the firm provided me with all of the information on this form and makes the firm certification above, and

(b) the individual provided the firm with all of the information on this form and makes the individual certification above.

Non-NRD format:

Individual

By signing below, I make the above individual certification.

Signature of individual ____________________

Date signed ____________________ (YYYY/MM/DD)

Firm

By signing below, I make the firm certification above.

Name of firm ____________________

Name of authorized signing officer or partner ____________________

Title of authorized signing officer or partner ____________________

Signature of authorized signing officer or partner ____________________

Date signed ____________________ (YYYY/MM/DD)

GENERAL INSTRUCTIONS

Complete and submit this form to the relevant regulator(s) or in Québec, the securities regulatory authority, or self-regulatory organization (SRO) if an individual is seeking

• registration in individual categories,

• to be reviewed as a permitted individual.

You are only required to submit one form even if you are applying to be registered in several categories. This form is also used if you are seeking to be reviewed as a permitted individual. A post office box is not acceptable as a valid business location address.

Terms

In this form:

"Approved person" means, in respect of a member (Member) of the Investment Industry Regulatory Organization of Canada (IIROC), an individual who is a partner, director, officer, employee or agent of a Member who is approved by IIROC or another Canadian SRO to perform any function required under any IIROC or another Canadian SRO by-law, rule, or policy;

"Canadian Investment Manager designation" means the designation earned through the Canadian investment manager program prepared and administered by CSI Global Education Inc. and so named on the day this Instrument comes into force, and every program that preceded that program, or succeeded that program, that does not have a significantly reduced scope and content when compared to the scope and content of the first-mentioned program;

"CFA Charter" means the charter earned through the Chartered Financial Analyst program prepared and administered by the CFA Institute and so named on the day this Instrument comes into force, and every program that preceded that program, or succeeded that program, that does not have a significantly reduced scope and content when compared to the scope and content of the first-mentioned program;

"Derivatives" means financial instruments, such as futures contracts (including exchange traded contracts), futures options and swaps whose market price, value or payment obligations are derived from, or based on, one or more underlying interests. Derivatives can be in the form of instruments, agreements or securities;

"Major shareholder" and "shareholder" mean a shareholder who, in total, directly or indirectly owns voting securities carrying 10 per cent or more of the votes carried by all outstanding voting securities;

"Sponsoring firm" means the registered firm where you will carry out your duties as a registered or permitted individual; and

"You", "your" and "individual" mean the individual who is seeking registration or the individual who is filing this form as a permitted individual under securities legislation or derivatives legislation or both.

How to submit this form

NRD format

Submit this form at the National Registration Database (NRD) website in NRD format at www.nrd.ca. If you have any questions, contact the compliance, registration or legal department of the sponsoring firm or a legal adviser with securities law experience, or visit the NRD information website at www.nrd-info.ca.

Format, other than NRD format

If you are relying on the temporary hardship exemption in section 5.1 of National Instrument 31-102 National Registration Database, you may submit this form in a format other than NRD format.

If you need more space, use a separate sheet of paper. Clearly identify the item and question number. Complete and sign the form, and send it to the relevant regulator(s) or, in Québec, the securities regulatory authority, SRO(s) or similar authority. The number of originally signed copies of the form you are required to submit depends on the province or territory, and on the regulator, the securities regulatory authority or SRO.

To avoid delays in processing this form, be sure to answer all of the questions that apply to you. If you have questions, contact the compliance, registration or legal department of the sponsoring firm or a legal adviser with securities law experience, or visit the NRD information website at www.nrd-info.ca.

Item 1 Name

1. Legal name

__________

__________

__________

__________

Last name

First name

Second name (N/A [ ])

Third name (N/A [ ])

NRD number (if applicable)_____

2. Other personal names

Are you currently, or have you ever been, known by any names other than your full legal name above, for example, nicknames or names due to marriage?

Yes [ ] No [ ]

If "Yes", complete Schedule A.

3. Use of other names

Are you currently, or have you ever used, operated under, or carried on business under any name other than the name(s) mentioned above, for example, trade names for sole proprietorships or team names?

Yes [ ] No [ ]

If "Yes", complete Schedule A.

Item 2 Residential address

Provide all of your residential addresses, including any foreign residential addresses, for the past 10 years.

1. Current and previous residential addresses

______________________________ (number, street, city, province, territory or state, country, postal code)

______________________________

Telephone number ____________________

Lived at this address since (YYYY/MM) ____________________

If you have lived at this address for less than 10 years, complete Schedule B.

2. Mailing address

[ ] Check here if your mailing address is the same as your current residential address provided above. Otherwise, complete the following:

______________________________ (number, street, city, province, territory or state, country, postal code)

______________________________

3. Business e-mail address

______________________________

Item 3 Personal information

1. Date of birth ____________________ (YYYY/MM/DD)

2. Place of birth ____________________ (city, province, territory or state, country)

3. Gender Female [ ] Male [ ]

4. Eye colour ____________________

5. Hair colour _____

6. Height _____ [ ] in. or _____ [ ] cm

7. Weight _____ [ ] lbs. or _____ [ ] kg

Item 4 Citizenship

1. Citizenship information

What is your country of citizenship?

[ ] Canada

[ ] Other, specify: __________

2. If you are a citizen of a country other than Canada, complete the following for that citizenship.

[ ] Check here if you do not have a valid passport. Otherwise, provide:

Passport number: ____________________

Date of issue: ____________________ (YYYY/MM/DD)

Place of issue: ____________________ (city, province, territory or state, country)

Item 5 Registration jurisdictions

1. Are you filing this form under the passport system / interface for registration?

Only choose "No" if:

(a) you are seeking registration only in your principal jurisdiction,

(b) you are seeking review as a permitted individual

and you are not currently registered under securities legislation in any jurisdiction of Canada.

Yes [ ] No [ ]

2. Check each jurisdiction where you are seeking registration or review as a permitted individual:

[ ] All jurisdictions

[ ] Alberta

[ ] British Columbia

[ ] Manitoba

[ ] New Brunswick

[ ] Newfoundland and Labrador

[ ] Northwest Territories

[ ] Nova Scotia

[ ] Nunavut

[ ] Ontario

[ ] Prince Edward Island

[ ] Québec

[ ] Saskatchewan

[ ] Yukon

2. Check each jurisdiction where you are seeking registration or, if you are seeking review as a permitted individual, check each jurisdiction where your sponsoring firm is registered:

[ ] All jurisdictions

[ ] Alberta

[ ] British Columbia

[ ] Manitoba

[ ] New Brunswick

[ ] Newfoundland and Labrador

[ ] Northwest Territories

[ ] Nova Scotia

[ ] Nunavut

[ ] Ontario

[ ] Prince Edward Island

[ ] Québec

[ ] Saskatchewan

[ ] Yukon

Item 6 Individual categories

1. On Schedule C, check each category for which you are seeking registration as an individual or review as a permitted individual. If you are seeking review as a permitted individual, check each category that describes your position with your sponsoring firm.

2. If you are seeking registration as a representative of a mutual fund dealer or of a scholarship plan dealer in Québec, are you covered by your sponsoring firm's professional liability insurance?

Yes [ ] No [ ]

If "No", state:

The name of your insurer ____________________

Your policy number ____________________

Item 7 Address and agent for service

1. Address for service

You must have one address for service in each province or territory where you are submitting this form. A residential address or a business address is acceptable. A post office box is not an acceptable address for service. Complete Schedule D for each additional address for service you are providing.

Address for service:

______________________________

(number, street, city, province or territory, postal code)

Telephone number ____________________

Fax number, if applicable ____________________

Business e-mail address

______________________________

2. Agent for service

If you have appointed an agent for service, provide the following information for the agent in each province or territory where you have an agent for service. The address of your agent for service must be the same as the address for service above. If your agent for service is not an individual, provide the name of your contact person.

Name of agent for service: ____________________

Contact person: ____________________ Last name, First name

Item 8 Proficiency

1. Course, examination or designation information and other education

Complete Schedule E to indicate each course, examination and designation that is required for registration or approval and that you have successfully completed or have been exempted from.

[ ] Check here if you are not required under securities legislation or derivatives legislation or both, or the rules of an SRO to satisfy any course, examination or designation requirements.

Complete Schedule E to state each course, examination and designation that

is required for registration or approval, and

you have successfully completed or, if you are an IIROC applicant, have been exempted from.

[ ] Check here if you are not required under securities legislation or derivatives legislation, or the rules of an SRO to satisfy any course, examination or designation requirements.

2. Student numbers

If you have a student number for a course that you successfully completed with one of the following organizations, provide it below:

CSI Global Education: ____________________

IFSE Institute: ____________________

Institute of Canadian Bankers (ICB): ____________________

CFA Institute: ____________________

Advocis: ____________________

RESP Dealers Association of Canada: ____________________

Other: ____________________

3. Exemption refusal

Has any securities regulator, derivatives regulator or SRO refused to grant you an exemption from a course, examination, designation or experience requirement?

Yes [ ] No [ ]

If "Yes", complete Schedule F.

4. Relevant securities industry experience

If you are an individual applying for IIROC approval, select "N/A".

If you have not been registered in the last 36 months and you passed the required examination more than 36 months ago, do you consider that you have gained 12 months of relevant securities industry experience during the 36-month period?

Yes [ ] No [ ] N/A [ ]

If "Yes", complete Schedule F.

If you are an individual applying for IIROC approval, select "N/A".

Do you have relevant securities experience?

Yes [ ] No [ ] N/A [ ]

If "Yes", complete Schedule F.

Item 9 Location of employment

1. Provide the following information for your new sponsoring firm. If you will be working out of more than one business location, provide the following information for the business location out of which you will be doing most of your business. If you are only filing this form because you are a permitted individual and you are not employed by, or acting as agent for, the sponsoring firm, select "N/A".

NRD location number: ____________________

Unique Identification Number (optional): ____________________

Business location address: ____________________ (number, street, city, province, territory or state, country, postal code)

Telephone number: (_____) ____________________

Fax number: (_____) ____________________

N/A [ ]

2. If the firm has a foreign head office, and/or you are not a resident of Canada, provide the address for the business location in which you will be conducting most of your business. If you are only filing this form because you are a permitted individual and you are not employed by, or acting as agent for, the sponsoring firm, select "N/A".

Business location address: ____________________ (number, street, city, province, territory or state, country, postal code)

Telephone number: (_____) ____________________

Fax number: (_____) ____________________

N/A [ ]

[The following under #3 "Type of business location", #4 and #5 is for a Format other than NRD format only]

3. Type of business location:

[ ] Head office

[ ] Branch or business location

[ ] Sub-branch (members of the Mutual Fund Dealers Association of Canada only)

4. Name of supervisor or branch manager: ____________________

5. [ ] Check here if the mailing address of the business location is the same as the business location address provided above. Otherwise, complete the following:

Mailing address: ____________________ (number, street, city, province, territory or state, country, postal code)

Item 10 Current employment, other business activities, officer positions held and directorships

Complete a separate Schedule G for each of your current business and employment activities, including employment and business activities with your sponsoring firm and any employment and business activities outside your sponsoring firm. Also include all officer or director positions and any other equivalent positions held, as well as positions of influence. The information must be provided

whether or not you receive compensation for such services, and

whether or not any such position is business related.

Item 10 Reportable activities

1. Activities with your sponsoring firm

Instructions: Describe all of your roles and responsibilities with your sponsoring firm, whether these roles and responsibilities are securities related or not (e.g., sale of securities, review of marketing materials, IT helpdesk, negotiation of employment contracts, sales of banking and insurance products and services). Include any other information about your position with your sponsoring firm that is relevant for the regulator or, in Québec, the securities regulatory authority to know (e.g., if your role is specialized).

Complete a Schedule G with respect to your roles and responsibilities with your sponsoring firm.

2. Reportable outside activities

Instructions: Consider all of the activities that you participate in outside of your sponsoring firm, whether or not you receive compensation for such activities and whether or not any such activity is business related. If any of the categories below describes one or more activities that you participate in, complete a separate Schedule G for each activity or entity.

Category 1 -- Activities with another registered firm

Instructions: Report activities with registered firms, other than your sponsoring firm. All activities in this category are reportable, whether or not you receive compensation for such activities. Major shareholder means a shareholder who, in total, directly or indirectly owns voting securities carrying 10 percent or more of the votes carried by all outstanding voting securities.

If you are a director, officer, employee, contractor, consultant, agent, or service provider of a registered firm other than your sponsoring firm, or hold any other equivalent position with or for that registered firm, or are a major shareholder or partner of that registered firm, complete a separate Schedule G for the registered firm.

Category 2 -- Activities with an entity that receives compensation from a registered firm

If you are a director, officer, employee, contractor, consultant, or agent of a specified entity, or hold any other equivalent position with or for a specified entity, or are a shareholder or partner of a specified entity, complete a separate Schedule G for the specified entity.

For the purposes of this category, "specified entity" means an entity that receives compensation from a registered firm for activities that you provide for your sponsoring firm or another registered firm.

Category 3 -- Other securities related activities

Instructions: All activities in this category are reportable, whether or not you receive compensation for such activities.

If you have been at any time in the last 7 years directly involved in raising money for an entity through the issuance of securities or derivatives or promoting the sale of an entity's securities or derivatives outside of your activities with your sponsoring firm or another registered firm, complete a separate Schedule G for each entity for which you performed these activities.

Directors and officers of reporting issuers and of entities that have been at any time in the last 7 years raising money through the issuance of securities or derivatives are considered to be directly involved in raising money for that entity.

Category 4 -- Provision of financial or financial-related services

Instructions: All activities in this category are reportable, whether or not you receive compensation for such activities. Major shareholder means a shareholder who, in total, directly or indirectly owns voting securities carrying 10 percent or more of the votes carried by all outstanding voting securities.

Complete a separate Schedule G for each activity, as applicable, if you are

an insurance broker or agent,

providing loan or deposit products and services,

carrying out a money service business,

a mortgage broker, agent or administrator,

preparing tax returns or providing tax advice,

providing financial planning or financial advice, including estate planning,

providing corporate finance services, including services provided in the capacity of a comptroller, treasurer and chief financial officer,

advising on credit/debt restructuring,

a pension consultant,

providing advice on mergers and acquisitions services,

providing accounting or bookkeeping services,

providing oversight or independent review or expert opinion on the management of an entity's financial assets, or

providing banking or insurance services.

Also complete a separate Schedule G for each activity, as applicable, if you are a director or officer, or hold any other equivalent position with or for, or are a major shareholder or active partner of, an entity that provides one or more of the services in the above list.

Category 5 -- Positions of influence

Instructions: All positions of influence (e.g., medical doctor, leader in a religious organization) are reportable, whether or not you receive compensation for such activities. For more information on positions of influence, see section 13.4.3 of National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations and section 13.4.3 of the Companion Policy to National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations.

Complete a separate Schedule G for each position of influence that you hold.

Category 6 -- Specified activities

Complete a separate Schedule G for activities not included in Categories 1 to 5 if the total time spent by you on specified activities exceeds, on average, 30 hours per month.

For this purpose, "specified activities" means all of the following:

activities to which any of Categories 1 to 5 apply;

activities for which you receive compensation or where you have a reasonable expectation of compensation;

all other activities (whether or not you are compensated) for which you are a director or officer of, or hold an equivalent position with or for the entity, or are a partner or shareholder of the entity.;

Item 11 Previous employment and other activities

On Schedule H, complete your history of employment and other activities for the past 10 years.

Item 12 Resignations and terminations

Have you ever resigned, been terminated or been dismissed for cause by an employer from a position following allegations that you:

1. Violated any statutes, regulations, rules or standards of conduct?

Yes [ ] No [ ]

If "Yes", complete Schedule I, Item 12.1.

2. Failed to appropriately supervise compliance with any statutes, regulations, rules or standards of conduct?

Yes [ ] No [ ]

If "Yes", complete Schedule I, Item 12.2.

3. Committed fraud or the wrongful taking of property, including theft?

Yes [ ] No [ ]

If "Yes", complete Schedule I, Item 12.3.

Item 12 Resignations and terminations

Instructions: Disclose any allegation that existed at the time of your termination or resignation, regardless of whether the allegation caused or contributed to your resignation or termination.

Have you ever resigned or been terminated from a position or contract when, at the time of your resignation or termination, there existed an allegation that you:

1. Contravened any statutes, regulations, orders of a court or regulatory body, rules or bylaws or failed to meet any standard of conduct of a sponsoring firm, of any industry association or of any authority exercising jurisdiction over specific business activities or professions?

Yes [ ] No [ ]

If "Yes", complete Schedule I, Item 12.1.

2. Failed to appropriately supervise compliance with any statutes, regulations, orders of a court or regulatory body, rules or bylaws or with any standard of conduct of a sponsoring firm, of any industry association, or of any authority exercising jurisdiction over specific business activities or professions?

Yes [ ] No [ ]

If "Yes", complete Schedule I, Item 12.2.

3. Committed a crime?

Yes [ ] No [ ]

If "Yes", complete Schedule I, Item 12.3.

Item 13 Regulatory disclosure

The questions below relate to any jurisdiction of Canada and any foreign jurisdiction.

1. Securities and derivatives regulation

a) Other than a registration or permitted individual status that has been recorded under this NRD number, are you now, or have you ever been, registered or licensed with any securities regulator or derivatives regulator or both, to trade in or advise on securities or derivatives or both?

Yes [ ] No [ ]

If "Yes", complete Schedule J, Item 13.1(a).

b) Have you ever been refused registration or a licence to trade in or advise on securities or derivatives or both?

Yes [ ] No [ ]

If "Yes", complete Schedule J, Item 13.1(b).

c) Have you ever been denied the benefit of any exemption from registration provided in any securities or derivatives or both legislation or rules, other than what was disclosed in Item 8.3 of this form?

Yes [ ] No [ ]

If "Yes", complete Schedule J, Item 13.1(c).

d) Are you now, or have you ever been subject to any disciplinary proceedings or any order resulting from disciplinary proceedings under any securities legislation or derivatives legislation or both?

Yes [ ] No [ ]

If "Yes", complete Schedule J, Item 13.1(d).

2. SRO regulation

a) Other than an approval that has been recorded under this NRD number, are you now, or have you ever been, an approved person of an SRO or similar organization?

Yes [ ] No [ ]

If "Yes", complete Schedule J, Item13.2(a).

b) Have you ever been refused approved person status by an SRO or similar organization?

Yes [ ] No [ ]

If "Yes", complete Schedule J, Item 13.2(b).

c) Are you now, or have you ever been, subject to any disciplinary proceedings conducted by any SRO or similar organization?

Yes [ ] No [ ]

If "Yes", complete Schedule J, Item 13.2(c).

3. Non-securities regulation

a) Are you now, or have you ever been, registered or licensed under any legislation which requires registration or licensing to deal with the public in any capacity other than to trade in or advise on securities or derivatives or both (e.g. insurance, real estate, accountant, lawyer, teacher, doctor, mortgage broker or agent)?

Yes [ ] No [ ]

If "Yes", complete Schedule J, Item 13.3(a)

b) Have you ever been refused registration or a licence under any legislation relating to your professional activities unrelated to securities or derivatives?

Yes [ ] No [ ]

If "Yes", complete Schedule J, Item 13.3(b).

c) Are you now, or have you ever been, a subject of any disciplinary actions conducted under any legislation relating to your professional activities unrelated to securities or derivatives?

Yes [ ] No [ ]

If "Yes", complete Schedule J, Item 13.3(c).

Item 14 Criminal disclosure

The questions below apply to offences committed in any jurisdiction of Canada and any foreign jurisdiction.

You must disclose all offences, including:

a criminal offence under federal statutes such as the Criminal Code (Canada), Income Tax Act (Canada), the Competition Act (Canada), Immigration and Refugee Protection Act (Canada) and theControlled Drugs and Substances Act (Canada), even if

a record suspension has been ordered under the Criminal Records Act (Canada)

you have been granted an absolute or conditional discharge under the Criminal Code (Canada), and

a criminal offence, with respect to questions 14.2 and 14.4, of which you or your firm has been found guilty or for which you or your firm have participated in the alternative measures program within the previous three years, even if a record suspension has been ordered under the Criminal Records Act (Canada)

You must disclose all offences, including:

a criminal offence under the laws of Canada such as the Criminal Code (Canada), the Income Tax Act (Canada), the Competition Act (Canada), the Immigration and Refugee Protection Act (Canada) and the Controlled Drugs and Substances Act (Canada), even if

a record suspension has been ordered under the Criminal Records Act (Canada), or

you have been granted an absolute or conditional discharge under the Criminal Code (Canada),

a criminal offence under the laws of any foreign jurisdiction (such as U.S. federal and state criminal offences), and

a criminal offence, with respect to questions 14.2 and 14.4,

of which you or any entity when you were a partner, director, officer or major shareholder of that entity has been found guilty, or

for which you or any entity when you were a partner, director, officer or major shareholder of that entity have participated in the alternative measures program, a diversion program, or any alternative resolution program within the previous three years, even if a record suspension has been ordered under the Criminal Records Act (Canada).

You are not required to disclose:

• charges for summary conviction offences that have been stayed for six months or more,

• charges for indictable offences that have been stayed for a year or more,

• offences under the Youth Criminal Justice Act (Canada), and

• speeding or parking violations.

Subject to the exceptions above:

1. Are there any outstanding or stayed charges against you alleging a criminal offence that was committed?

Yes [ ] No [ ]

If "Yes", complete Schedule K, Item 14.1.

2. Have you ever been found guilty, pleaded no contest to, or been granted an absolute or conditional discharge from any criminal offence that was committed?

Yes [ ] No [ ]

If "Yes", complete Schedule K, Item 14.2.

3. To the best of your knowledge, are there any outstanding or stayed charges against any firm entity of which you were, at the time the criminal offence was alleged to have taken place, a partner, director, officer or major shareholder?

Yes [ ] No [ ]

If "Yes", complete Schedule K, Item 14.3.

4. To the best of your knowledge, has any firmentity, when you were a partner, officer, director or major shareholder, ever been found guilty, pleaded no contest to or been granted an absolute or conditional discharge from a criminal offence that was committed?

Yes [ ] No [ ]

If "Yes", complete Schedule K, Item 14.4.

Item 15 Civil disclosure

The questions below relate to any jurisdiction of Canada and any foreign jurisdiction.

1. Are there currently any outstanding civil actions alleging fraud, theft, deceit, misrepresentation or similar misconduct against you or a firm an entity where you are or were a partner, director, officer or major shareholder?

Yes [ ] No [ ]

If "Yes", complete Schedule L, Item 15.1.

2. Have you or a firm an entity where you are or were a partner, director, officer or major shareholder ever been a defendant or respondent in any civil proceeding in which fraud, theft, deceit, misrepresentation or similar misconduct is, or was, successfully established in a judgment?

Yes [ ] No [ ]

If "Yes", complete Schedule L, Item 15.2.

Item 16 Financial disclosure

1. Bankruptcy

Under the laws of any applicable jurisdiction, have you or has any firm when you were a partner, director, officer or major shareholder of that firm:

a) Had a petition in bankruptcy issued or made a voluntary assignment in bankruptcy or any similar proceeding?

Yes [ ] No [ ]

If "Yes", complete Schedule M, Item 16.1(a).

b) Made a proposal under any legislation relating to bankruptcy or insolvency or any similar proceeding?

Yes [ ] No [ ]

If "Yes", complete Schedule M, Item 16.1(b).

c) Been subject to proceedings under any legislation relating to the winding up or dissolution of the firm, or under the Companies' Creditors Arrangement Act (Canada)?

Yes [ ] No [ ]

If "Yes", complete Schedule M, Item 16.1(c).

d) Been subject to or initiated any proceedings, arrangement or compromise with creditors? This includes having a receiver, receiver-manager, administrator or trustee appointed by or at the request of creditors, privately, through court process or by order of a regulatory authority, to hold your assets.

Yes [ ] No [ ]

If "Yes", complete Schedule M, Item 16.1(d).

2. Debt obligations

Over the past 10 years, have you failed to meet a financial obligation of $10,000 or more as it came due or, to the best of your knowledge, has any firm, while you were a partner, director, officer or major shareholder of that firm, failed to meet any financial obligation of $10,000 or more as it came due?

Yes [ ] No [ ]

If "Yes", complete Schedule M, Item 16.2.

3. Surety bond or fidelity bond

Have you ever been refused for a surety or fidelity bond?

Yes [ ] No [ ]

If "Yes", complete Schedule M, Item 16.3.

4. Garnishments, unsatisfied judgments or directions to pay

Has any federal, provincial, territorial, state authority or court ever issued any of the following against you regarding your indebtedness or, to the best of your knowledge, the indebtedness of a firm where you are or were a partner, director, officer or major shareholder:

Yes

No

 

Garnishment

[ ]

[ ]

Unsatisfied judgment

[ ]

[ ]

Direction to pay

[ ]

[ ]

If "Yes", complete Schedule M, Item 16.4.

Item 16 Financial disclosure

By submitting this form you consent to the collection by the regulator or, in Québec, securities regulatory authority of your financial personal financial information through the use of bankruptcy and insolvency records and other means (See Item 20 -- Collection and use of personal information).

1. Bankruptcies, insolvencies, consumer proposals and creditor arrangements

Instructions: You must provide the following informationeven if the event occurred more than 7 years ago.

The information is required to be reported even if you or the entity has been discharged or released from bankruptcy.

A proceeding, arrangement or compromise with creditors includes the appointment of a receiver, receiver-manager, administrator or trustee.

Under the laws of any jurisdiction, including any foreign jurisdiction, have any of the following events ever occurred to you or to any entity when you were a partner, director, officer or major shareholder of the entity:

a) a bankruptcy, a filing for bankruptcy or a proceeding governing an event similar to a bankruptcy?

Yes [ ] No [ ]

If "Yes", complete Schedule M, Item 16.1(a).

b) a proposal, including a consumer proposal, under any legislation relating to bankruptcy or insolvency or any similar proceeding?

Yes [ ] No [ ]

If "Yes", complete Schedule M, Item 16.1(b).

c) proceedings under any legislation relating to the winding up or dissolution of the entity, or under the Companies' Creditors Arrangement Act (Canada)?

Yes [ ] No [ ]

If "Yes", complete Schedule M, Item 16.1(c).

d) any proceedings, arrangement or compromise with creditors?

Yes [ ] No [ ]

If "Yes", complete Schedule M, Item 16.1(d).

2. Debt obligations

During the past 10 years:

have you failed to meet a financial obligation of $10,000 or more as it came due, or

to the best of your knowledge, has any entity, while you were a partner, director, officer or major shareholder of that entity, failed to meet any financial obligation of $10,000 or more as it came due?

Yes [ ] No [ ]

If "Yes", complete Schedule M, Item 16.2.

3. Surety bond or fidelity bond

Have you ever been refused for a surety or fidelity bond?

Yes [ ] No [ ]

If "Yes", complete Schedule M, Item 16.3.

4. Garnishments, unsatisfied judgments or directions to pay

Has any governmental authority or court, in any jurisdiction, ever issued any of the following against

you regarding your indebtedness, or

to the best of your knowledge, the indebtedness of an entity where you are or were a partner, director, officer or major shareholder:

<<Yes>>

<<No>>

<<Garnishment>>

<<[ ]>>

<<[ ]>>

<<Unsatisfied judgment>>

<<[ ]>>

<<[ ]>>

<<Direction to pay>>

<<[ ]>>

<<[ ]>>

If "Yes", complete Schedule M, Item 16.4.

Item 17 Ownership of securities and derivatives firms

Are you now, or have you ever been, a partner or major shareholder of any firm (including your sponsoring firm) whose business is trading in or advising on securities or derivatives or both?

Yes [ ] No [ ]

If "Yes", complete Schedule N.

Item 18 Agent for service

By submitting this form, you certify that in each jurisdiction of Canada where you have appointed an agent for service, you have completed the appointment of agent for service required in that jurisdiction.

Item 19 Submission to jurisdiction

By submitting this form, you agree to be subject to the securities legislation or derivatives legislation or both of each jurisdiction of Canada, and to the by-laws, regulations, rules, rulings and policies (collectively referred to as "rules" in this form) of the SROs to which you have submitted this form. This includes the jurisdiction of any tribunals or any proceedings that relate to your activities as a registrant or a partner, director or officer of a registrant under that securities legislation or derivatives legislation or both or as an Approved Person under SRO rules.

Item 20 Notice of collection and use of personal information

The personal information required under this form is collected on behalf of, and used by, the securities regulatory authorities in the jurisdictions set out in Schedule O to administer and enforce certain provisions of their securities legislation or derivatives legislation or both.

By submitting this form, the individual consents to the collection by the securities regulatory authorities of this personal information, and any police records, records from other government or non-governmental regulators or SROs, credit records and employment records about the individual that the securities regulatory authorities may need to complete their review of the information submitted in this form relating to the individual's continued fitness for registration or approval, if applicable, in accordance with the legal authority of the securities regulatory authorities while the individual is registered with or approved by it. Securities regulatory authorities may contact government and private bodies or agencies, individuals, corporations and other organizations for information about the individual.

If you have any questions about the collection and use of this information, contact the securities regulatory authority in any jurisdiction in which the required information is submitted. See Schedule O for details. In Québec, you can also contact the Commission d'accès à l'information at 1-888-528-7741 or visit its website at www.cai.gouv.qc.ca.

SROs

The principal purpose for the collection of personal information is to assess your suitability for registration or approval and to assess your continued fitness for registration or approval in accordance with the applicable securities legislation and the rules of the SROs.

By submitting this form, you authorize the SROs to which this form is submitted to collect any information from any source whatsoever. This includes, but is not limited to, personal confidential information about you that is otherwise protected by law such as police, credit, employment, education and proficiency course completion records, and records from other government or non-governmental regulatory authorities, securities commissions, stock exchanges, or other SROs, private bodies, agencies, individuals or corporations, as may be necessary for the SROs to complete their review of your form or continued fitness for registration or approval in accordance with their rules for the duration of the period you remain so registered or approved. You further consent to and authorize the transfer of confidential information between SROs, securities commissions or stock exchanges from whom you now, or may in the future, seek registration or approval, or with which you are currently registered or approved for the purpose of determining fitness or continued fitness for registration or approval or in connection with the performance of an investigation or other exercise of regulatory authority, whether or not you are registered with or approved by them.

By submitting this form, you certify that you understand the rules of the applicable SROs of which you are seeking registration or approval or of which your sponsoring firm is a member or participating organization. You also undertake to become conversant with the rules of any SROs of which you or your sponsoring firm becomes a member or participating organization. You agree to be bound by, observe and comply with these rules as they are from time to time amended or supplemented, and you agree to keep yourself fully informed about them as they are amended and supplemented. You submit to the jurisdiction of the SROs from whom you are seeking registration or approval, or of which your sponsoring firm is now or in the future becomes a member or participating organization and, wherever applicable, their Governors, Directors and Committees. You agree that any registration or approval granted pursuant to this form may be revoked, terminated or suspended at any time in accordance with the then applicable rules of the respective SROs. In the event of any such revocation or termination, you must terminate all activities which require registration or approval and, thereafter, not perform services that require registration or approval for any member of the SROs or any approved affiliated company or other affiliate of such member without obtaining the approval of or registration with the SROs, in accordance with their rules.

By submitting this form, you undertake to notify the SROs from whom you are seeking registration or approval or with which you are currently or may in the future be registered or approved of any material change to the information herein provided in accordance with their respective rules. You agree to the transfer of this form, without amendment, to other SROs in the event that at some time in the future you seek registration or approval from such other SROs.

You certify that you have discussed the questions in this form, together with this Agreement, with an Officer, Supervisor or Branch Manager of your sponsoring member firm and, to your knowledge and belief, the authorized Officer, Supervisor or Branch Manager was satisfied that you fully understood the questions and the terms of this Agreement. You further certify that your business activities that are subject to securities rules and derivatives rules or both will be limited strictly to those permitted by the category of your registration or approval.

Item 20 Collection and use of personal information

1. Notice of collection and use of personal information

Your personal information is collected by, or on behalf of, each securities regulatory authority and SRO set out in Schedule O. Any of the securities regulatory authorities or SROs set out in Schedule O may contact government or private bodies or agencies, individuals, corporations, employers, and other organizations, in Canada and in other countries, for information about you.

This personal information is being collected under the authority of the applicable securities legislation, derivatives legislation (including commodity futures legislation) or both of the securities regulatory authorities and pursuant to the SRO rules of an SRO set out in Schedule O. The collection, use and disclosure are done in accordance with applicable freedom of information and privacy legislation.

The principal purpose of this collection by the securities regulatory authorities is to administer, enforce, carry out their duties or exercise their powers under their respective securities legislation, derivatives legislation (including commodity futures legislation) or both, and by the SROs to administer and enforce the rules of the SROs.

The information submitted by you in this form with your consent, or collected indirectly with your authorization, may be collected

at the time of your application,

at any time during your registration or while you are a permitted individual, or

at the time the regulator or, in Québec, the securities regulatory authority, or SRO is informed by your sponsoring firm that you no longer have authority to act on behalf of the sponsoring firm or are not a permitted individual of the sponsoring firm.

If you have any questions about the collection, use, and disclosure of this information, contact the securities regulatory authority or SRO in any jurisdiction in which the required information is submitted. See Schedule O for details.

Note that certain information such as your name(s) (including aliases, trade names or some past names), your sponsoring firm, and other relevant registration information will be listed in a publicly available registry of registered individuals and, if applicable, on the Disciplined List.

Also note that certain securities regulatory authorities may provide or receive information to or from certain entities under separate provisions of their securities legislation or derivatives legislation (including commodity futures legislation) or both, and SROs may provide or receive information under the rules of the SROs. This consent and notice does not limit the authority, powers, obligations, or rights conferred on any of the securities regulatory authorities by legislation or regulations in effect in their jurisdiction.

2. Consent to collect and use personal information

By submitting this form, you consent to and authorize the collection, directly and indirectly, of personal information by each securities regulatory authority and SRO and to the use of your personal information as set out above.

The personal information that each securities regulatory authority or SRO collects, includes the following:

the personal information provided in this form;

the personal information provided by your sponsoring firm;

registration or financial services licensing information;

law enforcement records, including police records;

credit records;

bankruptcy or other insolvency records;

employment records and information received from an employer;

records and information received from entities you had or have an independent contractor or agency relationship with;

personal information available online;

records from government ministries and agencies, SROs or authorities exercising jurisdiction over specific business activities or professions; and

records of, and used in, court proceedings, including any probation records.

Item 21 Warning[repealed]

It is an offence under securities legislation and derivatives legislation, including commodity futures legislation, to give false or misleading information on this form.

Item 22 Certification[repealed]

1. Certification -- NRD format

I confirm I have discussed the questions in this form with an officer, branch manager or supervisor of my sponsoring firm. To the best of my knowledge, the officer, branch manager or supervisor was satisfied that I fully understood the questions. I will limit my activities to those permitted by my category of registration. If the business location specified in this form is a residence, I hereby give my consent for the regulator or, in Québec, the securities regulatory authority to enter that residence for the administration of securities legislation and derivatives legislation, including commodity futures legislation.

[ ] I am making this submission as agent for the individual identified in this form. By checking this box, I certify that the individual provided me with all of the information on this form and the certification above.

2. Certification -- Format other than NRD format

Individual

By signing below, I certify to the regulator, or in Québec the securities regulatory authority, in each jurisdiction where I am filing or submitting this form, either directly or through the principal regulator, that:

I have read this form and understand the questions,

all of the information provided on this form is true, and complete, and

if the business location specified in this form is a residence, I hereby give my consent for the regulator or, in Québec, the securities regulatory authority to enter that residence for the administration of securities legislation and derivatives legislation, including commodity futures legislation.

Signature of individual ____________________ Date ____________________

Authorized partner or officer of the firm

By signing below, I certify to the regulator, or in Québec the securities regulatory authority, in each jurisdiction where I am submitting this form, either directly or through the principal regulator, for the individual that:

the individual identified in this form will be engaged by the sponsoring firm as a registered individual or a permitted individual, and

I have, or a branch manager, or supervisor, or another officer or partner has, discussed the questions set out in this form with the individual and, to the best of my knowledge, the individual fully understands the questions.

Name of firm ____________________

Name of authorized signing officer or partner ____________________

Title of authorized signing officer or partner ____________________

Signature of authorized signing officer or partner ____________________

Date signed ____________________ (YYYY/MM/DD)

 

Schedule A

Names (Item 1)

Item 1.2 Other personal names

Name 1:

__________

__________

__________

__________

Last name

First name

Second name (N/A )

Third name (N/A )

Provide the reasons for the use of this name (for example, marriage, divorce, court order, commonly used name or nickname):

______________________________

When did you use this name?

From:

To:

__________ (YYYY/MM)

__________ (YYYY/MM)

Name 2:

__________

__________

__________

__________

Last name

First name

Second name (N/A [ ])

Third name (N/A [ ])

Provide the reasons for the use of this name (for example, marriage, divorce, court order, commonly used name or nickname):

______________________________

When did you use this name?

From:

To:

__________ (YYYY/MM)

__________ (YYYY/MM)

Name 3:

__________

__________

__________

__________

Last name

First name

Second name (N/A [ ])

Third name (N/A [ ])

Provide the reasons for the use of this name (for example, marriage, divorce, court order, commonly used name or nickname):

When did you use this name?

From:

To:

 

__________ (YYYY/MM)

__________ (YYYY/MM)

Item 1.3 Use of other names

Name 1:

Name: ____________________

Provide the reasons for the use of this other name (for example, trade name or team name): ____________________

If this other name is or was used in connection with any sponsoring firm, did the sponsoring firm approve the use of the name?

Yes [ ] No [ ] N/A [ ]

When did you use this name?

From:

To:

 

__________ (YYYY/MM)

__________ (YYYY/MM)

Name 2:

Name: ____________________

Provide the reasons for the use of this other name (for example, trade name or team name): ____________________

If this other name is or was used in connection with any sponsoring firm, did the sponsoring firm approve the use of the name?

Yes [ ] No [ ] N/A [ ]

When did you use this name?

From:

To:

 

__________ (YYYY/MM)

__________ (YYYY/MM)

Name 3:

Name: ____________________

Provide the reasons for the use of this other name (for example, trade name or team name): ____________________

If this other name is or was used in connection with any sponsoring firm, did the sponsoring firm approve the use of the name?

Yes [ ] No [ ] N/A [ ]

When did you use this name?

From:

To:

 

__________ (YYYY/MM)

__________ (YYYY/MM)

 

Schedule B

Residential address (Item 2)

Item 2.1 Current and previous residential addresses

If you have lived at your current address for less than 10 years, list all previous addresses for the past 10 years.

You do not have to include a postal code or ZIP code, or a telephone number for any previous address.

Address 1:

Residential address: ____________________ (number, street, city, province, territory or state, country)

When did you use this name?

From:

To:

 

__________ (YYYY/MM)

__________ (YYYY/MM)

Address 2:

Residential address: ____________________ (number, street, city, province, territory or state, country)

When did you live at this address?

From:

To:

 

__________ (YYYY/MM)

__________ (YYYY/MM)

Address 3:

Residential address: ____________________ (number, street, city, province, territory or state, country)

When did you live at this address?

From:

To:

 

__________ (YYYY/MM)

__________ (YYYY/MM)

 

Schedule C

Individual categories (Item 6)

Check each category for which you are seeking registration, approval or review as a permitted individual.

- - - - - - - - - - - - - - - - - - - -

Categories common to all jurisdictions under securities legislation

Firm categories [Format other than NRD format only]

[ ] Investment Dealer

[ ] Mutual Fund Dealer

[ ] Scholarship Plan Dealer

[ ] Exempt Market Dealer

[ ] Restricted Dealer

[ ] Portfolio Manager

[ ] Restricted Portfolio Manager

[ ] Investment Fund Manager

Individual categories and permitted activities

[ ] Dealing Representative

[ ] Advising Representative

[ ] Associate Advising Representative

[ ] Ultimate Designated Person

[ ] Chief Compliance Officer

[ ] Permitted Individual

[ ] Officer -- Specify title:

[ ] Director

[ ] Partner

[ ] Shareholder

[ ] Branch Manager (MFDA members only)

[ ] IIROC approval only

IIROC

Approval categories

[ ] Executive

[ ] Director (Industry)

[ ] Director (Non-Industry)

[ ] Supervisor

[ ] Investor

[ ] Registered Representative

[ ] Investment Representative

[ ] Trader

[ ] Executive

[ ] Director (Industry)

[ ] Director (Non-Industry)

[ ] Supervisor

[ ] Investor

[ ] Registered Representative

[ ] Investment Representative

[ ] Portfolio Manager

[ ] Associate Portfolio Manager

[ ] Trader

Additional approval categories

[ ] Chief Compliance Officer

[ ] Chief Financial Officer

[ ] Ultimate Designated Person

Products

[ ] Non-Trading

[ ] Securities

[ ] Options

[ ] Futures Contracts and Futures Contract Options

[ ] Mutual Funds only

Customer type

[ ] Retail

[ ] Institutional

[ ] Not Applicable

Portfolio management

[ ] Portfolio Management

Categories under local commodity futures and derivatives legislation

Ontario

Firm categories

[ ] Commodity Trading Adviser

[ ] Commodity Trading Counsel

[ ] Commodity Trading Manager

[ ] Futures Commission Merchant

Individual categories and permitted activities

[ ] Advising Representative

[ ] Salesperson

[ ] Branch Manager

[ ] Officer -- Specify title:

[ ] Director

[ ] Partner

[ ] Shareholder

[ ] IIROC approval only

Manitoba

Firm categories

[ ] Dealer (Merchant)

[ ] Dealer (Futures Commission Merchant)

[ ] Dealer (Floor Broker)

[ ] Adviser

[ ] Local

Individual categories and permitted activities

[ ] Floor Broker

[ ] Salesperson

[ ] Branch Manager

[ ] Adviser

[ ] Officer -- Specify title:

[ ] Director

[ ] Partner

[ ] Futures Contracts Portfolio Manager

[ ] Associate Futures Contracts Portfolio Manager

[ ] IIROC approval only

[ ] Local

Québec

Firm categories

[ ] Derivatives Dealer

[ ] Derivatives Portfolio Manager

Individual categories and permitted activities

[ ] Derivatives Dealing Representative

[ ] Derivatives Advising Representative

[ ] Derivatives Associate Advising Representative

- - - - - - - - - - - - - - - - - - - -

 

Schedule D

Address and agent for service (Item 7)

Item 7.1 Address for service

You must have one address for service in each province or territory in which you are now, or are seeking to become, a registered individual or permitted individual. A post office box is not an acceptable address for service.

Address for service: ____________________ (number, street, city, province or territory, postal code)

Telephone number: (_____) ____________________

Fax number: (_____) ____________________

Business e-mail address: ____________________

Item 7.2 Agent for service

If you have appointed an agent for service, provide the following information about the agent. The address for service provided above must be the address of the agent named below.

Name of agent for service: ____________________

(if applicable)

Contact person: ____________________ Last name, First name

 

Schedule E

Proficiency (Item 8)

Item 8.1 Course, examination or designation information and other education

Below, state each course, examination and designation that:

is required for registration or approval, and

you have successfully completed.

*For IIROC applicants only -- If applicable, please indicate the date of any exemption granted for any course, examination, designation or other education required for approval.

Course, examination, designation or other education

Date completed (YYYY/MM/DD)

Date exempted<<*>> (YYYY/MM/DD)

Regulator / securities regulatory authority granting the exemption<<*>>

 

__________

__________

__________

__________

 

__________

__________

__________

__________

 

__________

__________

__________

__________

 

__________

__________

__________

__________

If you have listed the CFA Charter in Item 8.1, please indicate by checking "Yes" below if you are a current member of the CFA Institute permitted to use this charter.

Yes [ ] No [ ]

If "No", please explain why you no longer hold this designation:

______________________________

______________________________

______________________________

If you have listed the Canadian Investment Manager Designation in Item 8.1, please indicate by checking "Yes" below if you are currently permitted to use this designation.

Yes [ ] No [ ]

If "No", please explain why you no longer hold this designation:

______________________________

______________________________

______________________________

 

Schedule F

Proficiency (Items 8.3 and 8.4)

Item 8.3 Exemption refusal

Complete the following for each exemption that was refused.

1. Which securities regulator, derivatives regulator or SRO refused to grant the exemption?

______________________________

State the name of the course, examination, designation or experience requirement:

______________________________

State the reason given for not being granted the exemption:

______________________________

Date exemption refused: ____________________ (YYYY/MM/DD)

2. Which securities regulator, derivatives regulator or SRO refused to grant the exemption?

______________________________

State the name of the course, examination, designation or experience requirement:

______________________________

State the reason given for not being granted the exemption:

______________________________

Date exemption refused: ____________________ (YYYY/MM/DD)

3. Which securities regulator, derivatives regulator or SRO refused to grant the exemption?

______________________________

State the name of the course, examination, designation or experience requirement:

______________________________

State the reason given for not being granted the exemption:

______________________________

Date exemption refused: ____________________ (YYYY/MM/DD)

Item 8.4 Relevant securities industry experience

Describe your responsibilities in areas relating to the category you are applying for, including the title(s) you have held, as well as start and end dates:

______________________________

______________________________

______________________________

What is the percentage of your time devoted to these activities?

_____ %

Indicate the continuing education activities in which you have participated during the last 36 months and that are relevant to the category of registration you are applying for:

______________________________

______________________________

______________________________

Item 8.4 Relevant securities experience

Instructions:

Some registration categories require a specified amount of experience be obtained within specified timeframes. Please see National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations for more information.

If you are applying to be an advising representative or an associate advising representative, provide details of the activities you performed for each experience that is relevant investment management experience. Such details may include the level of responsibility; value of accounts under direct supervision; number of years of experience in performing securities research and analysis for the purpose of portfolio securities selection, portfolio construction and analysis; number of years of experience collecting know-your-client information; or number of years of experience conducting suitability assessments.

1. If you are applying

to be an advising representative or an associate advising representative of a portfolio manager, describe the relevant investment management experience that you have gained, or

for any other category, describe the relevant securities industry experience that you have gained.

For each description of relevant experience, provide the following information:

(a) the name of the firm or entity with which you gained this experience;

(b) your title;

(c) the start and end dates of this experience;

(d) the details of the activities you performed that are relevant for the category of registration that you are applying for; and

(e) the percentage of your time in this position that was spent on activities relating to the experience.

______________________________

______________________________

______________________________

2. Indicate the continuing education activities in which you have participated during the last 36 months and that are relevant to the category of registration you are applying for:

______________________________

______________________________

______________________________

 

Schedule G

Current employment, other business activities, officer positions held and directorships (Item 10)

Complete a separate Schedule G for each of your current business and employment activities, including employment and business activities with your sponsoring firm and any employment and business activities outside your sponsoring firm. Also include all officer or director positions and any other equivalent positions held, as well as positions of influence. The information must be provided

whether or not you receive compensation for such services, and

whether or not any such position is business related.

1. Start date ____________________ (YYYY/MM/DD)

2. Firm information

[ ] Check here if this activity is employment with your sponsoring firm.

If the activity is with your sponsoring firm, you are not required to indicate the firm name and address information below:

Name of business or employer: ____________________

Address of business or employer: ____________________ (number, street, city, province, territory or state, country)

Name and title of your immediate supervisor: ____________________

3. Description of duties

Describe all employment and business activities related to this employer. Include the nature of the business and your duties, title or relationship with the business. If you are seeking registration that requires specific experience, include details such as level of responsibility, value of accounts under direct supervision, number of years of experience, and percentage of time spent on each activity.

______________________________

4. Number of work hours per week

How many hours per week do you devote to this business or employment? _____________

If this activity is employment with your sponsoring firm and you work less than 30 hours per week, explain why.

______________________________

5. Conflicts of interest

If you have more than one employer or are engaged in business related activities:

A. Disclose any potential for confusion by clients and any potential for conflicts of interest arising from your multiple employment or business related activities or proposed business related activities.

______________________________

______________________________

______________________________

B. Indicate whether or not any of your employers or organizations where you engage in business related activities are listed on an exchange.

______________________________

C. Confirm whether the firm has procedures for minimizing potential conflicts of interest and if so, confirm that you are aware of these procedures.

______________________________

______________________________

______________________________

D. State the name of the person at your sponsoring firm who has reviewed and approved your multiple employment or business related activities or proposed business related activities.

______________________________

E. If you do not perceive any conflicts of interest arising from this employment, explain why.

______________________________

______________________________

______________________________

 

Schedule G

Reportable activities (Item 10)

1. Start date ____________________ (YYYY/MM/DD)

2. Sponsoring firm or other entity information

[ ] Check here if the reportable activity is with your sponsoring firm.

If the reportable activity is with your sponsoring firm, you are not required to indicate the firm's name and address but are required to provide the name and title of your immediate supervisor. For all other types of reportable activity, enter all of the information below:

Name of business or employer: ____________________

Address of business or employer: ____________________ (number, street, city, province, territory or state, country)

Name and title of your immediate supervisor: ____________________

3. Description of the reportable activity and your roles and responsibilities

Instructions: If you are completing this schedule in relation to your activities with your sponsoring firm, for (e) below, provide the title(s) you will use once registered, and if you are already registered, provide the title(s) you use as of the date of this filing.

(a) Describe the entity that you carry on the activity with or for, including the nature of the entity's business.

(b) Is the entity listed on an exchange?

(c) Describe your relationship with the entity.

(d) Describe all of your roles and responsibilities relating to the activity.

______________________________

(e) Provide all title(s) you use for the activity.

______________________________

4. Number of work hours per month

How many hours per month do you spend on this activity? __________

5. Conflicts of interest

Instructions: Complete this section if you have reportable activity outside your sponsoring firm. Do not complete this section if your reportable activity is solely with your sponsoring firm.

Take into consideration existing and reasonably foreseeable material conflicts of interest and existing and potential client confusion.

(a) Does the activity give rise to any material conflicts of interest between the client and the sponsoring firm or you? Does the activity give rise to client confusion? If no conflicts of interest or client confusion are expected, explain why.

______________________________

______________________________

______________________________

(b) Describe (i) the material conflicts of interest, and (ii) how these conflicts will be addressed in the best interest of the client.

______________________________

(c) Describe (i) the client confusion, and (ii) how the client confusion will be addressed.

______________________________

______________________________

______________________________

(d) Does your sponsoring firm and the entity have procedures for identifying and addressing material conflicts of interest? If so, confirm you are complying with both sets of procedures.

______________________________

(e) State the name and title of the individual at your sponsoring firm who has reviewed and approved the activity.

______________________________

______________________________

______________________________

 

Schedule H

Previous employment and other activities (Item 11)

Provide the following information for each of your employment and other activities in the past 10 years. Account for all of your time, including full-time and part-time employment, self-employment or military service. Include your status for each, such as unemployed, full-time student, or other similar statuses. Do not include short-term employment of four months or less while a student, unless it was in the securities, derivatives or financial industry.

In addition to the information required in the paragraph above, if you were employed or had business activities in the securities or derivatives industry or both during and before the 10-year period, disclose all your securities and derivatives or both employment or business activities (both before and during the 10-year period).

[ ] Unemployed

[ ] Full-time student

[ ] Employed or self-employed

From: __________ (YYYY/MM)

To: __________ (YYYY/MM)

Complete the following only if you are, or were, employed or self-employed during this period.

Name of business or employer:

______________________________

Address of business or employer:

______________________________

(number, street, city, province, territory or state, country)

Name and title of immediate supervisor, if applicable:

______________________________

Describe the firm's business, your position, duties and your relationship to the firm. If you are seeking registration in a category of registration that requires specific experience, include details of that experience. Examples include level of responsibility, value of accounts under direct supervision, number of years of that experience and research experience, and percentage of time spent on each activity.

Reason why you left the firm:

______________________________

______________________________

______________________________

 

Schedule I

Resignations and terminations (Item 12)

Item 12.1

For each allegation of violation of any statutes, regulations, rules or internal/external standards of conduct, state below (1) the name of the firm from which you resigned, were terminated or dismissed for cause, (2) whether you resigned, were terminated or dismissed for cause, (3) the date you resigned, were terminated or dismissed for cause, and (4) the circumstances relating to your resignation, termination or dismissal for cause.

______________________________

Item 12.2

For each allegation of failure to supervise compliance with any statutes, regulations, rules or standards of conduct, state below, (1) the name of the firm from which you resigned, were terminated or dismissed for cause, (2) whether you resigned, were terminated or dismissed for cause, (3) the date you resigned, were terminated or dismissed for cause, and (4) the circumstances relating to your resignation, termination or dismissal for cause.

______________________________

Item 12.3

For each allegation of fraud or the wrongful taking of property, including theft, state below (1) the name of the firm from which you resigned, were terminated or dismissed for cause, (2) whether you resigned, were terminated or dismissed for cause, (3) the date you resigned, were terminated or dismissed for cause, and (4) the circumstances relating to your resignation, termination or dismissal for cause.

______________________________

 

Schedule I

Resignations and terminations (Item 12)

Item 12.1

For each allegation of contravention of any statute, regulation, order of a court or regulatory body, rule or bylaw or failure to meet any standard of conduct of a sponsoring firm, of any industry association or of any authority exercising jurisdiction over specific business activities or professions, state below (1) the name of the firm from which you resigned or were terminated, (2) whether you resigned or were terminated, (3) the date you ceased to carry on duties, (4) the circumstances relating to your resignation or termination, (5) details of the allegation (regardless of whether the allegation caused or contributed to your resignation or termination), including the statutes, regulations, orders, rules or bylaws allegedly contravened or standards of conduct allegedly not met, (6) details of how the allegation was addressed, and (7) any details of the resignation, termination, or allegation relevant to the determination of your suitability for registration or whether your registration is otherwise objectionable.

______________________________

Item 12.2

For each allegation of failure to supervise compliance with any statute, regulation, order of a court or regulatory body, rule or bylaw or with any standard of conduct of a sponsoring firm, of any industry association or of any authority exercising jurisdiction over specific business activities or professions, state below (1) the name of the firm from which you resigned or were terminated, (2) whether you resigned or were terminated, (3) the date you ceased to carry on duties, (4) the circumstances relating to your resignation or termination, (5) details of the allegation of failure to supervise (regardless of whether the allegation caused or contributed to your resignation or termination), (6) details of how the allegation was addressed, and (7) any details of the resignation, termination, or allegation relevant to the determination of your suitability for registration or whether your registration is otherwise objectionable.

______________________________

Item 12.3

For each allegation that you committed a crime, state below (1) the name of the firm from which you resigned or were terminated, (2) whether you resigned or were terminated, (3) the date you ceased to carry on duties, (4) the circumstances relating to your resignation or termination, (5) details of the allegation (regardless of whether the allegation caused or contributed to your resignation or termination), (6) details of how the allegation was addressed, and (7) any details of the resignation, termination, or allegation relevant to the determination of your suitability for registration or whether your registration is otherwise objectionable.

______________________________

 

Schedule J

Regulatory disclosure (Item 13)

Item 13.1 Securities and derivatives regulation

a) For each registration or licence, state below (1) the name of the firm, (2) the securities or derivatives regulator with which you are, or were, registered or licensed, (3) the type or category of registration or licence, and (4) the period that you held the registration or licence.

______________________________

b) For each registration or licence refused, state below (1) the name of the firm, (2) the securities or derivatives regulator that refused the registration or licence, (3) the type or category of registration or licence refused, (4) the date of the refusal, and (5) the reasons for the refusal.

______________________________

c) For each exemption from registration denied or licence refused, other than what was disclosed in Item 8.3 of this form, state below (1) the party that was refused the exemption from registration or licence, (2) the securities or derivatives regulator that refused the exemption from registration or licence, (3) the type or category or registration or licence refused, (4) the date of the refusal, and (5) the reasons for the refusal.

______________________________

d) For each order or disciplinary proceeding, state below (1) the name of the firm, (2) the securities or derivatives regulator that issued the order or is conducting or conducted the proceeding, (3) the date any notice of proceeding was issued, (4) the date any order or settlement was made, (5) a summary of any notice, order or settlement (including any sanctions imposed), (6) whether you are or were a partner, director, officer or major shareholder of the firm and named individually in the order or disciplinary proceeding, and (7) any other relevant details.

______________________________

Item 13.2 SRO regulation

a) For each approval, state below (1) the name of the firm, (2) the SRO with which you are or were an approved person, (3) the categories of approval, and (4) the period that you held the approval.

______________________________

b) For each approval refused, state below (1) the name of the firm, (2) the SRO that refused the approval, (3) the category of approval refused, (4) the date of the refusal, and (5) the reasons for the refusal.

______________________________

c) For each order or disciplinary proceeding, state below (1) the name of the firm, (2) the SRO that issued the order or that is, or was, conducting the proceeding, (3) the date any notice of proceeding was issued, (4) the date any order or settlement was made, (5) a summary of any notice, order or settlement (including any sanctions imposed), (6) whether you are or were a partner, director, officer or major shareholder of the firm and named individually in the order or disciplinary proceeding, and (7) any other information that you think is relevant or that the regulator or, in Québec, the securities regulatory authority may request.

c) For each order or disciplinary proceeding, state below (1) the name of the firm, (2) the SRO that issued the order or that is, or was, conducting the proceeding, (3) the date any notice of proceeding was issued, (4) the date any order or settlement was made, (5) a summary of any notice, order or settlement, including any sanctions imposed, (6) whether you are or were a partner, director, officer or major shareholder of the firm and named individually in the order or disciplinary proceeding, and (7) any details of the order or disciplinary proceeding relevant to the determination of your suitability for registration or whether your registration is otherwise objectionable.

______________________________

Item 13.3 Non-securities regulation

a) For each registration or licence, state below (1) the party who is, or was, registered or licensed (if insurance licensed, also indicate the name of the insurance agency), (2) with which regulatory authority, or under what legislation, the party is, or was, registered or licensed, (3) the type or category of registration or licence, and (4) the period that the party held the registration or licence.

______________________________

b) For each registration or licence refused, state below (1) the party that was refused registration or licensing (if insurance licensed, also indicate the name of the insurance agency), (2) with which regulatory authority, or under what legislation, the registration or licence was refused, (3) the type or category of registration or licence refused, (4) the date of the refusal, and (5) the reasons for the refusal.

______________________________

c) For each order or disciplinary proceeding, indicate below (1) the party against whom the order was made or the proceeding taken (if insurance licensed, indicate the name of the insurance agency), (2) the regulatory authority that made the order or that is, or was, conducting the proceeding, or under what legislation the order was made or the proceeding is being, or was conducted, (3) the date any notice of proceeding was issued, (4) the date any order or settlement was made, (5) a summary of any notice, order or settlement (including any sanctions imposed), (6) whether you are or were a partner, director, officer or major shareholder of the firm and named individually in the order or disciplinary proceeding and (7) any other information that you think is relevant or that the regulatory authority may request.

______________________________

Item 13.3 Non-securities regulation

a) For each registration or licence, state below (1) the party who is, or was, registered or licensed, (2) if applicable, the employer or entity for whom you performed the registrable or licensable activity, (3) with which regulatory authority, or under what legislation, the party is, or was, registered or licensed, (4) the type or category of registration or licence, (5) the period that the party held the registration or licence, and (6) the licence number.

______________________________

b) For each registration or licence refused, state below (1) the party that was refused registration or licensing, (2) if applicable, the employer or entity for whom you performed the registrable or licensable activity, (3) with which regulatory authority, or under what legislation, the registration or licence was refused, (4) the type or category of registration or licence refused, (5) the date of the refusal, and (6) the reasons for the refusal.

______________________________

c) For each order or disciplinary proceeding, indicate below (1) the party against whom the order was made or the proceeding taken, (2) the regulatory authority that made the order or that is, or was, conducting the proceeding, or under what legislation the order was made or the proceeding is being, or was conducted, (3) the date any notice of proceeding was issued, (4) the date any order or settlement was made, (5) a summary of any notice, order or settlement (including any sanctions imposed), (6) whether you are or were a partner, director, officer or major shareholder of the entity and named individually in the order or disciplinary proceeding, and (7) any details of the order or disciplinary proceeding relevant to the determination of your suitability for registration or whether your registration is otherwise objectionable.

______________________________

 

Schedule K

Criminal disclosure (Item 14)

Item 14.1

For each charge, state below (1) the type of charge, (2) the date of the charge, (3) any trial or appeal dates, and (4) the court location.

______________________________

Item 14.2

For each finding of guilty, pleading no contest to, or granting of an absolute or conditional discharge from a criminal offence, state below (1) the offence, (2) the date found guilty, and (3) the disposition (any penalty or fine and the date any fine was paid).

______________________________

Item 14.3

For each charge, state below (1) the name of the firmentity, (2) the type of charge, (3) the date of the charge, (4) any trial or appeal dates, and (5) the court location.

______________________________

Item 14.4

For each finding of guilty, pleading no contest to, or granting of an absolute or conditional discharge from a criminal offence, state below (1) the name of the firmentity, (2) the offence, (3) the date of the conviction, and (4) the disposition (any penalty or fine and the date any fine was paid).

______________________________

 

Schedule L

Civil disclosure (Item 15)

Item 15.1

For each outstanding civil proceeding, state below (1) the dates the statement of claim and statement of defence were issued, (2) the name of the plaintiff(s) in the proceeding, (3) whether the proceeding is pending or on appeal, (4) whether the proceeding was against a firm an entity where you are, or were, a partner, director, officer or major shareholder and whether you have been named individually in the allegations, and (5) the jurisdiction where the action is being pursued.

______________________________

Item 15.2

For each civil proceeding, state below (1) the dates the statement of claim and statement of defence were issued, (2) each plaintiff in the proceeding, (3) the jurisdiction where the action was pursued, (4) whether the proceeding was about a firman entity where you are, or were, a partner, director, officer or major shareholder and whether you have been named individually in the allegations and (5) a summary of any disposition or any settlement over $10,000. You must disclose any actions settled without admission of liability.

______________________________

 

Schedule M

Financial disclosure (Item 16)

Item 16.1 Bankruptcy

(a) For each event, state below (1) the date of the petition or voluntary assignment, (2) the person or firm about whom this disclosure is being made, (3) any amounts currently owing, (4) the creditors, (5) the status of the matter, (6) a summary of any disposition or settlement, (7) date of discharge or release, if applicable, and (8) any other information that you think is relevant or that the regulator or, in Québec, the securities regulatory authority may request.

______________________________

(b) For each event, state below (1) the date of the proposal, (2) the person or firm about whom this disclosure is being made, (3) any amounts currently owing, (4) the creditors, (5) the status of the matter, (6) a summary of any disposition or settlement, and (7) any other information that you think is relevant or that the regulator or, in Québec, the securities regulatory authority may request.

______________________________

(c) For each event, state below (1) the date of the proceeding, (2) the person or firm about whom this disclosure is being made, (3) any amounts currently owing, (4) the creditors, (5) the status of the matter, (6) a summary of any disposition or settlement, and (7) any other information that you think is relevant or that the regulator or, in Québec, the securities regulatory authority may request.

______________________________

(d) For each proceeding, arrangement or compromise with creditors, state below (1) the date of proceeding, (2) the person or firm about whom this disclosure is being made, (3) any amounts currently owing, (4) the creditors, (5) the status of the matter, (6) a summary of any disposition or settlement, and (7) any other information that you think is relevant or that the regulator or, in Québec, the securities regulatory authority may request.

______________________________

Item 16.2 Debt obligation

For each event, state below (1) the person or firm that failed to meet its financial obligation, (2) the amount that was owing at the time the person or firm failed to meet its financial obligation, (3) the person or firm to whom the amount is, or was, owing, (4) any relevant dates (for example, when payments are due or when final payment was made), (5) any amounts currently owing, and (6) any other information that you think is relevant or that the regulator or, in Québec, the securities regulatory authority may request, including why the obligation has not been met/satisfied.

______________________________

Item 16.3 Surety bond or fidelity bond

For each bond refused, state below (1) the name of the bonding company, (2) the address of the bonding company, (3) the date of the refusal, and (4) the reasons for the refusal.

______________________________

Item 16.4 Garnishments, unsatisfied judgments or directions to pay

For each garnishment, unsatisfied judgment or direction to pay regarding your indebtedness, indicate below (1) the amount that was owing at the time the garnishment, judgment or direction to pay was rendered, (2) the person or firm to whom the amount is, or was, owing, (3) any relevant dates (for example, when payments are due or when final payment was made), (4) the percentage of earnings to be garnished or the amount to be paid, (5) any amounts currently owing, and (6) any other information that you think is relevant or that the regulator or, in Québec, the securities regulatory authority may request.

______________________________

 

Schedule M

Financial disclosure (Item 16)

Item 16.1 Bankruptcies, insolvencies, consumer proposals and creditor arrangements

Instructions: Proposals includesconsumer proposals.

(a) For each event, state below (1) the date of your bankruptcy, filing for bankruptcy or a proceeding governing an event similar to a bankruptcy, (2) the person or entity about whom this disclosure is being made, (3) any amounts currently owing, (4) the creditors, (5) the status of the matter, (6) a summary of any disposition or settlement, (7) date of discharge or release, if applicable, and (8) any details of the bankruptcy, filing for bankruptcy or similar proceeding relevant to the determination of your suitability for registration or whether your registration is otherwise objectionable.

______________________________

(b) For each event, state below (1) the date of the proposal, (2) the person or firm about whom this disclosure is being made, (3) any amounts currently owing, (4) the creditors, (5) the status of the matter, (6) a summary of any disposition or settlement, and (7) any details of the proposal relevant to the determination of your suitability for registration or whether your registration is otherwise objectionable.

______________________________

(c) For each event, state below (1) the date of the proceeding, (2) the person or entity about whom this disclosure is being made, (3) any amounts currently owing, (4) the creditors, (5) the status of the matter, (6) a summary of any disposition or settlement, and (7) any details of the relevant to the determination of your suitability for registration or whether your registration is otherwise objectionable.

______________________________

(d) For each proceeding, arrangement or compromise with creditors, state below (1) the date of proceeding, arrangement or compromise, (2) the person or entity about whom this disclosure is being made, (3) any amounts currently owing, (4) the creditors, (5) the status of the matter, (6) a summary of any disposition or settlement, and (7) any details of the proceeding, arrangement or compromise relevant to the determination of your suitability for registration or whether your registration is otherwise objectionable.

______________________________

Item 16.2 Debt obligation

For each event, state below (1) the person or entity that failed to meet its financial obligation, (2) the amount that was owing at the time the person or entity failed to meet its financial obligation, (3) the person or entity to whom the amount is, or was, owing, (4) any relevant dates (for example, when payments are due or when final payment was made), (5) any amounts currently owing, and (6) any details of the debt obligation relevant to the determination of your suitability for registration or whether your registration is otherwise objectionable, including why the obligation has not been met/satisfied.

______________________________

Item 16.3 Surety bond or fidelity bond

For each bond refused, state below (1) the name of the bonding company, (2) the address of the bonding company, (3) the date of the refusal, and (4) the reasons for the refusal.

______________________________

Item 16.4 Garnishments, unsatisfied judgments or directions to pay

For each garnishment, unsatisfied judgment or direction to pay regarding your indebtedness or the indebtedness of an entity where you are or were a partner, director, officer or major shareholder, indicate below (1) the amount that was owing at the time the garnishment, judgment or direction to pay was rendered, (2) the person or entity to whom the amount is, or was, owing, (3) any relevant dates (for example, when payments are due or when final payment was made), (4) why the indebtedness has not been met or satisfied, (5) the percentage of earnings to be garnished or the amount to be paid, (6) any amounts currently owing, and (7) any details of the garnishment, unsatisfied judgement or direction to pay relevant to the determination of your suitability for registration or whether your registration is otherwise objectionable.

______________________________

 

Schedule N

Ownership of securities and derivatives firms (Item 17)

Name of firm (whose business is trading in or advising on securities or derivatives, or both):

______________________________

What is your relationship to the firm? [ ] Partner [ ] Major shareholder

What is the period of this relationship?

From:

To:

(if applicable)

__________ (YYYY/MM)

__________ (YYYY/MM)

Provide the following information:

a) State the number, value, class and percentage of securities, or the amount of partnership interest you own or propose to acquire when you are registered or approved as a result of the review of this form. If acquiring shares when you are so approved or registered, state the source (for example, treasury shares, or if upon transfer, state name of transferor).

______________________________

b) State the market value (approximate, if necessary) of any subordinated debentures or bonds of the firm to be held by you or any other subordinated loan to be made by you to the firm:

______________________________

c) If another person or firm has provided you with funds to invest in the firm, provide the name of the person or firm and state the relationship between you and that person or firm:

______________________________

d) Are the funds to be invested (or proposed to be invested) guaranteed directly or indirectly by any person or firm?

Yes [ ] No [ ]

If "Yes", provide the name of the person or firm and state the relationship between you and that person or firm:

______________________________

e) Have you directly or indirectly given up any rights relating to these securities or this partnership interest, or do you, when you are registered or approved as a result of the review of this form, intend to give up any of these rights (including by hypothecation, pledging or depositing as collateral the securities or partnership interest with any firm or person)?

Yes [ ] No [ ]

If "Yes", provide the name of the person or firm, state the relationship between you and that person or firm and describe the rights that have been or will be given up:

______________________________

c) If another person or entity has provided you with funds to invest in the firm, provide the name of the person or entity and state the relationship between you and that person or entity:

______________________________

d) Is the payment of the funds to be invested (or proposed to be invested) guaranteed directly or indirectly by any person or entity?

Yes [ ] No [ ]

If "Yes", provide the name of the person or entity and state the relationship between you and that person or entity:

______________________________

e) Have you directly or indirectly given up any rights relating to these securities or this partnership interest, or do you, when you are registered or approved as a result of the review of this form, intend to give up any of these rights (including by hypothecation, pledging or depositing as collateral the securities or partnership interest with any entity or person)?

Yes [ ] No [ ]

If "Yes", provide the name of the person or entity, state the relationship between you and that person or entity and describe the rights that have been or will be given up:

______________________________

f) Is a person other than you the beneficial owner of the shares, bonds, debentures, partnership units or notes held by you?

Yes [ ] No [ ]

If "Yes", complete (g), (h) and (i).

g) Name of beneficial owner:

__________

__________

__________

__________

Last name

First name

Second name (N/A [ ])

Third name (N/A [ ])

h) Residential address:

______________________________ (number, street, city, province, territory or state, country, postal code)

i) Occupation:

______________________________

 

Schedule O

Contact information for Notice consent and notice of collection and use of personal information

Alberta
Nunavut
Alberta Securities Commission,
Government of Nunavut
Suite 600, 250-5th St. SW
Department of Justice
Calgary, AB T2P 0R4
P.O. Box 1000 Station 570
Attention: Information Officer
Iqaluit, NU X0A 0H0
Telephone: (403) 297-6454
Attention: Deputy Registrar of Securities
Telephone: (867) 975-6590
 
British Columbia
Ontario
British Columbia Securities Commission
Ontario Securities Commission
P.O. Box 10142, Pacific Centre
22[SUP]nd[/SUP] Floor
701 West Georgia Street
20 Queen Street West
Vancouver, BC V7Y 1L2
Toronto, ON M5H 3S8
Attention: Freedom of Information Officer<<Registration staff>>
Attention: Compliance and Registrant Regulation
Telephone: (604) 899-6500 or (800) 373-6393 (in Canada)
Telephone: (416) 593-8314
<<E-mail: Registration@bcsc.bc.ca>>
E-mail: registration@osc.gov.on.ca
 
Manitoba
Prince Edward Island
The Manitoba Securities Commission
Securities Office
500 -- 400 St. Mary Avenue
Department of Community Affairs and Attorney General
Winnipeg, MB R3C 4K5
P.O. Box 2000
Attention: Director of Registrations
Charlottetown, PE C1A 7N8
Telephone: (204) 945-2548
Attention: Deputy Registrar of Securities
Fax (204) 945-0330
Telephone: (902) 368-6288
 
New Brunswick
Québec
Financial and Consumer Services Commission of New Brunswick / Commission des services financiers et des services aux consommateurs du Nouveau-Brunswick
Autorité des marchés financiers
Suite 300, 85 Charlotte Street
800, square Victoria, 22e étage
Saint John, NB E2L 2J2
C.P. 246, tour de la Bourse
Attention: Director of Securities
Montréal (Québec) H4Z 1G3
Telephone: (506) 658-3060
Attention: Responsable de l'accès à l'information
Telephone: (514) 395-0337 or (877) 525-0337
 
Newfoundland and Labrador
Saskatchewan
Superintendent of Securities, Service NL
Financial and Consumer Affairs Authority of Saskatchewan
Government of Newfoundland and Labrador
Suite 601, 1919 Saskatchewan Drive
P.O. Box 8700
Regina, SK S4P 4H2
2nd Floor, West Block
Attention: Deputy Director, Capital Markets
Confederation Building
Telephone: (306) 787-5871
St. John's, NL A1B 4J6
Attention: Manager of Registrations
Telephone: (709) 729-5661
 
Nova Scotia
Yukon
Nova Scotia Securities Commission
Government of Yukon
Suite 400, 5251 Duke Street
<<Office of the Yukon>> Superintendent of Securities
Halifax, NS B3J 1P3
Department of Community Services
Attention: Deputy Director, Capital Markets<<Registration>>
P.O. Box 2703 C-6
Telephone: (902) 424-7768
Whitehorse, YT Y1A 2C6
Attention: Superintendent of Securities
Telephone: (867) 667-5314<<(867) 667-5466>>
 
Northwest Territories
Self-regulatory organization
Government of the Northwest Territories
Investment Industry Regulatory Organization of Canada
Department of Justice
121 King Street West, Suite 2000
1[SUP]st[/SUP] Floor Stuart M. Hodgson Building
Toronto, Ontario M5H 3T9
5009 -- 49[SUP]th[/SUP] Street
Attention: Privacy Officer
Yellowknife, NWT X1A 2L9
Telephone: (416) 364-6133
Attention: Deputy Superintendent of Securities
E-mail: PrivacyOfficer@iiroc.ca
Telephone: (867) 920-8984

 

FORM 33-109F5 CHANGE OF REGISTRATION INFORMATION (sections 3.1 and 4.1 )

WARNING -- It is an offence under securities legislation and derivatives legislation, including commodity futures legislation, to knowingly give false or misleading information to the regulator or securities regulatory authority.

CERTIFICATION

1. Form 33-109F4: Use the following certification when making changes to Form 33-109F4

Individual

I certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where I am submitting this form and to any applicable self-regulatory organization (SRO) that

I have read this form,

I have read Form 33-109F4 and understand its questions,

I have discussed Form 33-109F4 with an officer, partner, branch manager or supervisor of my sponsoring firm and that to the best of my knowledge, the officer, partner, branch manager or supervisor is satisfied that I understand all matters within Form 33-109F4, including the questions in Form 33-109F4,

to the best of my knowledge and after reasonable inquiry, all of the information provided on this form is true, complete and accurate, including information required to be disclosed by Form 33-109F4 that I am not changing with this form,

if applicable, I will limit my activities to those allowed by my category of registration and any SRO approval, and

if the business location specified in this form is a residence, I hereby give my consent

for the regulator or, in Québec, the securities regulatory authority in each jurisdiction where I am submitting this form to enter that residence for the administration of securities legislation and derivatives legislation, including commodity futures legislation, and

where applicable, for the SRO to enter that residence for the administration of the rules of the SRO.

Firm

I certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where the firm is submitting this form and to any applicable SRO that

the individual identified in this form will be engaged by the sponsoring firm as a registered individual or a permitted individual, and

I have, or a branch manager, supervisor, officer or partner has, discussed this form with the individual. To the best of my knowledge, the individual understands all matters within this form, including the questions.

NRD format:

[ ] I am making this submission under authority delegated by the firm and the individual identified in this form. By checking this box, I certify that

(a) the firm provided me with all of the information on this form and makes the firm certification above, and

(b) the individual provided the firm with all of the information on this form and makes the individual certification above.

Non-NRD format:

Individual

By signing below, I make the above individual certification.

Signature of individual ____________________

Date signed ____________________ (YYYY/MM/DD)

Firm

By signing below, I make the firm certification above.

Name of firm ____________________

Name of authorized signing officer or partner ____________________

Title of authorized signing officer or partner ____________________

Signature of authorized signing officer or partner ____________________

Date signed ____________________ (YYYY/MM/DD)

2. Form 33-109F6: Use the following certification when making changes to Form 33-109F6

By signing below, I certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where the firm submitting this form and to any applicable SRO that

I have read this form and understand all matters within this form, including the questions, and to the best of my knowledge and after reasonable inquiry, all of the information provided on this form is true and complete.

Name of firm ____________________

Name of authorized signing officer or partner ____________________

Title of authorized signing officer or partner ____________________

Signature of authorized signing officer or partner ____________________

Date signed ____________________ (YYYY/MM/DD)

GENERAL INSTRUCTIONS

Complete and submit this form to notify the relevant regulator(s) or, in Québec, the securities regulatory authority, or self-regulatory organization (SRO) of changes to information in the following forms:

• Form 33-109F6, except for the changes set out in section 3.1 of National Instrument 33-109, or

• Form 33-109F4.

How to submit this form

To report changes to information in a Form 33-109F4, submit this form at the National Registration Database website in NRD format at www.nrd.ca.

Submit this form in a format other than NRD format to report changes to information in a:

a) Form 33-109F6, or

b) Form 33-109F4, if the individual is relying on the temporary hardship exemption in section 5.1 of National Instrument 31-102 National Registration Database.

Name of firm ____________________

Registration categories ____________________

NRD number (firm) ____________________

Item 1 Type of form

Check the form that is being updated:

[ ] Form 33-109F6

If submitting changes to Form 33-109F6, please attach a blackline of the amended sections of the form.

[ ] Form 33-109F4 Name of individual ____________________

Item 2 Details of change

Provide the item number and details for each change to the form selected above:

Item number ____________________ Details ____________________

Effective date of change ____________________ (YYYY/MM/DD)

Item 3 Notice of collection and use of personal information

The personal information required under this form is collected on behalf of, and used by, the securities regulatory authorities in the jurisdictions set out in Schedule A to administer and enforce certain provisions of their securities legislation or derivatives legislation or both.

The personal information required under this form is also collected by and used by the SRO set out in Schedule A to administer and enforce its by-laws, regulations, rules, rulings and policies.

By submitting this form, the individual consents to the collection by the securities regulatory authorities or applicable SRO of this personal information, and any police records, records from other government or non-governmental regulators or SROs, credit records and employment records about the individual that the securities regulatory authorities or applicable SRO may need to complete their review of the information submitted in this form relating to the individual's continued fitness for registration or approval, if applicable, in accordance with the legal authority of the securities regulatory authorities while the individual is registered with or approved by it. Securities regulatory authorities or SROs may contact government and private bodies or agencies, individuals, corporations and other organizations for information about the individual.

If you have any questions about the collection and use of this information, contact the securities regulatory authorities or applicable SRO in any jurisdiction in which the required information is submitted. See Schedule A for details. In Québec, you can also contact the Commission d'accès à l'information at 1-888-528-7741 or visit its website at www.cai.gouv.qc.ca.

Item 3 Collection and use of personal information

1. Notice of collection and use of personal information

Your personal information is collected by, or on behalf of, each securities regulatory authority and SRO set out in Schedule A. Any of the securities regulatory authorities or SROs set out in Schedule A may contact government or private bodies or agencies, individuals, corporations, employers, and other organizations, in Canada and in other countries, for information about you.

This personal information is being collected under the authority of the applicable securities legislation, derivatives legislation (including commodity futures legislation) or both of the securities regulatory authorities and pursuant to the SRO rules of an SRO set out in Schedule A. The collection, use and disclosure are done in accordance with applicable freedom of information and privacy legislation.

The principal purpose of this collection by the securities regulatory authorities is to administer, enforce, carry out their duties or exercise their powers under their respective securities legislation, derivatives legislation (including commodity futures legislation) or both, and by the SROs to administer and enforce the rules of the SROs.

The information submitted by you in this form with your consent, or collected indirectly with your authorization, may be collected

at any time during your registration or while you are a permitted individual, or

at the time the regulator or, in Québec, the securities regulatory authority, or SRO is informed by your sponsoring firm that you no longer have authority to act on behalf of the sponsoring firm or are not a permitted individual of the sponsoring firm.

If you have any questions about the collection, use, and disclosure of this information, contact the securities regulatory authorities or SRO in any jurisdiction in which the required information is submitted. See Schedule A for details.

Note that certain information such as your name(s) (including aliases, trade names or some past names), your sponsoring firm, and other relevant registration information will be listed in a publicly available registry of registered individuals and, if applicable, on the Disciplined List.

Also note that certain securities regulatory authorities may provide or receive information to or from certain entities under separate provisions of their securities legislation or derivatives legislation (including commodity futures legislation) or both, and SROs may provide or receive information under the rules of the SROs. This consent and notice does not limit the authority, powers, obligations or rights conferred on any of the securities regulatory authorities by legislation or regulations in effect in their jurisdiction.

2. Consent to collect and use personal information

By submitting this form, you consent to and authorize the collection, directly and indirectly, of personal information by each securities regulatory authority and SRO and to the use of your personal information as set out above.

The personal information that each securities regulatory authority or SRO collects, includes the following:

the personal information provided in this form;

the personal information provided by your sponsoring firm;

registration or financial services licensing information;

law enforcement records, including police records;

credit records;

bankruptcy or other insolvency records;

employment records and information received from an employer;

records and information received from entities you had or have an independent contractor or agency relationship with;

personal information available online;

records from government ministries and agencies, SROs or authorities exercising jurisdiction over specific business activities or professions; and

records of, and used in, court proceedings, including any probation records.

Item 4 Warning[repealed]

It is an offence under securities legislation and derivatives legislation, including commodity futures legislation, to give false or misleading information on this form.

Item 5 Certification[repealed]

1. Use the following certification when submitting this form in NRD format when making changes to Form 33-109F4

I confirm I have discussed the questions in this form with an officer, branch manager or supervisor of my sponsoring firm. To the best of my knowledge and belief, the officer, branch manager or supervisor was satisfied that I fully understood the questions. I will limit my activities to those permitted by my category of registration.

[ ] I am making this submission as agent for the individual identified in this form. By checking this box, I certify that the individual provided me with all of the information on this form.

2. Use the following certification when submitting this form in a format other than NRD format when making changes to Form 33-109F6

By signing below I certify to each regulator or, in Québec, the securities regulatory authority, in each jurisdiction where I am submitting this form, either directly or through the principal regulator, that:

I have read this form and understand the questions, and

all of the information provided on this form is true, and complete.

Name of authorized signing officer or partner ____________________

Title of authorized signing officer or partner ____________________

Signature of authorized signing officer or partner ____________________

Date signed ____________________ (YYYY/MM/DD)

3. Use the following certification when submitting this form in a format other than NRD format under the temporary hardship exemption in section 5.1 of NI 31-102 National Registration Database when making changes to Form 33-109F4

By signing below, I certify to the regulator or, in Québec, the securities regulatory authority, in each jurisdiction where I am submitting this form, either directly or through the principal regulator, that:

I have read this form and understand the questions; and

all of the information provided on this form is true and complete.

Signature of individual ____________________

Date signed ____________________ (YYYY/MM/DD)

 

Schedule A

Contact information for Noticeconsent and notice of collection and use of personal information

Alberta
Nunavut
Alberta Securities Commission,
Government of Nunavut
Suite 600, 250-5th St. SW
Department of Justice
Calgary, AB T2P 0R4
P.O. Box 1000 Station 570
Attention: Information Officer
Iqaluit, NU X0A 0H0
Telephone: (403) 297-6454
Attention: Deputy Registrar of Securities
Telephone: (867) 975-6590
 
British Columbia
Ontario
British Columbia Securities Commission
Ontario Securities Commission
P.O. Box 10142, Pacific Centre
22[SUP]nd[/SUP] Floor
701 West Georgia Street
20 Queen Street West
Vancouver, BC V7Y 1L2
Toronto, ON M5H 3S8
Attention: Freedom of Information Officer<<Registration staff>>
Attention: Compliance and Registrant Regulation
Telephone: (604) 899-6500 or (800) 373-6393 (in Canada)
Telephone: (416) 593-8314
<<E-mail: Registration@bcsc.bc.ca>>
E-mail: registration@osc.gov.on.ca
 
Manitoba
Prince Edward Island
The Manitoba Securities Commission
Securities Office
500 -- 400 St. Mary Avenue
Department of Community Affairs and Attorney
Winnipeg, MB R3C 4K5
P.O. Box 2000
Attention: Director of Registrations
Charlottetown, PE C1A 7N8
Telephone: (204) 945-2548
Attention: Deputy Registrar of Securities
Fax (204) 945-0330
Telephone: (902) 368-6288
 
New Brunswick
Québec
Financial and Consumer Services Commission of New Brunswick / Commission des services financiers et des services aux consommateurs du Nouveau-Brunswick
Autorité des marchés financiers
Suite 300, 85 Charlotte Street
800, square Victoria, 22e étage
Saint John, NB E2L 2J2
C.P. 246, tour de la Bourse
Attention: Director of Securities
Montréal (Québec) H4Z 1G3
Telephone: (506) 658-3060
Attention: Responsable de l'accès à l'information
Telephone: (514) 395-0337 or (877) 525-0337
 
Newfoundland and Labrador
Saskatchewan
Superintendent of Securities, Service NL
Financial and Consumer Affairs Authority of Saskatchewan
Government of Newfoundland and Labrador
Suite 601, 1919 Saskatchewan Drive
P.O. Box 8700
Regina, SK S4P 4H2
2nd Floor, West Block
Attention: Deputy Director, Capital Markets
Confederation Building
Telephone: (306) 787-5871
St. John's, NL A1B 4J6
Attention: Manager of Registrations
Telephone: (709) 729-5661
 
Nova Scotia
Yukon
Nova Scotia Securities Commission
Government of Yukon
Suite 400, 5251 Duke Street
<<Office of the Yukon>> Superintendent of Securities
Halifax, NS B3J 1P3
Department of Community Services
Attention: Deputy Director, Capital Markets<<Registration>>
P.O. Box 2703 C-6
Telephone: (902) 424-7768
Whitehorse, YT Y1A 2C6
Attention: Superintendent of Securities
Telephone: (867) 667-5314<<(867) 667-5466>>
 
Northwest Territories
Self-regulatory organization
Government of the Northwest Territories
Investment Industry Regulatory Organization of Canada
Department of Justice
121 King Street West, Suite 2000
1[SUP]st[/SUP] Floor Stuart M. Hodgson Building
Toronto, Ontario M5H 3T9
5009 -- 49[SUP]th[/SUP] Street
Attention: Privacy Officer
Yellowknife, NWT X1A 2L9
Telephone: (416) 364-6133
Attention: Deputy Superintendent of Securities
E-mail: PrivacyOfficer@iiroc.ca
Telephone: (867) 920-8984

 

Form 33-109F6 Firm Registration

Who should complete this form?

This form is for firms seeking registration under securities legislation, derivatives legislation or both.

Complete and submit this form to seek initial registration as a dealer, adviser or investment fund manager, or to add one or more jurisdiction of Canada or categories to a firm's registration.

Definitions

In this form:

Chief compliance officer -- see section 2.1 of NI 31-103.

Derivatives -- financial instruments, such as futures contracts (including exchange traded contracts), futures options and swaps whose market price, value or payment obligations are derived from or based on one or more underlying interests. Derivatives can be in the form of instruments, agreements or securities.

Firm -- the person or company seeking registration.

Foreign jurisdiction -- see National Instrument 14-101Definitions.

Form -- Form 33-109F6 Firm Registration.

Jurisdiction or jurisdiction of Canada -- see National Instrument 14-101Definitions.

NI 31-103 -- National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations.

NI 33-109 -- National Instrument 33-109 Registration Information.

NI 52-107 -- National Instrument 52-107 Acceptable Accounting Principles and Auditing Standards.

NRD -- National Registration Database. For more information, visit www.nrd-info.ca.

Parent -- a person or company that directly or indirectly has significant control of another person or company.

Permitted individual -- see NI 33-109.

Predecessor -- any entity listed in question 3.6 of this form.

Principal regulator -- see NI 33-109.

Significant control -- a person or company has significant control of another person or company if the person or company:

• directly or indirectly holds voting securities representing more than 20 per cent of the outstanding voting rights attached to all outstanding voting securities of the other person or company, or

• directly or indirectly is able to elect or appoint a majority of the directors (or individuals performing similar functions or occupying similar positions) of the other person or company.

Specified affiliate -- a person or company that is a parent of the firm, a specified subsidiary of the firm, or a specified subsidiary of the firm's parent.

Specified subsidiary -- a person or company of which another person or company has significant control.

SRO -- see National Instrument 14-101 Definitions.

Ultimate designated person -- see section 2.1 of NI 31-103.

You -- the individual who completes, submits, files and/or signs the form on behalf of the firm.

We and the regulator -- the securities regulatory authority or regulator in the jurisdiction(s) of Canada where the firm is seeking registration.

Contents of the form

This form consists of the following:

Part 1 -- Registration details

Part 2 -- Contact information

Part 3 -- Business history and structure

Part 4 -- Registration history

Part 5 -- Financial condition

Part 6 -- Client relationships

Part 7 -- Regulatory action

Part 8 -- Legal action

Part 9 -- Certification

Schedule A -- Contact information for notice of collection and use of personal information

Schedule B -- Submission to jurisdiction and appointment of agent for service

Schedule C -- Form 31-103F1 Calculation of excess working capital

This form consists of the following:

Certification

Part 1 -- Registration details

Part 2 -- Contact information

Part 3 -- Business history and structure

Part 4 -- Registration history

Part 5 -- Financial condition

Part 6 -- Client relationships

Part 7 -- Regulatory action

Part 8 -- Legal action

Part 9 -- [repealed]

Schedule A -- Contact information for consent and notice of collection and use of personal information

Schedule B -- Submission to jurisdiction and appointment of agent for service

Schedule C -- Form 31-103F1 Calculation of excess working capital

You are also required to submit the following supporting documents with your completed form:

1. Schedule B -- Submission to jurisdiction and appointment of agent for service for each jurisdiction where the firm is seeking registration (question 2.4)

2. Business plan, policies and procedures manual, and client agreements (except in Ontario) (question 3.3)

3. Constating documents (question 3.7)

4. Organization chart (question 3.11)

5. Ownership chart (question 3.12)

6. Calculation of excess working capital (question 5.1)

7. Directors' resolution approving insurance (question 5.7)

8. Audited financial statements (question 5.13)

9. Letter of direction to auditors (question 5.14)

The firm is required to pay a registration fee in each jurisdiction of Canada where it is submitting and filing this form. Refer to the prescribed fees of the applicable jurisdiction for details.

How to complete and submit the form

All dollar values are in Canadian dollars. If a question does not apply to the firm, write "n/a" in the space for the answer.

If the firm is seeking registration in more than one jurisdiction of Canada or category, other than in the category of restricted dealer, you only need to complete and submit one form. If the firm is seeking registration as a restricted dealer, submit and file the form with each jurisdiction of Canada where the firm is seeking that registration.

You can complete this form:

• on paper and deliver it to the principal regulator or relevant SRO

• on paper, scan it and e-mail it to the principal regulator or SRO

If the firm is seeking registration in Ontario, and Ontario is not the firm's principal regulator, you must also file a copy of this form, without supporting documents, with the Ontario Securities Commission.

You can find contact information for submitting and filing the form in Appendix B of Companion Policy 33-506CP Registration Information.

We may accept the form in other formats. Please check with the regulator before you complete, submit and file the form. If you are completing the form on paper and need more space to answer a question, use a separate sheet of paper and attach it to this form. Clearly identify the question number.

You must include all supporting documents with your submission. We may ask you to provide other information and documents to help determine whether the firm is suitable for registration.

In most of this form, answers are required to questions that apply only to Canadian provinces and territories; you will find that the questions are referenced to "jurisdictions" or "jurisdiction of Canada". These refer to all provinces and territories of Canada. However, the questions in Part 4 -- Registration History and Part 7 -- Regulatory Action are to be answered in respect of any jurisdiction in the world. It is an offence under securities legislation or derivatives legislation to give false or misleading information on this form.

It is an offence under securities legislation and derivatives legislation, including commodity futures legislation, to knowingly give false or misleading information on this formto the regulator or securities regulatory authority.

See Part 3 of OSC Rule 33-506.

Updating the information on the form

The firm is required to notify the regulator, within specified times, of any changes to the information on this form by submitting and filing Form 33-506109F5 Change of Registration Information.

Collection and use of personal information

We and the SROs (if applicable) require personal information about the people referred to in this form as part of our review to determine whether the firm is suitable for registration. If the firm is approved, we also require this information to assess whether the firm continues to meet the registration requirements.

We may only:

collect the personal information under the requirements in securities legislation or derivatives legislation or both

use this information to administer and enforce provisions of the securities legislation or derivatives legislation or both

We may collect personal information from police records, records of other regulators or SROs, credit records, employment records, government and private bodies or agencies, individuals, corporations, and other organizations. We may also collect personal information indirectly.

We may provide personal information about the individuals referred to in this form to other regulators, securities or derivatives exchanges, SROs or similar organizations, if required for an investigation or other regulatory issue.

If anyone referred to in this form has any questions about the collection and use of their personal information, they can contact the regulator or SRO, if applicable, in the relevant jurisdiction of Canada. See Schedule A for details. In Québec, they can also contact the Commission d'accès à l'information du Québec at 1-888-528-7741 or visit its website at www.cai.gouv.qc.ca.

In obtaining information about the firm, each securities regulatory authority and SRO set out in Appendix A may receive and collect personal information about individuals, if any, associated with the firm and its directors, officers, partners, employees, contractors and agents.

This may include the collection of

the personal information provided in this form,

registration or financial services licensing information,

personal information available online,

records from government ministries and agencies, SROs or authorities exercising jurisdiction over specific business activities or professions, or

records of, and used in, court proceedings, including any probation records.

Any of the securities regulatory authorities or SROs set out in Schedule A may contact government or private bodies or agencies, individuals, corporations, employers, and other organizations, in Canada and in other countries, for information about the individual.

This personal information is being collected under the authority of the applicable securities legislation, derivatives legislation (including commodity futures legislation) or both of the securities regulatory authorities and pursuant to the SRO rules of an SRO set out in Schedule A. The collection, use and disclosure are done in accordance with applicable freedom of information and privacy legislation.

The principal purpose of this collection by the securities regulatory authorities is to administer, enforce, carry out their duties or exercise their powers under their respective securities legislation, derivatives legislation (including commodity futures legislation) or both, and for the SROs to administer and enforce the rules of the SROs.

The information may be collected

at the time of the firm's application,

at any time during the firm's registration, or

at the time the regulator or, in Québec, the securities regulatory authority, or SRO is informed by the firm that it is surrendering its registration.

If you or anyone referred to in this form has any questions about the collection, use, and disclosure of this information, you or they can contact the regulator or, in Québec, the securities regulatory authority, or SRO in any jurisdiction in which the required information is submitted. See Schedule A for details.

Note that certain registration information about the firm and its registered individuals will be listed in a publicly available registry, including names used by the firm, the address of the firm's head office, whether the firm is on the Disciplined List, the jurisdictions and categories in which the firm is registered, and whether any terms and conditions have been imposed on the firm's registration, and the firm's registered individuals.

Also note that certain securities regulatory authorities may provide or receive information to or from certain entities under separate provisions of their securities legislation or derivatives legislation (including commodity futures legislation) or both, and SROs may provide or receive information under the rules of the SROs. This consent and notice does not limit the authority, powers, obligations, or rights conferred on any of the securities regulatory authorities by legislation or regulations in effect in their jurisdiction.

WARNING: It is an offence under securities legislation and derivatives legislation, including commodity futures legislation, to knowingly give false or misleading information to the regulator or securities regulatory authority.

CERTIFICATION

By signing this form, I

1. certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where the firm is submitting this form and to any applicable self-regulatory organization (SRO) that

I have read this form,

the firm has submitted and filed all information required to be submitted and filed under securities legislation and/or derivatives legislation in the principal jurisdiction of Canada where the firm is seeking registration, and

to the best of my knowledge and after reasonable inquiry, all of the information provided on this form is true and complete,

2. authorize the principal regulator to give each non-principal regulator and, where applicable, SRO access to any information the firm has submitted or filed with the principal regulator under securities legislation or derivatives legislation or both in relation to the firm's registration in that jurisdiction,

3. acknowledge that the regulator or, in Québec, the securities regulatory authority, and SRO may collect and provide personal information about the individuals referred to in this form under Collection and Use of Personal Information, and

4. confirm that the individuals referred to in this form have been notified that their personal information is disclosed on this form, the legal reason for doing so, how it will be used and who to contact for more information.

Name of firm ____________________

Name of authorized signing officer or partner ____________________

Title of authorized signing officer or partner ____________________

Signature of authorized signing officer or partner ____________________

Date signed ____________________ (YYYY/MM/DD)

For more information, visit www.nrd-info.ca.

Part 1 -- Registration details

1.1 Firm's full legal name

Provide the full legal name of the firm as it appears on the firm's constating documents required under question 3.7. If the firm is a sole proprietorship, provide your first, last and any middle names.

If the firm's legal name is in English and French, provide both versions.

- - - - - - - - - - - - - - - - - - - -

- - - - - - - - - - - - - - - - - - - -

1.2 Firm's NRD number

- - - - - - - - - - - - - - - - - - - -

- - - - - - - - - - - - - - - - - - - -

1.3

Why are you submitting this form?

Complete:

 

[ ]

To seek initial registration as a firm in one or more jurisdictions of Canada

The entire form

 

[ ]

To add one or more jurisdictions of Canada to the firm's registration

Questions 1.1, 1.2, 1.4, 1.5, 2.4, 3.9, 5.4, 5.6{*}, and Part 9

 

[ ]

To add one or more categories to the firm's registration

Questions 1.1, 1.2, 1.4, 1.5, 3.1, 5.1, 5.4, 5.5, 5.6{*}, 5.7, 5.8, Part 6 and Part 9

{*} If the firm is adding Québec as a jurisdiction for registration in the category of mutual fund dealer or scholarship plan dealer, complete question 5.6.

Abbreviations

Alberta (AB) British Columbia (BC) Manitoba (MB) New Brunswick (NB) Newfoundland and Labrador (NL) Nova Scotia (NS) Northwest Territories (NT) Nunavut (NU) Ontario (ON) Prince Edward Island (PE) Québec (QC) Saskatchewan (SK) Yukon (YT)

1.4 In what category and jurisdiction is the firm seeking registration? Check all that apply.

(a) Categories under securities legislation

Jurisdiction

 

Category

AB

BC

MB

NB

NL

NS

NT

NU

ON

PE

QC

SK

YT

 

Investment dealer

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

 

Mutual fund dealer

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

 

Scholarship plan dealer

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

 

Exempt market dealer

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

 

Restricted dealer

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

 

Investment fund manager

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

 

Portfolio manager

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

 

Restricted portfolio manager

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

(b) Categories under derivatives legislation (Manitoba and Ontario only)

Category

Manitoba

 

Dealer (merchant)

[ ]

 

Dealer (futures commission merchant)

[ ]

 

Dealer (floor broker)

[ ]

 

Local

[ ]

 

Adviser

[ ]

 

Ontario

 

Commodity trading adviser

[ ]

 

Commodity trading counsel

[ ]

 

Commodity trading manager

[ ]

 

Futures commission merchant

[ ]

(c) Investment dealers and portfolio managers (Québec only)

If the firm is seeking registration in Québec as an investment dealer or a portfolio manager, will the firm also act as a:

Derivatives dealer

Yes

[ ]

No

[ ]

Derivatives portfolio manager

Yes

[ ]

No

[ ]

1.5 Exemptions

Is the firm applying for any exemptions under securities or derivatives legislation?

Yes [ ] No [ ]

If yes, provide the following information for each exemption:

Type of exemption

 

Legislation

 

Jurisdiction(s) where the firm has applied for the exemption

 

AB

BC

MB

NB

NL

NS

NT

NU

ON

PE

QC

SK

YT

 

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

Part 2 -- Contact information

Addresses

A post office box on its own is not acceptable for a head office address.

2.1 Head office address

Address line 1

 

Address line 2

 

City

Province/territory/state

 

Country

Postal/zip code

 

Telephone number

Fax number

 

Website

If the firm's head office is in Canada, go to question 2.3.

If the firm's head office is not in Canada, go to question 2.2.

2.2 Firms whose head office is not in Canada

(a) Does the firm have any business location addresses in Canada?

Yes [ ] No [ ]

If yes, provide the firm's primary Canadian business location address:

Address line 1

 

Address line 2

 

City

Province/territory

 

Postal code

The securities regulatory authority in this jurisdiction of Canada is the firm's principal regulator in Canada.

(b) If a firm is not registered in a jurisdiction of Canada, indicate the jurisdiction of Canada in which the firm expects to conduct most of its activities that require registration as at the end of its current financial year or conducted most of its activities that require registration as at the end of its most recently completed financial year.

AB

BC

MB

NB

NL

NS

NT

NU

ON

PE

QC

SK

YT

 

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

A post office box is acceptable for a mailing address.

2.3 Mailing address

[ ] Same as the head office address

Address line 1

 

Address line 2

 

City

Province/territory/state

 

Country

Postal/zip code

If the firm does not have an office in a jurisdiction of Canada where it is seeking registration, it must appoint an agent for service in that jurisdiction of Canada.

2.4 Address for service and agent for service

Attach a completed Schedule B an executed Schedule B Submission to jurisdiction and appointment of agent for service for each jurisdiction of Canada where the firm is seeking registration and does not have an office.

Contact names

A registered firm must have an individual registered in the category of ultimate designated person.

2.5 Ultimate designated person

Legal name

 

Officer title

 

Telephone number

 

E-mail address

 

NRD number, if available

 

Address

 

[ ]

Same as firm head office address

 

Address line 1

 

Address line 2

 

City

Province/territory/state

 

Country

Postal/zip code

A registered firm must have an individual registered in the category of chief compliance officer.

2.6 Chief compliance officer

[ ] Same as ultimate designated person

Legal name

 

Officer title

 

Telephone number

 

E-mail address

 

NRD number, if available

 

Address

 

[ ]

Same as firm head office address

 

Address line 1

 

Address line 2

 

City

Province/territory/state

 

Country

Postal/zip code

Part 3 -- Business history and structure

Business activities

3.1 The firm's business

Provide a description of the firm's proposed business, including its primary business activities, target market, and the products and services it will provide to clients.

3.2 Other names

In addition to the firm's legal name in question 1.1, does the firm use any other names, such as a trade name?

Yes [ ] No [ ]

If yes, list all other names and indicate if each name has been registered:

- - - - - - - - - - - - - - - - - - - -

- - - - - - - - - - - - - - - - - - - -

3.3 Business documents

Does the firm have the following documents to support its business activities?

Yes

No

 

(a)

Business plan for at least the next three years

_____

_____

 

(b)

Policies and procedures manual, including account opening procedures and the firm's policy on fairness in allocation of investment opportunities, if applicable

_____

_____

If no, explain why the firm does not have the document:

- - - - - - - - - - - - - - - - - - - -

- - - - - - - - - - - - - - - - - - - -

Attach the firm's business plan, policies and procedures manual and client agreements, including any investment policy statements and investment management agreements, except if the regulator in Ontario is the principal regulator of the firm seeking registration, unless the regulator in Ontario has requested they be provided.

History of the firm

3.4 When was the firm created?

- - - - - - - - - - - - - - - - - - - -

yyyy/mm/dd

- - - - - - - - - - - - - - - - - - - -

3.5 How was the firm created?

New start-up

[ ]

Go to question 3.7.

Merger or amalgamation

[ ]

Go to question 3.6.

Reorganization

[ ]

Go to question 3.6.

Other statutory arrangement

[ ]

Please specify below and go to question 3.6.

- - - - - - - - - - - - - - - - - - - -

- - - - - - - - - - - - - - - - - - - -

3.6 Predecessors

List the entities that were merged, amalgamated, reorganized or otherwise arranged to create the firm.

- - - - - - - - - - - - - - - - - - - -

- - - - - - - - - - - - - - - - - - - -

3.7 Constating documents

Attach the legal documents that established the firm as an entity, for example, the firm's articles and certificate of incorporation, any articles of amendments, partnership agreement or declaration of trust. If the firm is a sole proprietorship, provide a copy of the registration of trade name.

As part of their constating documents, firms whose head office is outside Canada may be required to provide proof of extra-provincial registration.

Business structure and ownership

3.8 Type of legal structure

Sole proprietorship

[ ]

Partnership

[ ]

Limited partnership

[ ]

Name of general partner ____________________

Corporation

[ ]

Other

[ ]

Please specify ____________________

This is the firm's corporate registration number or Québec enterprise number (NEQ).

3.9 Business registration number, if applicable

List the firm's business registration number for each jurisdiction of Canada where the firm is seeking registration.

Business registration number

Jurisdiction of Canada

__________

__________

3.10 Permitted individuals

List all permitted individuals of the firm.

Name

Title

NRD number, if applicable

 

__________

__________

__________

3.10 Permitted individuals

List all permitted individuals of the firm.

State why the individual is considered a permitted individual (e.g., director, partner, officer, shareholder, or a permitted individual as described in paragraph (c) of the definition of "permitted individual" in section 1.1 of National Instrument 33-109 Registration Information).

<<Name>>

<<Type of Permitted Individual>>

<<NRD number, if applicable>>

 

__________

__________

__________

3.11 Organization chart

Attach an organization chart showing the firm's reporting structure. Include all permitted individuals, the ultimate designated person and/or supervisory procedure person(s) and the chief compliance officer.

3.12 Ownership chart

Attach a chart showing the firm's structure and ownership. At a minimum, include all parents, specified affiliates and specified subsidiaries.

Include the name of the person or company, and class, type, amount and voting percentage of ownership of the firm's securities.

3.12 Ownership chart

Attach a chart showing the firm's structure and ownership. Include all parents, specified affiliates and specified subsidiaries. Indicate which of the parents, specified affiliates and specified subsidiaries are registered under securities legislation in any jurisdiction of Canada and provide their NRD number.

Include the name of the person or company, and class, type, amount and percentage ownership of the firm's voting securities.

Part 4 -- Registration history

The questions in Part 4 apply to any jurisdiction and any foreign jurisdiction.

4.1 Securities registration

In the last seven years, has the firm, or any predecessors or specified affiliates of the firm been registered or licensed to trade or advise in securities or derivatives?

Yes [ ] No [ ]

If yes, provide the following information for each registration:

Name of entity

 

Registration category

 

Regulator/organization

 

Date registered or licensed (yyyy/mm/dd)

Expiry date, if applicable (yyyy/mm/dd)

 

Jurisdiction

4.2 Exemption from securities registration

Is the firm currently relying on any exemptions from registration or licensing to trade or advise in securities or derivatives (other than those exemptions with respect to which the firm has already notified the securities regulator or, in Québec, the securities regulatory authority in accordance with the applicable exemption)?

Yes [ ] No [ ]

If yes, provide the following information for each exemption:

- - - - - - - - - - - - - - - - - - - -

Type of exemption

Regulator/organization

Date of exemption (yyyy/mm/dd)

Jurisdiction

- - - - - - - - - - - - - - - - - - - -

4.3 Membership in an exchange or SRO

In the last seven years, has the firm, or any predecessors or specified affiliates of the firm been a member of a securities or derivatives exchange, SRO or similar organization?

Yes [ ] No [ ]

If yes, provide the following information for each membership:

Name of entity

 

Organization

 

Date of membership (yyyy/mm/dd)

Expiry date, if applicable (yyyy/mm/dd)

 

Jurisdiction

4.4 Exemption from membership in an exchange or SRO

Is the firm currently relying on any exemptions from membership with a securities or derivatives exchange, SRO or similar organization?

Yes [ ] No [ ]

If yes, provide the following information for each exemption:

- - - - - - - - - - - - - - - - - - - -

Type of exemption

Organization

Date of exemption (yyyy/mm/dd)

Jurisdiction

- - - - - - - - - - - - - - - - - - - -

4.5 Refusal of registration, licensing or membership

Has the firm, or any predecessors or specified affiliates of the firm been refused registration, licensing or membership with a financial services regulator, securities or derivatives exchange, SRO or similar organization?

Yes [ ] No [ ]

If yes, provide the following information for each refusal:

- - - - - - - - - - - - - - - - - - - -

Name of entity

Reason for refusal

Regulator/organization

Date of refusal (yyyy/mm/dd)

Jurisdiction

- - - - - - - - - - - - - - - - - - - -

Examples of other financial products include financial planning, life insurance and mortgages.

4.6 Registration for other financial products

In the last seven years, has the firm, or any predecessors or specified affiliates of the firm been registered or licensed under legislation that requires registration or licensing to sell or advise in a financial product other than securities or derivatives?

Yes [ ] No [ ]

If yes, provide the following information for each registration or licence:

Name of entity

 

Type of licence or registration

 

Regulator/organization

 

Date of registration (yyyy/mm/dd)

Expiry date, if applicable (yyyy/mm/dd)

 

Jurisdiction

<<Name of entity>>

 

<<Type of licence or registration>>

 

<<Licence number>>

 

<<Regulator/organization>>

 

<<Date of registration (yyyy/mm/dd)>>

<<Expiry date, if applicable (yyyy/mm/dd)>>

 

<<Jurisdiction>>

Part 5 -- Financial Condition

Capital requirements

5.1 Calculation of excess working capital

Attach the firm's calculation of excess working capital.

• Investment dealers must use the capital calculation form required by the Investment Industry Regulatory Organization of Canada (IIROC).

• Mutual fund dealers must use the capital calculation form required by the Mutual Fund Dealers Association of Canada (MFDA), except for mutual fund dealers registered in Québec only.

• Firms that are not members of either IIROC or the MFDA must use Form 31-103F1 Calculation of Excess Working Capital. See Schedule C.

5.2 Sources of capital

List all cash, cash equivalents, debt and equity sources of the firm's capital.

Name of person or entity providing the capital

Type of capital

Amount ($)

 

__________

__________

__________

See Schedule C Form 31-103F1 Calculation of Excess Working Capital.

5.3 Guarantors

In relation to its business, does the firm:

Yes

No

 

(a)

Have any guarantors?

_____

_____

 

(b)

Act as a guarantor for any party?

_____

_____

If yes, provide the following information for each guarantee:

Name of party to the guarantee

 

NRD number, if applicable

 

Relationship to the firm

Amount of guarantee ($)

 

Details of the guarantee

Bonding and insurance

Questions 5.4 to 5.8 apply to the firm's bonding or insurance coverage or proposed bonding or insurance coverage for securities and derivatives activities only. This in accordance with Part 12, Division 2 of NI 31-103.

This information is on the financial institution bond.

5.4 Jurisdictions covered

Where does the firm have bonding or insurance coverage?

AB

[ ]

BC

[ ]

MB

[ ]

NB

[ ]

NL

[ ]

NS

[ ]

NT

[ ]

NU

[ ]

ON

[ ]

PE

[ ]

QC

[ ]

SK

[ ]

YT

[ ]

If the firm's bonding or insurance does not cover all jurisdictions of Canada where it is seeking registration, explain why.

- - - - - - - - - - - - - - - - - - - -

- - - - - - - - - - - - - - - - - - - -

This information is on the binder of insurance or on the financial institution bond.

5.5 Bonding or insurance details

Name of insurer

 

Bond or policy number

 

Specific insuring agreements and clauses

 

Coverage for each claim ($)

Annual aggregate coverage ($)

 

Total coverage ($)

 

Amount of the deductible ($)

Expiry date (yyyy/mm/dd)

If the firm's insurance or proposed insurance is not in the form of a financial institution bond, explain how it provides equivalent coverage to the bond.

- - - - - - - - - - - - - - - - - - - -

- - - - - - - - - - - - - - - - - - - -

This information is required only if the firm is applying for registration in Québec as a mutual fund dealer or as a scholarship plan dealer.

5.6 Professional liability insurance (Québec only)

If the firm is seeking registration in Québec as a mutual fund dealer or a scholarship plan dealer, provide the following information about the firm's professional liability insurance:

Name of insurer

 

Policy number

 

Specific insuring agreements and clauses

 

Coverage for each claim ($)

Annual aggregate coverage ($)

 

Total coverage ($)

 

Amount of the deductible ($)

Renewal date (yyyy/mm/dd)

 

Jurisdictions covered:

 

AB

BC

MB

NB

NL

NS

NT

NU

ON

PE

QC

SK

YT

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

[ ]

 

Which insurance policy applies to your representatives?

 

Firm's policy

[ ]

Individual's policy

[ ]

Both

[ ]

5.7 Directors' resolution for approving insurance

Attach a directors' resolution confirming that the firm has sufficient insurance coverage for its securities or derivatives-related activities.

5.8 Bonding or insurance claims

In the last seven years, has the firm made any claims against a bond or on its insurance?

Yes [ ] No [ ]

If yes, provide the following information for each claim:

Type of bond or insurance

 

Date of claim (yyyy/mm/dd)

Amount ($)

 

Reason for claim

 

Date resolved (yyyy/mm/dd)

Result

 

Jurisdiction

Solvency

5.9 Bankruptcy

In the last seven years, has the firm or any of its specified affiliates declared bankruptcy, made an assignment or proposal in bankruptcy, or been the subject of a petition in bankruptcy, or the equivalent in any jurisdiction?

Yes [ ] No [ ]

If yes, provide the following information for each bankruptcy or assignment in bankruptcy:

Name of entity

 

Reason for bankruptcy or assignment

 

Date of bankruptcy, assignment or petition (yyyy/mm/dd)

Date discharge granted, if applicable (yyyy/mm/dd)

 

Name of trustee

 

Jurisdiction

If applicable, attach a copy of any discharge, release or equivalent document.

5.10 Appointment of receiver

In the last seven years, has the firm or any of its specified affiliates appointed a receiver or receiver manager, or had one appointed, or the equivalent in any jurisdiction?

Yes [ ] No [ ]

If yes, provide the following information for each appointment of receiver:

Name of entity

 

Date of appointment (yyyy/mm/dd)

Reason for appointment

 

Date appointment ended (yyyy/mm/dd)

Reason appointment ended

 

Name of receiver or receiver manager

 

Jurisdiction

Financial reporting

5.11 Financial year-end

- - - - - - - - - - - - - - - - - - - -

(mm/dd)

- - - - - - - - - - - - - - - - - - - -

If the firm has not established its financial year-end, explain why.

- - - - - - - - - - - - - - - - - - - -

- - - - - - - - - - - - - - - - - - - -

Provide the name of the individual auditing the financial statements and the name of the firm, if applicable.

5.12 Auditor

- - - - - - - - - - - - - - - - - - - -

Name of auditor and accounting firm

- - - - - - - - - - - - - - - - - - - -

5.13 Audited financial statements

(a) Attach, for your most recently completed year, either

(i) non-consolidated audited financial statements; or

(ii) audited financial statements prepared in accordance with section 3.2(3) of NI 52-107.

(b) If the audited financial statements attached for item (a) were prepared for a period ending more than 90 days before the date of this application, also attach an interim financial report interim financial information (as set out in subsection 12.11 of NI 31-103) for a period of not more than 90 days before the date of this application.

If the firm is a start-up company, you can attach an audited opening statement of financial position instead.

We may request an audit of the firm at any time while the firm is registered.

5.14 Letter of direction to auditors

Attach a letter of direction from the firm authorizing the auditor to conduct any audit or review of the firm that the regulator may request.

Part 6 -- Client relationships

See Part 14, Division 3 of NI 31-103 and Companion Policy 31-103CP.

For guidance regarding whether a firm will hold or have access to client assets see section 12.4 of Companion Policy 31-103CP.

6.1 Client assets

Will the firm hold or have access to client assets?

Yes [ ] No [ ]

If yes, provide the following information for each financial institution where the trust accounts for client assets are held.

Name of financial institution

 

Address line 1

 

Address line 2

 

City

Province/territory

 

Postal code

Telephone number

6.2 Conflicts of interest

Does the firm have or expect to have any relationships that could reasonably result in any significant conflicts of interest in carrying out its registerable activities in accordance with securities or derivatives legislation?

Yes [ ] No [ ]

If yes, complete the following questions:

(a) Provide details about each conflict:

- - - - - - - - - - - - - - - - - - - -

- - - - - - - - - - - - - - - - - - - -

(b) Does the firm have policies and procedures to identify and respond to its conflicts of interest?

Yes [ ] No [ ]

If no, explain why:

- - - - - - - - - - - - - - - - - - - -

- - - - - - - - - - - - - - - - - - - -

Part 7 -- Regulatory action

The questions in Part 7 apply to any jurisdiction and any foreign jurisdiction. The information must be provided in respect of the last 7 years.

7.1 Settlement agreements

Has the firm, or any predecessors or specified affiliates of the firm entered into a settlement agreement with any financial services regulator, securities or derivatives exchange, SRO or similar organization?

Yes [ ] No [ ]

If yes, provide the following information for each settlement agreement:

- - - - - - - - - - - - - - - - - - - -

Name of entity

Regulator/organization

Date of settlement (yyyy/mm/dd)

Details of settlement

Jurisdiction

- - - - - - - - - - - - - - - - - - - -

7.2 Disciplinary history

Has any financial services regulator, securities or derivatives exchange, SRO or similar organization:

Yes

No

 

Determined that the firm, or any predecessors or specified affiliates of the firm violated any securities regulations or any rules of a securities or derivatives exchange, SRO or similar organization?

_____

_____

 

Determined that the firm, or any predecessors or specified affiliates of the firm made a false statement or omission?

_____

_____

 

Issued a warning or requested an undertaking by the firm, or any predecessors or specified affiliates of the firm?

_____

_____

 

Suspended or terminated any registration, licensing or membership of the firm, or any predecessors or specified affiliates of the firm?

_____

_____

 

Imposed terms or conditions on any registration or membership of the firm, or predecessors or specified affiliates of the firm?

_____

_____

 

Conducted a proceeding or investigation involving the firm, or any predecessors or specified affiliates of the firm?

_____

_____

 

Issued an order (other than an exemption order) or a sanction to the firm, or any predecessors or specified affiliates of the firm for securities or derivatives-related activity (e.g. cease trade order)?

_____

_____

If yes, provide the following information for each action:

Name of entity

 

Type of action

 

Regulator/organization

 

Date of action (yyyy/mm/dd)

Reason for action

 

Jurisdiction

7.3 Ongoing investigations

Is the firm aware of any ongoing investigations of which the firm or any of its specified affiliates is the subject?

Yes [ ] No [ ]

If yes, provide the following information for each investigation:

- - - - - - - - - - - - - - - - - - - -

Name of entity

Reason or purpose of investigation

Regulator/organization

Date investigation commenced (yyyy/mm/dd)

Jurisdiction

- - - - - - - - - - - - - - - - - - - -

Part 8 -- Legal action

The firm must disclose offences or legal actions under any statute governing the firm and its business activities in any jurisdiction. The information must be provided in respect of the last 7 years.

8.1 Criminal convictions

Has the firm, or any predecessors or specified affiliates of the firm been convicted of any criminal or quasi-criminal offence?

Yes [ ] No [ ]

If yes, provide the following information for each conviction:

Name of entity

 

Type of offence

 

Case name

Case number, if applicable

 

Date of conviction (yyyy/mm/dd)

 

Jurisdiction

8.2 Outstanding criminal charges

Is the firm or any of its specified affiliates currently the subject of any outstanding criminal or quasi-criminal charges?

Yes [ ] No [ ]

If yes, provide the following information for each charge:

- - - - - - - - - - - - - - - - - - - -

Name of entity

Type of offence

Date of charge (yyyy/mm/dd)

Jurisdiction

- - - - - - - - - - - - - - - - - - - -

8.3 Outstanding legal actions

Yes

No

 

Is the firm currently a defendant or respondent (or the equivalent in any jurisdiction) in any outstanding legal action?

_____

_____

 

Are any of the firm's specified affiliates currently a defendant or respondent (or the equivalent in any jurisdiction) in any outstanding legal action that involves fraud, theft or securities-related activities, or that could significantly affect the firm's business?

_____

_____

If yes, provide the following information for each legal action:

- - - - - - - - - - - - - - - - - - - -

Name of entity

Type of legal action

Date of legal action (yyyy/mm/dd)

Current stage of litigation

Remedies requested by plaintiff or appellant

Jurisdiction

- - - - - - - - - - - - - - - - - - - -

8.4 Judgments

Yes

No

 

Has any judgment been rendered against the firm or is any judgment outstanding in any civil court for damages or other relief relating to fraud, theft or securities-related activities?

_____

_____

 

Are any of the firm's specified affiliates currently the subject of any judgments that involve fraud, theft or securities-related activities, or that could significantly affect the firm's business?

_____

_____

If yes, provide the following information for each judgment:

- - - - - - - - - - - - - - - - - - - -

Name of entity

Type of judgment

Date of judgment (yyyy/mm/dd)

Current stage of litigation, if applicable

Remedies requested by plaintiffs

- - - - - - - - - - - - - - - - - - - -

Part 9 -- Certification[repealed]

It is an offence under securities legislation and derivatives legislation, including commodity futures legislation, to give false or misleading information on this form.

By signing below, you:

1. Certify to the regulator in each jurisdiction of Canada where the firm is submitting and filing this form, either directly or through the principal regulator, that:

you have read this form, and

to the best of your knowledge and after reasonable inquiry, all of the information provided on this form is true and complete.

2. Certify to each regulator in a non-principal jurisdiction of Canada where the firm is submitting and filing this form, either directly or through the principal regulator, that at the date of this submission:

the firm has submitted and filed all information required to be submitted and filed under the securities legislation or derivatives legislation or both of the principal jurisdiction of Canada in relation to the firm's registration in that jurisdiction, and

this information is true and complete.

3. Authorize the principal regulator to give each non-principal regulator access to any information the firm has submitted or filed with the principal regulator under securities legislation or derivatives legislation or both of the principal jurisdiction of Canada in relation to the firm's registration in that jurisdiction.

4. Acknowledge that the regulator may collect and provide personal information about the individuals referred to in this form under Collection and use of personal information.

5. Confirm that the individuals referred to in this form have been notified that their personal information is disclosed on this form, the legal reason for doing so, how it will be used and who to contact for more information.

Name of firm

 

Name of firm's authorized signing officer or partner

 

Title of firm's authorized signing officer or partner

 

Signature

 

Date (yyyy/mm/dd)

The witness must be a lawyer, notary public or commissioner of oaths.

Witness

Name of witness

 

Title of witness

 

Signature

 

Date (yyyy/mm/dd)

 

Schedule A

Contact information for notice of collection and use of personal information

Alberta
Nunavut
Alberta Securities Commission,
Government of Nunavut
Suite 600, 250-5th St. SW
Department of Justice
Calgary, AB T2P 0R4
P.O. Box 1000 Station 570
Attention: Information Officer
Iqaluit, NU X0A 0H0
Telephone: (403) 297-6454
Attention: Deputy Registrar of Securities
Telephone: (867) 975-6590
 
British Columbia
Ontario
British Columbia Securities Commission
Ontario Securities Commission
P.O. Box 10142, Pacific Centre
22[SUP]nd[/SUP] Floor
701 West Georgia Street
20 Queen Street West
Vancouver, BC V7Y 1L2
Toronto, ON M5H 3S8
Attention: Freedom of Information Officer<<Registration staff>>
Attention: Compliance and Registrant Regulation
Telephone: (604) 899-6500 or (800) 373-6393 (in Canada)
Telephone: (416) 593-8314
<<E-mail: Registration@bcsc.bc.ca>>
E-mail: registration@osc.gov.on.ca
 
Manitoba
Prince Edward Island
The Manitoba Securities Commission
Securities Office
500 -- 400 St. Mary Avenue
Department of Community Affairs and Attorney
Winnipeg, MB R3C 4K5
P.O. Box 2000
Attention: Director of Registrations
Charlottetown, PE C1A 7N8
Telephone: (204) 945-2548
Attention: Deputy Registrar of Securities
Fax (204) 945-0330
Telephone: (902) 368-6288
 
New Brunswick
Québec
Financial and Consumer Services Commission of New Brunswick / Commission des services financiers et des services aux consommateurs du Nouveau-Brunswick
Autorité des marchés financiers
Suite 300, 85 Charlotte Street
800, square Victoria, 22e étage
Saint John, NB E2L 2J2
C.P. 246, tour de la Bourse
Attention: Director of Securities
Montréal (Québec) H4Z 1G3
Telephone: (506) 658-3060
Attention: Responsable de l'accès à l'information
Telephone: (514) 395-0337 or (877) 525-0337
 
Newfoundland and Labrador
Saskatchewan
Superintendent of Securities, Service NL
Financial and Consumer Affairs Authority of Saskatchewan
Government of Newfoundland and Labrador
Suite 601, 1919 Saskatchewan Drive
P.O. Box 8700
Regina, SK S4P 4H2
2nd Floor, West Block
Attention: Deputy Director, Capital Markets
Confederation Building
Telephone: (306) 787-5871
St. John's, NL A1B 4J6
Attention: Manager of Registrations
Telephone: (709) 729-5661
 
Nova Scotia
Yukon
Nova Scotia Securities Commission
Government of Yukon
Suite 400, 5251 Duke Street
<<Office of the Yukon>> Superintendent of Securities
Halifax, NS B3J 1P3
Department of Community Services
Attention: Deputy Director, Capital Markets<<Registration>>
P.O. Box 2703 C-6
Telephone: (902) 424-7768
Whitehorse, YT Y1A 2C6
Attention: Superintendent of Securities
Telephone: (867) 667-5314<<(867) 667-5466>>
 
Northwest Territories
Self-regulatory organization
Government of the Northwest Territories
Investment Industry Regulatory Organization of Canada
Department of Justice
121 King Street West, Suite 2000
1[SUP]st[/SUP] Floor Stuart M. Hodgson Building
Toronto, Ontario M5H 3T9
5009 -- 49[SUP]th[/SUP] Street
Attention: Privacy Officer
Yellowknife, NWT X1A 2L9
Telephone: (416) 364-6133
Attention: Deputy Superintendent of Securities
E-mail: PrivacyOfficer@iiroc.ca
Telephone: (867) 920-8984

 

Schedule B

Submission to jurisdiction and appointment of agent for service

1. Name of person or company (the "Firm"): ____________________

2. Jurisdiction of incorporation of the person or company: ____________________

3. Name of agent for service of process (the "Agent for Service"): ____________________

4. Address for service of process on the Agent for Service: ____________________

______________________________

______________________________

Phone number of the Agent for Service:

______________________________

5. The Firm designates and appoints the Agent for Service at the address stated above as its agent upon whom may be served a notice, pleading, subpoena, summons or other process in any action, investigation or administrative, criminal, quasi-criminal or other proceeding (a "Proceeding") arising out of or relating to or concerning the Firm's activities in the local jurisdiction and irrevocably waives any right to raise as a defense in any such proceeding any alleged lack of jurisdiction to bring such Proceeding.

6. The Firm irrevocably and unconditionally submits to the non-exclusive jurisdiction of the judicial, quasi-judicial and administrative tribunals of the local jurisdiction and any administrative proceeding in the local jurisdiction, in any proceeding arising out of or related to or concerning the Firm's activities in the local jurisdiction.

7. Until six years after the Firm ceases to be registered, the Firm must file

a. a new Submission to jurisdiction and appointment of agent for service in this form no later than the 10th day after the date this Submission to jurisdiction and appointment of agent for service is terminated; and

b. an amended Submission to jurisdiction and appointment of agent for service no later than the 10th day after any change in the name or above address of the Agent for Service.

7. Until six years after the Firm ceases to be registered, the Firm must file a new executed Submission to jurisdiction and appointment of agent for service in this form

a. no later than the 15th day after the date this Submission to jurisdiction and appointment of agent for service is terminated, and

b. no later than the 15th day after any change in the name or address of the Agent for Service.

8. This Submission to jurisdiction and appointment of agent for service is governed by and construed in accordance with the laws of the local jurisdiction.

Dated: ____________________

______________________________

(Signature of the Firm or authorized signatory)

______________________________

(Name and Title of authorized signatory)

Acceptance

The undersigned accepts the appointment as Agent for Service of (Insert name of the Firm) under the terms and conditions of the foregoing Submission to jurisdiction and appointment of agent for service.

Dated: ____________________

______________________________

(Signature of Agent for Service or authorized signatory)

______________________________

(Name and Title of authorized signatory)

 

Schedule C

FORM 31-103F1 CALCULATION OF EXCESS WORKING CAPITAL

______________________________

Firm Name

Capital Calculation (as at _______________ with comparative figures as at _______________)

Component

Current period

Prior period

 

1.

Current assets

__________

__________

 

2.

Less current assets not readily convertible into cash (e.g., prepaid expenses)

__________

__________

 

3.

Adjusted current assets Line 1 minus line 2 =

__________

__________

 

4.

Current liabilities

__________

__________

 

5.

Add 100% of non-current related party debt unless the firm and the lender have executed a subordination agreement in the form set out in Appendix B of National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations and the firm has delivered a copy of the agreement to the regulator or, in Québec, the securities regulatory authority. See section 12.2 of National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations.

__________

__________

 

6.

Adjusted current liabilities Line 4 plus line 5 =

__________

__________

 

7.

Adjusted working capital Line 3 minus line 6 =

__________

__________

 

8.

Less minimum capital

__________

__________

 

9.

Less market risk

__________

__________

 

10.

Less any deductible under the bonding or insurance policy required under Part 12 of National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations

__________

__________

 

11.

Less Guarantees

__________

__________

 

12.

Less unresolved differences

__________

__________

 

13.

Excess working capital

__________

__________

Notes:

Form 31-103F1 Calculation of Excess Working Capital must be prepared using the accounting principles that you use to prepare your financial statements in accordance with National Instrument 52-107 Acceptable Accounting Principles and Auditing Standards. Section 12.1 of Companion Policy 31-103CP Registration Requirements, Exemptions and Ongoing Registrant Obligations provides further guidance in respect of these accounting principles.

Line 5. Related-party debt -- Refer to the CICA Handbook CPA Canada Handbook for the definition of "related party" for publicly accountable enterprises. The firm is required to deliver a copy of the executed subordination agreement to the regulator or, in Québec, the securities regulatory authority on the earlier of a) 10 days after the date the agreement is executed or b) the date an amount subordinated by the agreement is excluded from its calculation of excess working capital on Form 31-103F1 Calculation of Excess Working Capital. The firm must notify the regulator or, in Québec, the securities regulatory authority, 10 days before it repays the loan (in whole or in part), or terminates the subordination agreement. See section 12.2 of National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations.

Line 8. Minimum Capital -- The amount on this line must be not less than (a) $25,000 for an adviser and (b) $50,000 for a dealer. For an investment fund manager, the amount must be not less than $100,000 unless subsection 12.1(4) of National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations applies.

Line 9. Market Risk -- The amount on this line must be calculated according to the instructions set out in Schedule 1 to Form 31-103F1 Calculation of Excess Working Capital. A schedule supporting the calculation of any amounts included in Line 9 as market risk should be provided to the regulator or, in Québec, the securities regulatory authority in conjunction with the submission of Form 31-103F1 Calculation of Excess Working Capital.

Line 11. Guarantees -- If the registered firm is guaranteeing the liability of another party, the total amount of the guarantee must be included in the capital calculation. If the amount of a guarantee is included in the firm's statement of financial position as a current liability and is reflected in line 4, do not include the amount of the guarantee on line 11.

Line 12. Unresolved differences -- Any unresolved differences that could result in a loss from either firm or client assets must be included in the capital calculation. The examples below provide guidance as to how to calculate unresolved differences:

(i) If there is an unresolved difference relating to client securities, the amount to be reported on Line 12 will be equal to the fair value of the client securities that are short, plus the applicable margin rate for those securities.

(ii) If there is an unresolved difference relating to the registrant's investments, the amount to be reported on Line 12 will be equal to the fair value of the investments (securities) that are short.

(iii) If there is an unresolved difference relating to cash, the amount to be reported on Line 12 will be equal to the amount of the shortfall in cash.

Please refer to section 12.1 of Companion Policy 31-103CP Registration Requirements, Exemptions and Ongoing Registrant Obligations for further guidance on how to prepare and file Form 31-103F1 Calculation of Excess Working Capital.

Management Certification

 

Registered Firm Name: ____________________

We have examined the attached capital calculation and certify that the firm is in compliance with the capital requirements as at ____________________.

Name and Title

Signature

Date

1.

_______________

_______________

_______________

2.

_______________

_______________

_______________

 

Schedule 1 of Form 31-103F1 Calculation of Excess Working Capital (calculating line 9 [market risk])

For purposes of completing this form:

(1) "Fair value" means the value of a security determined in accordance with Canadian GAAP applicable to publicly accountable enterprises.

(2) For each security whose value is included in line 1, Current Assets, multiply the fair value of the security by the margin rate for that security set out below. Add up the resulting amounts for all of the securities you hold. The total is the "market risk" to be entered on line 9.

(a) Bonds, Debentures, Treasury Bills and Notes

(i) Bonds, debentures, treasury bills and other securities of or guaranteed by the Government of Canada, of the United Kingdom, of the United States of America or of any other national foreign government (provided those foreign government securities have a current credit rating described in subparagraph (i.1)) maturing (or called for redemption):

within 1 year:

1% of fair value multiplied by the fraction determined by dividing the number of days to maturing by 365

 

over 1 year to 3 years:

1% of fair value

 

over 3 years to 7 years:

2% of fair value

 

over 7 years to 11 years:

4% of fair value

 

over 11 years:

4% of fair value

(i.1) A credit rating from a designated rating organization listed below, from a DRO affiliate of an organization listed below, from a designated rating organization that is a successor credit rating organization of an organization listed below or from a DRO affiliate of such successor credit rating organization, that is the same as one of the following corresponding rating categories or that is the same as a category that replaces one of the following corresponding rating categories:

Designated Rating Organization

Long Term Debt

Short Term Debt

 

DBRS Limited

AAA

R-1(high)

 

Fitch Ratings, Inc.

AAA

F1+

 

Moody's Canada Inc.

Aaa

Prime-1

 

S&P Global Ratings Canada

AAA

A-1+

(ii) Bonds, debentures, treasury bills and other securities of or guaranteed by any jurisdiction of Canada and obligations of the International Bank for Reconstruction and Development, maturing (or called for redemption):

within 1 year:

2% of fair value multiplied by the fraction determined by dividing the number of days to maturity by 365

 

over 1 year to 3 years:

3% of fair value

 

over 3 years to 7 years:

4% of fair value

 

over 7 years to 11 years:

5% of fair value

 

over 11 years:

5% of fair value

(iii) Bonds, debentures or notes (not in default) of or guaranteed by any municipal corporation in Canada or the United Kingdom maturing:

within 1 year:

3% of fair value multiplied by the fraction determined by dividing the number of days to maturity by 365

 

over 1 year to 3 years:

5% of fair value

 

over 3 years to 7 years:

5% of fair value

 

over 7 years to 11 years:

5% of fair value

 

over 11 years:

5% of fair value

(iv) Other non-commercial bonds and debentures (not in default): 10% of fair value

(v) Commercial and corporate bonds, debentures and notes (not in default) and non-negotiable and non-transferable trust company and mortgage loan company obligations registered in the registered firm's name maturing:

within 1 year:

3% of fair value

 

over 1 year to 3 years:

6% of fair value

 

over 3 years to 7 years:

7% of fair value

 

over 7 years to 11 years:

10% of fair value

 

over 11 years:

10% of fair value

(b) Bank Paper

Deposit certificates, promissory notes or debentures issued by a Canadian chartered bank (and of Canadian chartered bank acceptances) maturing:

within 1 year:

2% of fair value multiplied by the fraction determined by dividing the number of days to maturity by 365

 

over 1 year:

apply rates for commercial and corporate bonds, debentures and notes

(c) Acceptable foreign bank paper

Deposit certificates, promissory notes or debentures issued by a foreign bank, readily negotiable and transferable and maturing:

within 1 year:

2% of fair value multiplied by the fraction determined by dividing the number of days to maturity by 365

 

over 1 year:

apply rates for commercial and corporate bonds, debentures and notes

"Acceptable Foreign Bank Paper" consists of deposit certificates or promissory notes issued by a bank other than a Canadian chartered bank with a net worth (i.e., capital plus reserves) of not less than $200,000,000.

(d) Mutual Funds

Securities of mutual funds qualified by prospectus for sale in any jurisdiction of Canada:

(i) 5% of the net asset value per security as determined in accordance with National Instrument 81-106 Investment Fund Continuous Disclosure, where the fund is a money market mutual fund as defined in National Instrument 81-102 Investment Funds; or

(ii) the margin rate determined on the same basis as for listed stocks multiplied by the net asset value per security of the fund as determined in accordance with National Instrument 81-106 Investment Fund Continuous Disclosure.

Securities of mutual funds qualified by prospectus for sale in the United States of America: 5% of the net asset value per security if the fund is registered as an investment company under the Investment Companies Act of 1940, as amended from time to time, and complies with Rule 2a-7 thereof.

(e) Stocks

In this paragraph, "securities" includes rights and warrants and does not include bonds and debentures.

(i) On securities including investment fund securities, rights and warrants, listed on any exchange in Canada or the United States of America:

Long Positions -- Margin Required

Securities selling at $2.00 or more -- 50% of fair value

Securities selling at $1.75 to $1.99 -- 60% of fair value

Securities selling at $1.50 to $1.74 -- 80% of fair value

Securities selling under $1.50 -- 100% of fair value

Short Positions -- Credit Required

Securities selling at $2.00 or more -- 150% of fair value

Securities selling at $1.50 to $1.99 -- $3.00 per share

Securities selling at $0.25 to $1.49 -- 200% of fair value

Securities selling at less than $0.25 -- fair value plus $0.25 per share

(ii) For positions in securities that are constituent securities on a major broadly-based index of one of the following exchanges, 50% of the fair value:

(a) Australian Stock Exchange Limited

(b) Bolsa de Madrid

(c) Borsa Italiana

(d) Copenhagen Stock Exchange

(e) Euronext Amsterdam

(f) Euronext Brussels

(g) Euronext Paris S.A.

(h) Frankfurt Stock Exchange

(i) London Stock Exchange

(j) New Zealand Exchange Limited

(k) Stockholm Stock Exchange

(l) SIX Swiss Exchange

(m) The Stock Exchange of Hong Kong Limited

(n) Tokyo Stock Exchange

(f) Mortgages

(i) For a firm registered in any jurisdiction of Canada except Ontario:

(a) Insured mortgages (not in default): 6% of fair value

(b) Mortgages which are not insured (not in default): 12% of fair value

(ii) For a firm registered in Ontario:

(a) Mortgages insured under the National Housing Act (Canada) (not in default): 6% of fair value

(b) Conventional first mortgages (not in default): 12% of fair value

- - - - - - - - - - - - - - - - - - - -

If you are registered in Ontario regardless of whether you are also registered in another jurisdiction of Canada, you will need to apply the margin rates set forth in (ii) above.

- - - - - - - - - - - - - - - - - - - -

(g) For all other securities -- 100% of fair value.

FORM 33-109F7 REINSTATEMENT OF REGISTERED INDIVIDUALS AND PERMITTED INDIVIDUALS (sections 2.3 and 2.5(2))

WARNING -- It is an offence under securities legislation and derivatives legislation, including commodity futures legislation, to knowingly give false or misleading information to the regulator or securities regulatory authority.

CERTIFICATION

Individual

I certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where I am submitting this form and to any applicable self-regulatory organization (SRO) that

I have read this form and understand all matters within this form, including the questions,

I have discussed this form with an officer, partner, branch manager or supervisor of my sponsoring firm and that to the best of my knowledge, the officer, partner, branch manager or supervisor is satisfied that I understand all matters within this form, including the questions,

to the best of my knowledge and after reasonable inquiry, all of the information provided on this form is true and complete,

if applicable, I will limit my activities to those allowed by my category of registration and any SRO approval,

the new sponsoring firm understands that if the individual's reinstatement of registration was subject to any terms and conditions that were unsatisfied when the individual left the individual's former sponsoring firm, those terms and conditions remain in effect and the new sponsoring firm agrees to assume any ongoing obligations that apply to the sponsoring firm in respect of the individual under those terms and conditions, and

if the business location specified in this form is a residence, I hereby give my consent

for the regulator or, in Québec, the securities regulatory authority in each jurisdiction where I am submitting this form to enter that residence for the administration of securities legislation and derivatives legislation, including commodity futures legislation, and

where applicable, for the SRO to enter that residence for the administration of the rules of the SRO.

Firm

I certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where the firm is submitting this form and to any applicable SRO that

the individual identified in this form will be engaged by the new sponsoring firm as a registered individual or a permitted individual,

I have, or a branch manager, supervisor, officer or partner has, discussed this form with the individual. To the best of my knowledge, the individual understands all matters within this form, including the questions, and

the new sponsoring firm understands that if the individual's reinstatement of registration was subject to any undischarged terms and conditions when the individual left their former sponsoring firm, those terms and conditions remain in effect and agrees to assume any ongoing obligations that apply to the sponsoring firm in respect of the individual under those terms and conditions.

NRD format:

[ ] I am making this submission under authority delegated by the firm and the individual identified in this form. By checking this box, I certify that

(a) the firm provided me with all of the information on this form and makes the firm certification above, and

(b) the individual provided the firm with all of the information on this form and makes the individual certification above.

Non-NRD format:

Individual

By signing below, I make the above individual certification.

Signature of individual ____________________

Date signed ____________________ (YYYY/MM/DD)

Firm

By signing below, I make the firm certification above.

Name of firm ____________________

Name of authorized signing officer or partner ____________________

Title of authorized signing officer or partner ____________________

Signature of authorized signing officer or partner ____________________

Date signed ____________________, (YYYY/MM/DD)

GENERAL INSTRUCTIONS

Complete and submit this form to the relevant regulator(s) or in Québec, the securities regulatory authority, or self-regulatory organization (SRO) if an individual has left a sponsoring firm and is seeking to reinstate their registration in one or more of the same categories or reinstate their same status of permitted individual as before with a sponsoring firm. You only need to complete and submit one form regardless of the number of registration categories or permitted individual statuses you are seeking to be reinstated in.

An individual may reinstate their registration or permitted individual status by submitting this form. This form may only be used if all of the following apply:

1. this form is submitted on or before the 90th day after the cessation date of the individual's employment, partnership or agency relationship with the individual's former sponsoring firm,

2. there have been no changes to the information previously submitted in respect of Items 13 (Regulatory Disclosure), other than changes to Item 13.3(c), 14 (Criminal Disclosure), 15 (Civil Disclosure) and 16 (Financial Disclosure) of the individual's Form 33-109F4 since the individual left their former sponsoring firm, and

3. the individual's employment, partnership or agency relationship with their former sponsoring firm did not end because the individual was asked by the firm to resign, resigned voluntarily or was dismissed, following an allegation against the individual of criminal activity, a breach of securities legislation, or a breach of the rules of an SRO.

If you do not meet all of the above conditions then you must apply for reinstatement by completing on NRD a Form 33-109F4 by making the NRD submission entitled 'Reactivation of Registration'.

GENERAL INSTRUCTIONS

Complete and submit this form to the relevant regulator(s) or, in Québec, the securities regulatory authority, or self-regulatory organization (SRO) if

an individual has left a sponsoring firm and is seeking to reinstate their registration in one or more of the same categories or reinstate their same status of permitted individual as before with a sponsoring firm, and

the new sponsoring firm is registered in the same category of registration in which the individual's former sponsoring firm was registered.

You only need to complete and submit one form regardless of the number of registration categories or permitted individual statuses you are seeking to be reinstated in.

An individual may reinstate the individual's registration or permitted individual status by submitting this form. This form must not be used unless all of the following apply:

1. this form is submitted on or before the 90th day after the cessation date of the individual's employment, partnership or agency relationship with the individual's former sponsoring firm;

2. the information in the individual's Form 33-109F4 was up-to-date as of the cessation date of the individual's employment, partnership or agency relationship with the individual's former sponsoring firm;

3. there have been no changes to the information previously submitted in respect of

Item 13 (Regulatory Disclosure), other than changes to Item 13.3(a),

Item 14 (Criminal Disclosure),

Item 15 (Civil Disclosure), and

Item 16 (Financial Disclosure)

of the individual's Form 33-109F4 since the individual left their former sponsoring firm; and

4. at the time of resignation or termination with the individual's former sponsoring firm, there were no allegations against the individual, in Canada or in any foreign jurisdiction, relevant to an assessment whether the individual is not suitable for reinstatement of registration or the proposed reinstatement of registration is objectionable, including, for greater certainty, an allegation against the individual of any of the following:

a crime,

a contravention of any statute, regulation, or order of a court or regulatory body,

a contravention of any rule or bylaw of an SRO, of an authority exercising jurisdiction over specific business activities or professions, or of a similar organization, or

a failure to meet any standard of conduct of the sponsoring firm, of any industry association or of any authority exercising jurisdiction over specific business activities or professions.

If you do not meet all of the above conditions, then you must apply for reinstatement by completing on NRD a Form 33-109F4 by making the NRD submission entitled "Reactivation of Registration".

Terms

In this form,

"you", "your" and "individual" means the individual who is seeking to reinstate their registration or their status as permitted individual.

"former sponsoring firm" means the registered firm where you most recently carried out duties as a registered or permitted individual.

"major shareholder" and "shareholder" mean a shareholder who, in total, directly or indirectly owns voting securities carrying 10 per cent or more of the votes carried by all outstanding voting securities.

"new sponsoring firm" means the registered firm where you will begin carrying out duties as a registered or permitted individual when your registration or permitted individual status is reinstated.

Several terms used in this form are defined in the Form 33-109F4 Registration of Individuals and Review of Permitted Individuals that you submitted when you first became registered.

How to submit this form

NRD format

Submit this form at the National Registration Database (NRD) website in NRD format at www.nrd.ca. If you have any questions, contact the compliance, registration or legal department of the new sponsoring firm or a legal adviser with securities law experience, or visit the NRD information website at www.nrd-info.ca.

Format, other than NRD format

If you are relying on the temporary hardship exemption in section 5.1 of National Instrument 31-102 National Registration Database, you may submit this form in a format other than NRD format.

If you need more space, use a separate sheet of paper. Clearly identify the Item and question number. Complete and sign the form, and send it to the relevant regulator(s) or, in Québec, the securities regulatory authority, SRO(s) or similar authority. The number of originally signed copies of the form you are required to submit depends on the province or territory, and on the regulator, the securities regulatory authority or SRO.

To avoid delays in processing this form, be sure to answer all of the items that apply to you. If you have questions, contact the compliance, registration or legal department of the new sponsoring firm or a legal adviser with securities law experience, or visit the National Registration Database information website at www.nrd-info.ca.

Item 1 Name

1. NRD number: ____________________

2. Legal name

__________

__________

__________

__________

Last name

First name

Second name (N/A [ ])

Third name (N/A [ ])

3. Date of birth (YYYY/MM/DD):

4. Use of other names

Are you currently using, or have you ever used, operated under, or carried on business under, a name other than the name(s) mentioned above (for example, trade names for sole proprietorships or team names)?

Yes [ ] No [ ]

If "Yes", complete Schedule A.

Item 2 Number of jurisdictions

1. Are you seeking to reinstate your registration or permitted individual status in more than one jurisdiction of Canada?

Yes [ ] No [ ]

2. Check each province or territory in which you are seeking reinstatement of registration or reinstatement as a permitted individual:

[ ] All jurisdictions

[ ] Alberta

[ ] British Columbia

[ ] Manitoba

[ ] New Brunswick

[ ] Newfoundland and Labrador

[ ] Northwest Territories

[ ] Nova Scotia

[ ] Nunavut

[ ] Ontario

[ ] Prince Edward Island

[ ] Québec

[ ] Saskatchewan

[ ] Yukon

2. Check each province or territory in which you are seeking reinstatement of registration or, if you are seeking reinstatement as a permitted individual, check each province or territory where your sponsoring firm is registered:

[ ] All jurisdictions

[ ] Alberta

[ ] British Columbia

[ ] Manitoba

[ ] New Brunswick

[ ] Newfoundland and Labrador

[ ] Northwest Territories

[ ] Nova Scotia

[ ] Nunavut

[ ] Ontario

[ ] Prince Edward Island

[ ] Québec

[ ] Saskatchewan

[ ] Yukon

Item 3 Individual categories

1. On Schedule B, check each category for which you are seeking to reinstate your registration or permitted individual status. If you are seeking reinstatement of status as a permitted individual, check each category that describes your position with your new sponsoring firm.

2. If you are seeking reinstatement as a representative of a mutual fund dealer or of a scholarship plan dealer in Québec, are you covered by your new sponsoring firm's professional liability insurance?

Yes [ ] No [ ]

If "No", state:

The name of your insurer ____________________

Your policy number ____________________

Item 4 Address and agent for service

1. Address for service

You must have one address for service in each province or territory where you are submitting this form. A residential or business address is acceptable. A post office box is not acceptable. Complete Schedule C for each additional address for service you are providing.

Address for service:

____________________ (number, street, city, province or territory, postal code)

Telephone number ____________________

Fax number, if applicable ____________________

Business e-mail address ____________________

2. Agent for service

If you have appointed an agent for service, provide the following information for the agent in each province or territory where you have an agent for service. The address of your agent for service must be the same as the address for service above. If your agent for service is not an individual, provide the name of your contact person.

Name of agent for service: ____________________

Contact person: ____________________ Last name, First name

Item 5 Location of employment

1. Provide the following information for your new sponsoring firm. If you will be working out of more than one business location, provide the following information for the business location out of which you will be doing most of your business. If you are only filing this form because you are a permitted individual and are not employed by, or acting as agent for, the sponsoring firm, select "N/A".

Unique Identification Number (optional): ____________________

NRD location number: ____________________

Business location address: ____________________ (number, street, city, province, territory or state, country, postal code)

Telephone number: (_____) ____________________ Fax number: (_____) ____________________

N/A [ ]

2. If the new sponsoring firm has a foreign head office, and/or you are not a resident of Canada, provide the address for the business location in which you will be conducting most of your business. If you are only filing this form because you are a permitted individual and are not employed by, or acting as agent for, the sponsoring firm, select "N/A".

Business location address: ____________________ (number, street, city, province, territory or state, country, postal code)

Telephone number: (_____) ____________________ Fax number: (_____) ____________________

N/A [ ]

[The following under #3 "Type of business location", #4 and #5 is for a Format other than NRD format only]

3. Type of business location:

[ ] Head office

[ ] Branch or business location

[ ] Sub-branch (Mutual Fund Dealers Association of Canada members only)

4. Name of supervisor or branch manager: ____________________

5. [ ] Check here if the mailing address of the business location is the same as the business location address provided above. Otherwise, complete the following:

Mailing address: ____________________ (number, street, city, province, territory or state, country, postal code)

Item 6 Previous employment

Provide the following information for your former sponsoring firm.

Name: ____________________

Date on which you were no longer authorized to act on behalf of your former sponsoring firm as a registered individual or permitted individual: ____________________ (YYYY/MM/DD)

The reason why you left your former sponsoring firm:

______________________________

Item 7 Current employment, other business activities, officer positions held and directorships

Name of your new sponsoring firm: ____________________

Complete a separate Schedule D for each of your current business and employment activities, including employment and business activities with your new sponsoring firm and any employment and business activities outside your new sponsoring firm. Also include all officer or director positions and any other equivalent positions held, as well as positions of influence. The information must be provided

whether or not you receive compensation for such services, and

whether or not any such position is business related.

Item 7 Reportable activities

Name of your new sponsoring firm: ____________________

1. Activities with your sponsoring firm

Instructions: Describe all of your roles and responsibilities with your sponsoring firm, whether these roles and responsibilities are securities related or not (e.g., sale of securities, review of marketing materials, IT helpdesk, negotiation of employment contracts, sales of banking and insurance products and services). Include any other information about your position with your sponsoring firm that is relevant for the regulator or, in Québec, the securities regulatory authority to know (e.g., if your role is specialized).

Complete a Schedule D with respect to your roles and responsibilities with your sponsoring firm.

2. Reportable outside activities

Instructions: Consider all of the activities that you participate in outside of your sponsoring firm, whether or not you receive compensation for such activities and whether or not any such activity is business related. If any of the categories below describes one or more activities that you participate in, complete a separate Schedule D for each activity or entity.

Category 1 -- Activities with another registered firm

Instructions: Report activities with registered firms, other than your sponsoring firm. All activities in this category are reportable whether or not you receive compensation for such activities. Major shareholder means a shareholder who, in total, directly or indirectly owns voting securities carrying 10 percent or more of the votes carried by all outstanding voting securities.

If you are a director, officer, employee, contractor, consultant, agent, or a service provider of a registered firm other than your sponsoring firm, or hold any other equivalent position with or for that registered firm, or are a major shareholder or partner of that registered firm, complete a separate Schedule D for the registered firm.

Category 2 -- Activities with an entity that receives compensation from a registered firm

If you are a director, officer, employee, contractor, consultant, or agent of a specified entity, or hold any other equivalent position with or for a specified entity, or are a shareholder or partner of a specified entity, complete a separate Schedule D for the specified entity.

For the purposes of this category, "specified entity" means an entity that receives compensation from a registered firm for activities that you provide for your sponsoring firm or another registered firm.

Category 3 -- Other securities related activities

Instructions: All activities in this category are reportable, whether or not you receive compensation for such activities.

If you have been at any time in the last 7 years directly involved in raising money for an entity through the issuance of securities or derivatives or promoting the sale of an entity's securities or derivatives outside of your activities with your sponsoring firm or another registered firm, complete a separate Schedule D for each entity for which you performed these activities.

Directors and officers of reporting issuers and of entities that have been at any time in the last 7 years raising money through the issuance of securities or derivatives are considered to be directly involved in raising money for that entity.

Category 4 -- Provision of financial or financial-related services

Instructions: All activities in this category are reportable, whether or not you receive compensation for such activities. Major shareholder means a shareholder who, in total, directly or indirectly owns voting securities carrying 10 percent or more of the votes carried by all outstanding voting securities.

Complete a separate Schedule D for each activity, as applicable, if you are

an insurance broker or agent,

providing loan or deposit products and services,

carrying out a money service business,

a mortgage broker, agent or administrator,

preparing tax returns or providing tax advice,

providing financial planning or financial advice, including estate planning,

providing corporate finance services, including services provided in the capacity of a comptroller, treasurer and chief financial officer,

advising on credit/debt restructuring,

a pension consultant,

providing advice on mergers and acquisitions services,

providing accounting or bookkeeping services,

providing oversight or independent review or expert opinion on the management of an entity's financial assets, or

providing banking or insurance services.

Also complete a separate Schedule D for each activity, as applicable, if you are a director or officer, or hold any other equivalent position with or for, or are a major shareholder or active partner of, an entity that provides one or more of the services in the above list.

Category 5 -- Positions of influence

Instructions: All positions of influence (e.g., medical doctor, leader in a religious organization) are reportable, whether or not you receive compensation for such activities. For more information on positions of influence, see section 13.4.3 of National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations and section 13.4.3 of the Companion Policy to National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations.

Complete a separate Schedule D for each position of influence that you hold.

Category 6 -- Specified activities

Complete a separate Schedule D for activities not included in Categories 1 to 5 if the total time spent by you on specified activities exceeds, on average, 30 hours per month.

For this purpose, "specified activities" means all of the following:

activities to which any of Categories 1 to 5 apply;

activities for which you receive compensation or where you have a reasonable expectation of compensation;

all other activities (whether or not you are compensated) for which you are a director or officer of, or hold an equivalent position with or for the entity, or are a partner or shareholder of the entity.

Item 8 Ownership of securities in new sponsoring firm

Are you a partner or major shareholder of your new sponsoring firm?

Yes [ ] No [ ]

If "Yes", complete Schedule E.

Item 9 Confirm permanent record

1. Check the appropriate box to indicate that, since leaving your former sponsoring firm, there has been a change to any information previously submitted for the items of your Form 33-109F4 that are listed below.

[ ] Regulatory disclosure (Item 13, other than changes to Item 13.3(c))

[ ] Criminal disclosure (Item 14)

[ ] Civil disclosure (Item 15)

[ ] Financial disclosure (Item 16)

2. Check the box below I am eligible to file this Form 33-109F7, only if you satisfy both of the following conditions:

(a) there are no changes to any of the disclosure items under Item 9.1 above, and

(b) your employment, partnership or agency relationship with your former sponsoring firm did not end because you were asked by the firm to resign or resigned voluntarily, or were dismissed, following an allegation against you of

criminal activity,

a breach of securities legislation, or

a breach of the rules of an SRO.

If you do not meet the above conditions for selecting the box 'I am eligible to file this Form 33-109F7', then you must apply for reinstatement by completing on NRD a Form 33-109F4 by making the NRD submission entitled "Reactivation of Registration". If you are submitting a Form 33-109F4 in a format other than NRD format you must complete the entire form.

[ ] I am eligible to file this Form 33-109F7.

2. Check the box below -- I am eligible to file this Form 33-109F7, only if you satisfy all of the following conditions:

(a) the information in your Form 33-109F4 was up-to-date when you left your sponsoring firm;

(b) there are no changes to any of the disclosure items under Item 9.1 above; and

(c) at the time of your resignation or termination, there was no allegation against you, in Canada or in any foreign jurisdiction, relevant to an assessment whether you are not suitable for reinstatement of registration or your proposed reinstatement of registration is objectionable, including, for greater certainty, any allegations against you of

a crime,

a contravention of any statute, regulation, or order of a court or regulatory body,

a contravention of any rule or bylaw of an SRO, or an authority exercising jurisdiction over specific business activities or professions, or of a similar organization, or

a failure to meet any standard of conduct of the sponsoring firm, of any industry association, or of any authority exercising jurisdiction over specific business activities or professions.

If you do not meet the above conditions for selecting the box 'I am eligible to file this Form 33-109F7', then you must apply for reinstatement by completing on NRD a Form 33-109F4 by making the NRD submission entitled "Reactivation of Registration". If you are submitting a Form 33-109F4 in a format other than NRD format you must complete the entire form.

[ ] I am eligible to file this Form 33-109F7.

Item 10 Acknowledgements, submission to jurisdiction and notice of collection and use of personal information

By submitting this form, you:

acknowledge that the submission to jurisdiction, consent to collection and use of personal information, and authorization in respect of SROs (to the extent applicable) that you provided in your Form 33-109F4 remain in effect and extend to this form

consent to the collection and disclosure of your personal information by regulators and by your sponsoring firm, in each case, for registration and other related regulatory purposes.

If you have any questions about the collection and use of your personal information, contact the securities regulatory authority or applicable SRO in the relevant jurisdiction. See Schedule F for details. In Québec, you can also contact the Commission d'accès à l'information at 1-888-528-7741 or visit its website at www.cai.gouv.qc.ca.

You acknowledge and agree that if you are seeking reinstatement of your registration and it was subject to any undischarged terms and conditions when you left your former sponsoring firm, those terms and conditions will remain in effect at your new sponsoring firm.

Item 10 Submission to jurisdiction and collection and use of personal information

1. Submission to jurisdiction

By submitting this form, you agree to be subject to the securities legislation or derivatives legislation or both of each jurisdiction of Canada, and to the bylaws, regulations, rules, rulings and policies (collectively referred to as "rules" in this form) of the SROs to which you have submitted this form. This includes the jurisdiction of any tribunals or any proceedings that relate to your activities as a registrant or a partner, director or officer of a registrant under that securities legislation or derivatives legislation or both or as an approved person under SRO rules.

2. Notice of collection and use of personal information

Your personal information is collected by, or on behalf of, each securities regulatory authority and SRO set out in Schedule F. Any of the securities regulatory authorities or SROs set out in Schedule F may contact government or private bodies or agencies, individuals, corporations, employers, and other organizations, in Canada and in other countries, for information about you.

This personal information is being collected under the authority of the applicable securities legislation, derivatives legislation (including commodity futures legislation) or both of the securities regulatory authorities and pursuant to the SRO rules of an SRO set out in Schedule F. The collection, use and disclosure are done in accordance with applicable freedom of information and privacy legislation.

The principal purpose of this collection by the securities regulatory authorities is to administer, enforce, carry out their duties or exercise their powers under their respective securities legislation, derivatives legislation (including commodity futures legislation) or both, and by the SROs to administer and enforce the rules of the SROs.

The information submitted by you in this form with your consent, or collected indirectly with your authorization, may be collected

at the time of your application,

at any time during your registration or while you are a permitted individual, or

at the time the regulator or, in Québec, the securities regulatory authority, or SRO is informed by your sponsoring firm that you no longer have authority to act on behalf of the sponsoring firm or are no longer a permitted individual of the sponsoring firm.

If you have any questions about the collection, use, and disclosure of this information, contact the securities regulatory authority or SRO in any jurisdiction in which the required information is submitted. See Schedule F for details.

Note that certain information such as your name(s) (including aliases, trade names or some past names), your sponsoring firm, and other relevant registration information will be listed in a publicly available registry of registered individuals and, if applicable, on the Disciplined List.

Also note that certain securities regulatory authorities may provide or receive information to or from certain entities under separate provisions of their securities legislation or derivatives legislation (including commodity futures legislation) or both, and SROs may provide or receive information under the rules of the SROs. This consent and notice does not limit the authority, powers, obligations or rights conferred on any of the securities regulatory authorities by legislation or regulations in effect in their jurisdiction.

3. Consent to collect and use personal information

By submitting this form, you consent to and authorize the collection, directly and indirectly, of personal information by each securities regulatory authority and SRO and to the use of your personal information as set out above.

The personal information that each securities regulatory authority or SRO collects, includes the following:

the personal information provided in this form;

the personal information provided by your sponsoring firm;

registration or financial services licensing information;

law enforcement records, including police records;

credit records;

bankruptcy or other insolvency records;

employment records and information received from an employer;

records and information received from entities you had or have an independent contractor or agency relationship with;

personal information available online;

records from government ministries and agencies, SROs or authorities exercising jurisdiction over specific business activities or professions; and

records of, and used in, court proceedings, including any probation records.

Item 11 Warning[repealed]

It is an offence under securities legislation and derivatives legislation, including commodity futures legislation, to give false or misleading information on this form.

Item 12 Certification[repealed]

1. Certification -- NRD format:

I confirm I have discussed the questions in this form with an officer, branch manager or supervisor of my sponsoring firm. To the best of my knowledge, the officer, branch manager or supervisor was satisfied that I fully understood the questions. I will limit my activities to those permitted by my category of registration. If the business location specified in this form is a residence, I hereby give my consent for the regulator or, in Québec, the securities regulatory authority to enter that residence for the administration of securities legislation and derivatives legislation, including commodity futures legislation.

[ ] I am making this submission as agent for the individual. By checking this box, I certify that the individual provided me with all of the information on this form and the certification above.

2. Certification -- Format other than NRD format:

Individual

By signing below, I certify to the regulator, or in Québec the securities regulatory authority, in each jurisdiction where I am submitting this form, either directly or through the principal regulator that:

I have read the form and understand the questions,

all of the information provided on this form is true, and complete, and

if the business location specified in this form is a residence, I hereby give my consent for the regulator or, in Québec, the securities regulatory authority to enter that residence for the administration of securities legislation and derivatives legislation, including commodity futures legislation.

Signature of individual ____________________ Date signed ____________________ (YYYY/MM/DD)

Authorized partner or officer of the new sponsoring firm

By signing below, I certify to the regulator, or in Québec the securities regulatory authority, in each jurisdiction where I am submitting this form for the individual that:

the individual will be engaged by the new sponsoring firm as a registered individual or a permitted individual

I have, or a branch manager or another officer or supervisor has, discussed the questions set out in this form with the individual and, to the best of my knowledge, the individual fully understands the questions, and

the new sponsoring firm understands that if the individual's reinstatement of registration was subject to any undischarged terms and conditions when the individual left their former sponsoring firm, those terms and conditions remain in effect and agrees to assume any ongoing obligations that apply to the sponsoring firm in respect of the individual under those terms and conditions.

Name of firm ____________________

Name of authorized signing officer or partner ____________________

Title of authorized signing officer or partner ____________________

Signature of authorized signing officer or partner ____________________

Date signed ____________________ (YYYY/MM/DD)

 

Schedule A

Use of other names (Item 1.4)

Item 1.4 Use of other names

Name 1:

Name: ____________________

Provide the reasons for the use of this other name (for example, trade name or team name): ____________________

If this other name is or was used in connection with any sponsoring firm, did the sponsoring firm approve the use of the name?

Yes [ ] No [ ]

When did you use this name?

From:

To:

 

__________ (YYYY/MM)

__________ (YYYY/MM)

Name 2:

Name: ____________________

Provide the reasons for the use of this other name (for example, trade name or team name): __________

If this other name is or was used in connection with any sponsoring firm, did the sponsoring firm approve the use of the name?

Yes [ ] No [ ]

When did you use this name?

From:

To:

 

__________ (YYYY/MM)

__________ (YYYY/MM)

Name 3:

Name: ____________________

Provide the reasons for the use of this other name (for example, trade name or team name): __________

If this other name is or was used in connection with any sponsoring firm, did the sponsoring firm approve the use of the name?

Yes [ ] No [ ]

When did you use this name?

From:

To:

 

__________ (YYYY/MM)

__________ (YYYY/MM)

 

Schedule B

Individual Categories (Item 3)

Check each category for which you are seeking reinstatement of registration, approval or permitted individual status

Categories Common to all jurisdictions under securities legislation

Firm categories [Format other than NRD format only]

[ ] Investment Dealer

[ ] Mutual Fund Dealer

[ ] Scholarship Plan Dealer

[ ] Exempt Market Dealer

[ ] Restricted Dealer

[ ] Portfolio Manager

[ ] Restricted Portfolio Manager

[ ] Investment Fund Manager

Individual categories and permitted activities

[ ] Dealing Representative

[ ] Advising Representative

[ ] Associate Advising Representative

[ ] Ultimate Designated Person

[ ] Chief Compliance Officer

[ ] Permitted Individual

[ ] Officer -- Specify title:

[ ] Director

[ ] Partner

[ ] Shareholder

[ ] Branch Manager (MFDA members only)

[ ] IIROC approval only

IIROC

Approval categories

[ ] Executive

[ ] Director (Industry)

[ ] Director (Non-Industry)

[ ] Supervisor

[ ] Investor

[ ] Registered Representative

[ ] Investment Representative

[ ] Trader

[ ] Executive

[ ] Director (Industry)

[ ] Director (Non-Industry)

[ ] Supervisor

[ ] Investor

[ ] Registered Representative

[ ] Investment Representative

[ ] Portfolio Manager

[ ] Associate Portfolio Manager

[ ] Trader

Additional approval categories

[ ] Chief Compliance Officer

[ ] Chief Financial Officer

[ ] Ultimate Designated Person

Products

[ ] Non-Trading

[ ] Securities

[ ] Options

[ ] Futures Contracts and Futures Contract Options

[ ] Mutual Funds only

Customer type

[ ] Retail

[ ] Institutional

[ ] Not Applicable

Portfolio management

[ ] Portfolio Management

Categories under local commodity futures and derivatives legislation

Ontario

Firm categories

[ ] Commodity Trading Adviser

[ ] Commodity Trading Counsel

[ ] Commodity Trading Manager

[ ] Futures Commission Merchant

Individual categories and permitted activities

[ ] Advising Representative

[ ] Salesperson

[ ] Branch Manager

[ ] Officer -- Specify title:

[ ] Director

[ ] Partner

[ ] Shareholder

[ ] IIROC approval only

Manitoba

Firm categories

[ ] Dealer (Merchant)

[ ] Dealer (Futures Commission Merchant)

[ ] Dealer (Floor Broker)

[ ] Adviser

[ ] Local

Individual categories and permitted activities

[ ] Floor Broker

[ ] Salesperson

[ ] Branch Manager

[ ] Adviser

[ ] Officer -- Specify title

[ ] Director

[ ] Partner

[ ] Futures Contracts Portfolio Manager

[ ] Associate Futures Contracts Portfolio Manager

[ ] IIROC approval only

[ ] Local

Québec

Firm categories

[ ] Derivatives Dealers

[ ] Derivatives Portfolio Manager

Individual categories and permitted activities

[ ] Derivatives Dealing Representative

[ ] Derivatives Advising Representative

[ ] Derivatives Associate Advising Representative

 

Schedule C

Address and agent for service (Item 4)

Item 4.1 Address for service

You must have one address for service in each province or territory in which you are now, or are seeking to become, a registered individual or permitted individual. A post office box is not an acceptable address for service.

Address for service:

____________________ (number, street, city, province or territory, postal code)

Telephone number: (_____) ____________________ Fax number: (_____) ____________________

Business e-mail address: ____________________

Item 4.2 Agent for service

If you have appointed an agent for service, provide the following information for the agent. The address for service provided above must be the address of the agent named below.

Name of agent for service: ____________________

(if applicable)

Contact person:

______________________________

Last name, First name

 

Schedule D

Current employment, other business activities, officer positions held and directorships (Item 7)

Complete a separate Schedule D for each of your current business and employment activities, including employment and business activities with your new sponsoring firm and any employment and business activities outside your new sponsoring firm. Also include all officer or director positions and any other equivalent positions held, as well as positions of influence. The information must be provided

whether you receive compensation for such services, and

whether or not such position is business related.

1. Start date

__________ (YYYY/MM/DD)

2. Firm information

[ ] Check here if this activity is employment with your sponsoring firm.

If the activity is with your sponsoring firm, you are not required to indicate the firm name and address information below:

Name of business or employer: ____________________

______________________________

Address of business or employer:

______________________________

(number, street, city, province, territory or state, country)

Name and title of your immediate supervisor: ____________________

3. Description of duties

Describe all employment and business activities related to this employer. Include the nature of the business and your duties, title or relationship with the business. If you are seeking registration that requires specific experience, include details such as level of responsibility, value of accounts under direct supervision, number of years of experience, and percentage of time spent on each activity.

______________________________

4. Number of work hours per week

How many hours per week do you devote to this business or employment? __________

If this activity is employment with your sponsoring firm and you work less than 30 hours per week, explain why.

______________________________

5. Conflict of Interest

If you have more than one employer or are engaged in business related activities:

A. Disclose any potential for confusion by clients and any potential for conflicts of interest arising from your multiple employment or business related activities or proposed business related activities.

______________________________

______________________________

______________________________

B. Indicate whether or not any of your employers or organizations where you engage in business related activities are listed on an exchange.

______________________________

______________________________

______________________________

C. Confirm whether the firm has procedures for minimizing potential conflicts of interest and if so, confirm that you are aware of these procedures.

______________________________

______________________________

______________________________

D. State the name of the person at your sponsoring firm who has reviewed and approved your multiple employment or business related activities or proposed business related activities.

______________________________

______________________________

______________________________

E. If you do not perceive any conflicts of interest arising from this employment, explain why.

______________________________

______________________________

______________________________

 

Schedule D

Reportable activities (Item 7)

1. Start date ____________________ (YYYY/MM/DD)

2. Sponsoring firm or other entity information

[ ] Check here if the reportable activity is with your sponsoring firm.

If the reportable activity is with your sponsoring firm, you are not required to indicate the firm's name and address but are required to provide the name and title of your immediate supervisor. For all other types of reportable activity, enter all of the information below:

Name of business or employer: ____________________

Address of business or employer: ____________________ (number, street, city, province, territory or state, country)

Name and title of your immediate supervisor: ____________________

3. Description of the reportable activity and your roles and responsibilities

Instructions: If you are completing this schedule in relation to your activities with your sponsoring firm, for (e) below, provide the title(s) you will use once registered, and if you are already registered, provide the title(s) you use as of the date of this filing.

(a) Describe the entity that you carry on the activity with or for, including the nature of the entity's business.

(b) Is the entity listed on an exchange?

(c) Describe your relationship with the entity.

(d) Describe all of your roles and responsibilities relating to the activity.

______________________________

(e) Provide all title(s) you use for the activity.

______________________________

4. Number of work hours per month

How many hours per month do you spend on this activity? __________

5. Conflicts of interest

Instructions: Complete this section if you have reportable activity outside your sponsoring firm. Do not complete this section if your reportable activity is solely with your sponsoring firm.

Take into consideration existing and reasonably foreseeable material conflicts of interest and existing and potential client confusion.

(a) Does the activity give rise to any material conflicts of interest between the client and the sponsoring firm or you? Does the activity give rise to client confusion? If no material conflicts of interest or client confusion are expected, explain why.

____________________

____________________

____________________

(b) Describe (i) the material conflicts of interest, and (ii) how these conflicts will be addressed in the best interest of the client.

____________________

(c) Describe (i) the client confusion, and (ii) how the client confusion will be addressed.

____________________

____________________

____________________

(d) Does your sponsoring firm and the entity have procedures for identifying and addressing material conflicts of interest? If so, confirm you are complying with both sets of procedures.

____________________

(e) State the name and title of the individual at your sponsoring firm who has reviewed and approved the activity.

____________________

____________________

____________________

 

Schedule E

Ownership of securities in new sponsoring firm (Item 8)

Firm name (whose business is trading in or advising on securities or derivatives, or both):

______________________________

What is your relationship to the firm? [ ] Partner Major shareholder [ ]

What is the period of this relationship?

From:

To:

(if applicable)

__________ (YYYY/MM)

__________ (YYYY/MM)

Provide the following information:

a) State the number, value, class and percentage of securities, or the amount of partnership interest you own or propose to acquire when you are reinstated or approved as a result of the review of this form. If acquiring shares when you are so approved or registered, state the source (for example, treasury shares, or if upon transfer, state name of transferor).

______________________________

b) State the market value (approximate, if necessary) of any subordinated debentures or bonds of the firm to be held by you or any other subordinated loan to be made by you to the firm:

______________________________

c) If another person or firm has provided you with funds to invest in the firm, provide the name of the person or firm and state the relationship between you and that person or firm:

______________________________

d) Are the funds to be invested (or proposed to be invested) guaranteed directly or indirectly by any person or firm?

Yes [ ] No [ ]

If "Yes", provide the name of the person or firm and state the relationship between you and that person or firm:

______________________________

e) Have you directly or indirectly given up any rights relating to these securities or this partnership interest, or do you, when you are registered or approved as a result of the review of this form, intend to give up any of these rights (including by hypothecation, pledging or depositing as collateral the securities or partnership interest with any firm or person)?

Yes [ ] No [ ]

If "Yes", provide the name of the person or firm, state the relationship between you and that person or firm and describe the rights that have been or will be given up: ____________________

c) If another person or entity has provided you with funds to invest in the firm, provide the name of the person or entity and state the relationship between you and that person or entity:

______________________________

d) Is the payment of the funds to be invested (or proposed to be invested) guaranteed directly or indirectly by any person or entity?

Yes [ ] No [ ]

If "Yes", provide the name of the person or entity and state the relationship between you and that person or entity:

______________________________

e) Have you directly or indirectly given up any rights relating to these securities or this partnership interest, or do you, when you are registered or approved as a result of the review of this form, intend to give up any of these rights (including by hypothecation, pledging or depositing as collateral the securities or partnership interest with any entity or person)?

Yes [ ] No [ ]

If "Yes", provide the name of the person or entity, state the relationship between you and that person or entity and describe the rights that have been or will be given up:

______________________________

f) Is a person other than you the beneficial owner of the shares, bonds, debentures, partnership units or notes held by you?

Yes [ ] No [ ]

If "Yes", complete (g), (h) and (i).

g) Name of beneficial owner:

__________

__________

__________

__________

Last name

First name

Second name (N/A [ ])

Third name (N/A [ ])

h) Residential address:

______________________________ (number, street, city, province, territory or state, country, postal code)

i) Occupation:______________________________

 

Schedule F

Contact information for Notice consent and notice of collection and use of personal information

Alberta
Nunavut
Alberta Securities Commission,
Government of Nunavut
Suite 600, 250-5th St. SW
Department of Justice
Calgary, AB T2P 0R4
P.O. Box 1000 Station 570
Attention: Information Officer
Iqaluit, NU X0A 0H0
Telephone: (403) 297-6454
Attention: Deputy Registrar of Securities
Telephone: (867) 975-6590
 
British Columbia
Ontario
British Columbia Securities Commission
Ontario Securities Commission
P.O. Box 10142, Pacific Centre
22[SUP]nd[/SUP] Floor
701 West Georgia Street
20 Queen Street West
Vancouver, BC V7Y 1L2
Toronto, ON M5H 3S8
Attention: Freedom of Information Officer<<Registration staff>>
Attention: Compliance and Registrant Regulation
Telephone: (604) 899-6500 or (800) 373-6393 (in Canada)
Telephone: (416) 593-8314
<<E-mail: Registration@bcsc.bc.ca>>
E-mail: registration@osc.gov.on.ca
 
Manitoba
Prince Edward Island
The Manitoba Securities Commission
Securities Office
500 -- 400 St. Mary Avenue
Department of Community Affairs and Attorney General
Winnipeg, MB R3C 4K5
P.O. Box 2000
Attention: Director of Registrations
Charlottetown, PE C1A 7N8
Telephone: (204) 945-2548
Attention: Deputy Registrar of Securities
Fax (204) 945-0330
Telephone: (902) 368-6288
 
New Brunswick
Québec
Financial and Consumer Services Commission of New Brunswick / Commission des services financiers et des services aux consommateurs du Nouveau-Brunswick
Autorité des marchés financiers
Suite 300, 85 Charlotte Street
800, square Victoria, 22e étage
Saint John, NB E2L 2J2
C.P. 246, tour de la Bourse
Attention: Director of Securities
Montréal (Québec) H4Z 1G3
Telephone: (506) 658-3060
Attention: Responsable de l'accès à l'information
Telephone: (514) 395-0337 or (877) 525-0337
 
Newfoundland and Labrador
Saskatchewan
Superintendent of Securities, Service NL
Financial and Consumer Affairs Authority of Saskatchewan
Government of Newfoundland and Labrador
Suite 601, 1919 Saskatchewan Drive
P.O. Box 8700
Regina, SK S4P 4H2
2nd Floor, West Block
Attention: Deputy Director, Capital Markets
Confederation Building
Telephone: (306) 787-5871
St. John's, NL A1B 4J6
Attention: Manager of Registrations
Telephone: (709) 729-5661
 
Nova Scotia
Yukon
Nova Scotia Securities Commission
Government of Yukon
Suite 400, 5251 Duke Street
<<Office of the Yukon>> Superintendent of Securities
Halifax, NS B3J 1P3
Department of Community Services
Attention: Deputy Director, Capital Markets<<Registration>>
P.O. Box 2703 C-6
Telephone: (902) 424-7768
Whitehorse, YT Y1A 2C6
Attention: Superintendent of Securities
Telephone: (867) 667-5314<<(867) 667-5466>>
 
Northwest Territories
Self-regulatory organization
Government of the Northwest Territories
Investment Industry Regulatory Organization of Canada
Department of Justice
121 King Street West, Suite 1600
1[SUP]st[/SUP] Floor Stuart M. Hodgson Building
Toronto, Ontario M5H 3T9
5009 -- 49[SUP]th[/SUP] Street
Attention: Privacy Officer
Yellowknife, NWT X1A 2L9
Telephone: (416) 364-6133
Attention: Deputy Superintendent of Securities
E-mail: PrivacyOfficer@iiroc.ca
Telephone: (867) 920-8984

 

Annex C -- Proposed Changes to 33-109CP

ANNEX C

PROPOSED CHANGES TO COMPANION POLICY 33-109CP REGISTRATION INFORMATION

1. Companion Policy 33-109CP Registration Information is changed by this Document.

2. Section 1.2 is changed by adding "(Section 1.1)" at the end of the heading "Definition of permitted individuals".

3. Section 1.3 is changed by replacing the first bullet in the second paragraph with the following:

• Form 33-109F1 Notice of End of Individual Registration or Permitted Individual Status -- to notify the regulator or, in Québec, the securities regulatory authority that a registered individual or permitted individual has ceased to have authority to act on behalf of the sponsoring firm.

4. Section 1.4 is changed by adding "(Sections 3.1 and 4.1)" at the end of the heading "Notice requirements".

5. Section 2.2 is changed

(a) by adding "(Subsections 2.2(1) and 2.5(1))" at the end of the subheading "Types of submissions using Form 33-109F4",

(b) by adding "(Sections 2.3 and 2.5)" at the end of the subheading "Submissions by Permitted Individuals",

(c) by adding the following text between the subheading "Submissions by permitted individuals" and the subheading "Agent for service":

Relevant securities industry experience (Form 33-109F2 -- Item 4.3 and Schedule A; Form 33-109F4 -- Item 8.4 and Schedule F)

The regulators or, in Québec, the securities regulatory authority will assess whether an individual has gained relevant securities industry experience on a case-by-case basis. It may include experience acquired:

• during employment at a registered dealer, a registered adviser or an investment fund manager;

• in related investment fields, such as investment banking, securities trading on behalf of a financial institution, securities research, portfolio management, investment advisory services or supervision of those activities;

• in legal, accounting or consulting practices related to the securities industry; and

• in other professional service fields that relate to the securities industry, or in a securities-related business in a foreign jurisdiction.

The securities industry experience described should be relevant to the category applied for. Please see section 3.4 [Proficiency -- initial and ongoing] of the Companion Policy to National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations for more guidance on relevant securities industry experience.

Reportable activities (Form 33-109F4 -- Item 10 and Schedule G; Form 33-109F7 -- Item 7 and Schedule D)

Individuals must report all activities with their sponsoring firm and certain activities carried on outside of their sponsoring firm in Form 33-109F4 and Form 33-109F7. Activity changes must be reported by the individuals in Form 33-109F5.

To illustrate the analysis on whether an activity outside of the sponsoring firm is reportable in Item 10.2 [Reportable outside activities] of Form 33-109F4 or in Item 7.2 [Reportable outside activities] of Form 33-109F7, Appendix C has been included in this Companion Policy.

The regulator or, in Québec, the securities regulatory authority will take into account the reportable activities when assessing that individual's application for registration or continuing fitness for registration and the sponsoring firm's fitness for registration, including the following:

• whether the individual will have sufficient time to effectively carry out their registerable activities, including remaining current on securities law and product knowledge,

• whether the individual will be able to properly service clients,

• whether there is a risk of client confusion and if so, what the risk is and whether there are effective controls and supervision in place to address the risk,

• whether the reportable outside activity presents a material conflict of interest for the individual, and whether that material conflict of interest has been addressed in the best interest of the client,

• whether the reportable outside activity provides the individual with access to privileged, confidential or insider information relevant to their registerable activities.

Category 1 -- Activities with another registered firm

Generally, we expect any activity with another registered firm to be reported, whether or not the activity at the other firm requires the individual to be registered. For example, the following roles are reportable: being an advising or dealing representative, owner, director, research analyst, compliance consultant, client relationship manager, human resources manager, or IT service provider for another registered firm.

Category 2 -- Activities with an entity that receives compensation from a registered firm

If the individual is the owner (e.g., shareholder, partner), management (e.g., director or officer), or employee of an unregistered entity that receives compensation, such as sales commissions or referral fees, from a registered firm, this activity is reportable. For example, being an employee or owner of an entity that has entered into an agreement in the form set out in Schedule 'A' of MFDA Staff Notice MSN-0072 Payment of Commissions to Unregistered Corporations is reportable.

Category 3 -- Other securities-related activities

Activities that involve raising money for an entity, such as structuring the security or derivative, preparing the offering document, soliciting investors, or promoting the sale of a security or derivative are reportable. The activity must be reported if it was carried out any time in the last 7 years.

Given the role of a director or officer in a corporation as the directing mind and management and the nature of partnerships and trusts, we would consider a director, officer, partner, or equivalent position (such as trustees) of an entity that, within the last 7 years, raised money through the issuance of securities or derivatives to be directly involved and thus would be reportable. For example, being the President of a mortgage investment entity that is raising money would be reportable. We would also consider being a director or officer of a reporting issuer to be reportable, such as being a director of a TSX-listed company.

An individual who works at an entity that is raising money through the issuance of securities or derivatives, but has no direct involvement in the capital raising activity, such as a computer programmer at a fintech start-up, would not be required to report, unless the activity falls within another reporting category.

Similarly, charitable or other fundraising activities that do not involve the issuance of securities or derivatives would not be reportable. For example, volunteering for an organization to seek charitable donations would not be reportable.

Category 4 -- Provision of financial or financial-related services

An individual is required to report certain financial and financial-related activities, whether or not compensation is received for providing the services. An individual is also expected to report if the individual is a shareholder, partner, director, or officer of an entity that provides one of those services. This includes activities where the individual is responsible for the oversight or provides independent review or expert opinion on the management of an entity's financial assets. For example, being a member of an investment committee that oversees the management of a university's endowment funds or a charity's financial capital, or being a trustee of a family trust.

Category 5 -- Positions of influence

A position of influence is defined in section 13.4.3 of National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations. All positions of influence are reportable. Please see the guidance in section 13.4.3 of the Companion Policy to National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations.

Category 6 -- Specified activities

An individual may participate in one or more activities outside of their sponsoring firm. Where an individual is involved in multiple activities, each activity on its own may not require a significant amount of time. However, if the total amount of time required to carry out all of these activities is significant, particularly where the activity is compensated, it could interfere with the individual's ability to properly carry out registrable functions. As a result, each of these activities is required to be reported when the total amount of time spent on specified activities exceeds 30 hours per month. For example, if an individual held two part-time jobs that each requires the individual to work 20 hours per month, the individual would be required to report each position separately since the total amount of time required is 40 hours per month.

When calculating the total amount of time spent on outside activities, time spent on all reportable outside activities from each category is to be included. For example, if an individual spends 20 hours per month working for the sponsoring firm, but also holds a part-time job providing bookkeeping services that requires on average 15 hours per month, and provides taxi services for 20 hours per month, then both the bookkeeping position (which is reportable under Category 4) and the taxi services should be summed up. In this scenario, the total number of hours spent on outside activities per month, on average, is 35 hours (the 20 hours per month working for the sponsoring firm is not counted). Since the total amount of time spent on specified activities exceeds 30 hours per month, the taxi position is required to be reported under Category 6. However, if the individual did not provide bookkeeping services, then the taxi services would not be required to be reported because the total amount of time spent on specified activities is less than 30 hours per month. The bookkeeping activity is reportable under Category 4 no matter how much time it takes or what other activities the individual undertakes.

Appendix C sets out a chart to help individuals determine whether a particular activity is reportable. For example, an individual may need to determine whether a paid part-time job in a warehouse fulfilment centre that requires on average 10 hours per month should be reported. The individual spends 15 hours per month working for the sponsoring firm, has a paid part-time job as a restaurant employee for 15 hours per month, and also volunteers at a local veterinary clinic for 10 hours per month. The position with the warehouse fulfilment centre does not fall within Categories 1 to 5, but is compensated activity and would fall within the first box of Category 6. As a result, the total amount of time working at the warehouse fulfilment centre and the restaurant should be summed up (the restaurant position would fall within item (iii) of the second box of Category 6 being other activities for which the individual is compensated). The volunteer position at the local veterinary clinic does not fall under Categories 1 to 6 since it is unpaid activity and does not need to be reported. In this scenario, the total number of hours spent on outside activities per month, on average, is 25 hours (the 20 hours per month working for the sponsoring firm is not counted). Since the total amount of time spent on specified activities is less than 30 hours per month, neither the position with the warehouse fulfilment centre nor with the restaurant are required to be reported under Category 6.

We expect individuals to determine how much time they spend on a particular activity in any given month by taking into consideration that the time spent may vary from week to week and from month to month over a year, particularly where the activity is seasonal, such as tax services. For example, if an activity requires 60 hours for 3 months, but only 5 hours for the remaining 9 months of the year, the activity on average would only require 18.75 hours per month. If this was the only outside activity the individual participates in, it would not be reportable. However, we note that even if the activity is not reportable, we would expect firms to have policies and procedures in place to address the impact of seasonal work on the registered individual's and the firm's ability to meet their regulatory obligations.

Uncompensated activities and activities not requiring significant amounts of time

Generally, uncompensated activities that do not involve securities or financial services and are not positions of influence are not reportable and not factored in when calculating the total amount of time spent on outside activities. For example, volunteer activities, such as being a little league soccer coach or volunteering at an animal shelter, are not required to be reported as they are uncompensated. Additionally, involvement with entities with non-active operations, such as being the owner of a holding company, would likely not be reportable because time spent on this activity does not usually meet the threshold requiring more than an average of 30 hours or more per month.

Resignation and terminations (Form 33-109F4 -- Item 12 and Schedule I)

Individuals must report whether they have resigned or been terminated from a position or contract and whether, at the time of their resignation or termination, there existed allegations that the individual: (i) contravened any statutes, regulations, orders of a court or regulatory body, rules or bylaws, or failed to meet standards of conduct, (ii) failed to appropriately supervise compliance with any statutes, regulations, orders of a court or regulatory body, rules, bylaws or standards of conduct, or (iii) committed a crime. Standards of conduct may be internal to the sponsoring firm, such as a sponsoring firm's policies and procedures, or may be external to the sponsoring firm, such as the standards of conduct of an authority exercising jurisdiction over specific business activities or professions.

When providing information about resignations or terminations, individuals must disclose the day that they ceased to carry on duties for the entity or firm they resigned or were terminated from. This date may coincide with the end of the individual's employment, partnership or agency relationship. However, this date can also occur earlier, such as when an individual is subjected to an internal firm suspension or the individual's authority has otherwise been reduced or curtailed pending an internal review. Individuals should provide the date they ceased to carry on duties and not merely the end of an individual's employment, partnership or agency relationship.

(d) by adding "(Form 33-109F4 -- Item 18)" at the end of the subheading "Agent for service",

(e) by replacing "NI 33-109" with "the Rule" in the paragraph under the subheading "Agent for service".

6. Section 2.3 is changed by adding "(Subsection 2.2(2), Section 2.4, Subsection 2.6(2), Subsection 4.1(4))" at the end of the heading "Form 33-109F2".

7. Section 2.5 is changed

(a) by adding "(Sections 2.3 and 2.5)" at the end of the heading "Form 33-109F7 for reinstatement", and

(b) by adding the following paragraph immediately at the end:

If certain allegations existed at the time of the individual leaving a sponsoring firm, then regardless of whether the allegations caused or contributed to the individual leaving, the individual may not use the Form 33-109F7. In addition, at the time the individual resigned or was terminated from the former sponsoring firm, all of the information previously submitted in Form 33-109F4, including Item 12, must have been up-to-date. If these conditions are not met, then the individual must apply for reinstatement by completing on NRD a Form 33-109F4 by making the NRD submission entitled "Reactivation of Registration".

8. Section 2.6 is changed by adding "and derivatives legislation, including commodity futures legislation" immediately after "legislation".

9. Section 2.7 is changed by replacing "termination" with "cessation".

10. Section 3.1 is changed

(a) by adding "(Paragraph 2.1(a))" at the end of the heading "Form 33-109F6", and

(b) by adding the following immediately at the end:

Changes in outstanding legal actions

Registered firms are required to provide updates on the changes in legal actions reported in Item 8.3 of Form 33-109F6. This includes claims, defenses, counterclaims, and amendments. In addition, we expect registered firms to inform regulators of any decisions in the legal action that could significantly affect the firm, its business or the outcome of the legal action. Reporting of documentary discovery and adjournments is not required.

11. Section 3.2 is changed by adding "(Subsection 3.1(6))" at the end of the heading "Form 33-109F5".

12. Section 3.3 is changed by adding "(Paragraph 2.1(b); Form 33-109F4 -- Item 22)" at the end of the heading "Form 33-109F3".

13. Section 3.4 is changed by replacing "Appendix C" with "Appendix D".

14. Section 3.5 is changed

(a) by adding "(Section 4.2)" at the end of the heading "Form 33-109F1", and

(b) by replacing the two paragraphs following the heading with the following:

Under section 4.2 of the Rule, a registered firm must notify the regulator or, in Québec, the securities regulatory authority no more than 10 days after an individual ceased to have authority to act on behalf of the registered firm, as a registered individual or permitted individual. Typically, this occurs due to the cessation of the individual's employment, partnership or agency relationship with the registered firm. However, it also occurs when an individual is re-assigned to a different position at the registered firm that does not require registration or is no longer a permitted individual category. Section 4.2 requires that firms notify the regulator within 10 days of the date that the person ceased to have authority to act and not merely the end of an individual's employment, partnership or agency relationship. Please refer to the definition "cessation date". Form 33-109F1 is submitted through the NRD website to give notice of the cessation date and the reason for the cessation.

Under paragraph 4.2(1)(b) of the Rule, the information in Item 5 [Details about the cessation] of a Form 33-109F1 must be submitted unless the cessation of authority to act on behalf of the registered firm was caused by the death of the individual. A registered firm can submit the information in Item 5 either at the time of making the initial submission on NRD, if the information is available within that 10 day period, or within 30 days of the cessation date, by making an NRD submission entitled "Update / Correct Cessation Information"..

15. Section 4.1 is changed by adding "(Subsections 4.2(3) and (4))" at the end of the heading "Obligations of former sponsoring firm".

16. Section 4.2 is changed

(a) by adding "(Section 5.1)" at the end of the heading "Obligations of new sponsoring firm", and

(b) by adding "sponsoring" before "firm" wherever it appears, except in the following sentence "If a sponsoring firm cannot obtain it from the sponsored individual, as a last resort the sponsored individual should request it from the regulator.".

17. Appendix A is replaced with the following:

Appendix A

Summary of Notice Requirements in National Instrument 33-109

Description of Change

Notice Period

Section

Form Submitted

 

Firms -- Form 33-109F6 information

by e-mail, fax or mail

 

Part 1 -- Registration details

15 days

3.1(1.1)(b)

Form 33-109F5

 

Part 2 -- Contact information, including head office address (except 2.4)

15 days

 

Item 2.4 -- Agent and Address for service [Items 3 and 4 of Schedule B to Form 33-109F6]

15 days

3.1(4)

Schedule B to Form 33-109F6 Submission to jurisdiction

 

Part 3 -- Business history & structure

30 days

3.1(1.1)(a)

Form 33-109F5

 

Part 4 -- Registration history (except item 4.1)

15 days

3.1(1.1)(b)

 

Item 4.1 -- Securities registration

30 days

3.1(1.1)(a)

 

Part 5 -- Financial condition (except item 5.12)

15 days

3.1(1.1)(b)

 

Item 5.12 -- Auditor

30 days

3.1(1.1)(a)

 

Part 6 -- Client relationships (except items 6.1 and 6.2)

15 days

3.1(1.1)(b)

 

Item 6.1 -- Client assets

30 days

3.1(1.1)(a)

 

Item 6.2 -- Conflicts of interest

 

Part 7 -- Regulatory action

15 days

3.1(1.1)(b)

 

Part 8 -- Legal action

15 days

3.1(1.1)(b)

 

Firms -- other notice requirements

in NRD format

 

Open / change of business location (other than head office)

15 days

3.2

Form 33-109F3

 

Cessation of Authority of a registered or permitted individual -- Items 1-4 -- Item 5

10 days{*}

4.2(2)(a)

Form 33-109F1

 

30 days

4.2(2)(b)

 

Individuals -- Form F4 information

in NRD format

 

Item 1 -- Name

15 days

4.1(1)(b)

Form 33-109F5

 

Item 2 -- Address (except items 2.1 and 2.2)

15 days

 

Item 2.1 -- Current and previous residential address

30 days

4.1(1)(a)

 

Item 2.2 -- Mailing address

 

Item 3 -- Personal information

No update required

4.1(2)

 

Item 4 -- Citizenship

30 days

4.1(1)(a)

 

Item 5 -- Registration jurisdictions

15 days

4.1(1)(b)

 

Item 6 -- Individual categories

15 days

 

Item 7 -- Address for service

15 days

 

Item 8 -- Proficiency

15 days

 

Item 9 -- Location of employment

15 days

 

Item 10 -- Reportable activities

30 days

 

Item 11 -- Previous employment

30 days

4.1(1)(a)

 

Item 12 -Terminations

15 days

 

Item 13 -- Regulatory disclosure

15 days

 

Item 14 -- Criminal disclosure

15 days

4.1(1)(b)

 

Item 15 -- Civil disclosure

15 days

 

Item 16 -- Financial disclosure

15 days

 

Item 17 -- Ownership of securities

15 days

 

Change of F4: registrant position or relationship with sponsoring firm / permitted status

15 days

4.1(4)

Form 33-109F2

 

Review of a permitted individual

10 days{*} after appointment

2.5

Form 33-109F4 or Form 33-109F7, subject to conditions

 

Automatic reinstatement of registration subject to conditions

within 90 days of cessation date

2.3(2)

Form 33-109F7

{*} The notice period for a cessation of authority of registered individuals and permitted individuals and a review of permitted individuals is within 10 days of such event.

18. Appendix B is changed by

(a) replacing "representatives" with "Approved Persons" wherever it appears,

(b) deleting the comma after "Alberta Securities Commission",

(c) adding "Attention:" before "Registration" and deleting "department" after "Registration" in the portion under "Alberta" under "Part 1 -- Regulator's Contact Information",

(d) replacing "email: corporateaffairs@gov.yk.ca" with "email: securities@gov.yk.ca",

(e) adding "Office of the Yukon" before "Superintendent of Securities",

(f) adding "C-6" after "P.O. Box 2703",

(g) deleting "** Newfoundland and Labrador -- IIROC **" from above "* Ontario -- IIROC *",

(h) inserting "** Newfoundland and Labrador -- IIROC **" and "** New Brunswick -- IIROC **" above "* Quebec -- IIROC *", and

(i) replacing the contact information below "* Quebec -- IIROC *" with the following:

e-mail: registration@iiroc.ca
fax: (514) 878-0797
Organisme canadien de réglementation du commerce
des valeurs mobilières
525 Viger Avenue West,
Suite 601
Montréal (Québec) H2Z 0B2
Attention : Service des inscriptions

19. The Companion Policy is changed by renaming "Appendix C" to "Appendix D".

20. The Companion Policy is changed by adding the following as "Appendix C":

Appendix C

Reportable Outside Activities

No reporting of the outside activity required

20. These changes become effective on •.

 

Annex D -- Blackline Showing Proposed Changes to 33-109CP

ANNEX D

BLACKLINE OF CHANGES TO COMPANION POLICY 33-109CP REGISTRATION INFORMATION

This Annex shows, by way of blackline, changes to Companion Policy 33-109CP Registration Information that will take effect upon the coming into force of the rule amendments set out in Annex A. Additions are represented with underlined text and deletions are represented with strikethrough text.

Table of Contents

PART 1 -- GENERAL

1.1

Purpose

1.2

Definition of permitted individuals

1.3

Overview of the forms

1.4

Notice requirements

1.5

Contact information

 

PART 2 -- FORMS USED BY INDIVIDUALS

2.1

National Registration Database (NRD)

2.2

Form 33-109F4

2.3

Form 33-109F2

2.4

Form 33-109F5 for individuals

2.5

Form 33-109F7 for reinstatement

2.6

Business locations (Form 33-109F4 and Form 33-109F7)

2.7

Ongoing fitness for registration

 

PART 3 -- FORMS USED BY FIRMS

3.1

Form 33-109F6

3.2

Form 33-109F5

3.3

Form 33-109F3

3.4

Discretionary exemption for bulk transfers

3.5

Form 33-109F1

 

PART 4 -- DUE DILIGENCE BY FIRMS

4.1

Obligations of former sponsoring firm

4.2

Obligations of new sponsoring firm

 

PART 5 -- COMMODITY FUTURES ACT SUBMISSIONS

5.1

Ontario

5.2

Manitoba

 

Appendix A -- Summary of Notice Requirements in National Instrument 33-109

Appendix B -- Contact Information for the Regulators and IIROC

<<Appendix C -- Reportable Outside Activities>>

Appendix <<D>>C -- Discretionary Exemption for Bulk Transfers of Business Locations and Individuals

 

Companion Policy 33-109CP Registration Information

PART 1 -- GENERAL

1.1 Purpose

This Companion Policy sets out how the Canadian Securities Administrators interpret or apply National Instrument 33-109 Registration Information (the Rule).

The registration requirement in securities legislation provides protection to investors from unfair, improper or fraudulent practices and enhances capital market integrity and efficiency. The information required under the Rule allows regulators to assess a filer's fitness for registration or for permitted individual status, with regard to their solvency, integrity and proficiency. These fitness requirements are the cornerstones of the registration requirement. In each jurisdiction of Canada the registration requirement and the Rule apply to dealers, underwriters, advisers and investment fund managers and to individuals who act on their behalf as registered or permitted individuals.

1.2 Definition of permitted individuals(Section 1.1)

Section 1.1 of the Rule defines a permitted individual as an individual who meets the criteria set forth in paragraph (a), (b) or (c) of the definition. A permitted individual may or may not be a registered individual. For example, the chief executive officer of a registered firm is registered as the firm's ultimate designated person and is also a permitted individual. The definition of permitted individual allows the Rule to separate out the filing requirements which are applicable only to permitted individuals from those which are applicable to registered individuals.

1.3 Overview of the forms

The following forms are for firms:

• Form 33-109F3 Business Locations other than Head Office -- to disclose each business location of the firm and any change of business location

• Form 33-109F6 Firm Registration -- to apply for registration as a dealer, adviser or investment fund manager

The following forms are for individuals and are submitted in NRD format:

Form 33-109F1 Notice of Termination of Registered Individuals and Permitted Individuals -- to notify the regulator that a registered or permitted individual has ceased to have authority to act on behalf of the firmForm 33-109F1 Notice of End of Individual Registration or Permitted Individual Status -- to notify the regulator or, in Québec, the securities regulatory authority that a registered individual or permitted individual has ceased to have authority to act on behalf of the sponsoring firm

• Form 33-109F2 Change or Surrender of Individual Categories -- to apply for registration or review in an additional category or to surrender a category

• Form 33-109F4 Registration of Individuals and Review of Permitted Individuals -- to apply for registration or review as a permitted individual

• Form 33-109F7 Reinstatement of Registered Individuals and Permitted Individuals -- to reinstate an individual's registration or a permitted individual status

1.4 Notice requirements(Sections 3.1 and 4.1)

Form 33-109F5 Change of Registration Information is used by firms and individuals to notify regulators of any change to their registration information. Under sections 3.1 and 4.1 of the Rule, a registrant and a permitted individual must keep their registration information current on an ongoing basis by filing notices of change of information within the required time.

Appendix A summarizes the notice requirements, time periods and the forms under the Rule to notify regulators of a change to a firm's or individual's registration information.

1.5 Contact information

When a firm submits a Form 33-109F6, supporting documents or a Form 33-109F5, it can make the submission using e-mail, fax or mail. Appendix B attached to this policy sets out the contact information for the regulator in each jurisdiction of Canada and for the Investment Industry Regulatory Organization of Canada (IIROC) in those jurisdictions where the securities regulatory authority has delegated, assigned or authorized IIROC to perform registration functions.

PART 2 -- FORMS USED BY INDIVIDUALS

2.1 National Registration Database (NRD)

The NRD is the database containing information about all registrants and permitted individuals under securities or commodity futures legislation in each jurisdiction of Canada. The requirement for firms to enrol, and to make certain submissions, on NRD are set out in National Instrument 31-102 National Registration Database. Detailed information about the NRD and the enrolment process is available in the NRD User Guide published at www.nrd-info.ca.

2.2 Form 33-109F4

Types of submissions using Form 33-109F4 (Subsections 2.2(1) and 2.5(1))

The NRD format for submitting a completed Form 33-109F4 under subsection 2.2(1) or 2.5(1) of the Rule include four distinct NRD submission types that are made in the following circumstances:

Initial Registration, when an individual is seeking registration, or review as a permitted individual, through NRD for the first time

Registration in an Additional Jurisdiction, when an individual is registered or is a permitted individual in a jurisdiction of Canada and is seeking registration, or review as a permitted individual, in an additional jurisdiction

Registration with an Additional Sponsoring Firm, when an individual is registered, or is a permitted individual, on behalf of one sponsoring firm and applies for registration, or seeks review as a permitted individual, to act on behalf of an additional sponsoring firm

Reactivation of Registration, when an individual who has an NRD record is applying for registration, reinstatement of registration or is seeking review as a permitted individual and is not eligible under subsection 2.3(2) or 2.5(2) of the Rule to submit a Form 33-109F7

Submissions by permitted individuals (Sections 2.3 and 2.5)

Under subsection 2.5(1) of the Rule, within 10 days of becoming a permitted individual, the individual must submit a Form 33-109F4 for review by the regulator. An individual whose registration is suspended may apply to reinstate the registration by submitting a completed Form 33-109F4 to the regulator. This is done with the Reactivation of registration submission on NRD. After making this submission the individual may not conduct activities requiring registration unless and until the regulator has approved the application. However, an application for reinstatement or review is not required if the individual meets all of the conditions for automatic reinstatement in subsection 2.3(2) or 2.5(2) of the Rule, which include submitting a completed Form 33-109F7 to the regulator as described in section 2.5 below.

Relevant securities industry experience (Form 33-109F2 -- Item 4.3 and Schedule A; Form 33-109F4 -- Item 8.4 and Schedule F)

The regulators or, in Québec, the securities regulatory authority will assess whether an individual has gained relevant securities industry experience on a case-by-case basis. It may include experience acquired:

during employment at a registered dealer, a registered adviser or an investment fund manager;

in related investment fields, such as investment banking, securities trading on behalf of a financial institution, securities research, portfolio management, investment advisory services or supervision of those activities;

in legal, accounting or consulting practices related to the securities industry; and

in other professional service fields that relate to the securities industry, or in a securities-related business in a foreign jurisdiction.

The securities industry experience described should be relevant to the category applied for. Please see section 3.4 [Proficiency -- initial and ongoing] of the Companion Policy to National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations for more guidance on relevant securities industry experience.

Reportable activities (Form 33-109F4 -- Item 10 and Schedule G; Form 33-109F7 -- Item 7 and Schedule D)

Individuals must report all activities with their sponsoring firm and certain activities carried on outside of their sponsoring firm in Form 33-109F4 and Form 33-109F7. Activity changes must be reported by the individuals in Form 33-109F5.

To illustrate the analysis on whether an activity outside of the sponsoring firm is reportable in Item 10.2 [Reportable outside activities] of Form 33-109F4 or in Item 7.2 [Reportable outside activities] of Form 33-109F7, Appendix C has been included in this Companion Policy.

The regulator or, in Québec, the securities regulatory authority will take into account the reportable activities when assessing that individual's application for registration or continuing fitness for registration and the sponsoring firm's fitness for registration, including the following:

whether the individual will have sufficient time to effectively carry out their registerable activities, including remaining current on securities law and product knowledge,

whether the individual will be able to properly service clients,

whether there is a risk of client confusion and if so, what the risk is and whether there are effective controls and supervision in place to address the risk,

whether the reportable outside activity presents a material conflict of interest for the individual, and whether that material conflict of interest has been addressed in the best interest of the client,

whether the reportable outside activity provides the individual with access to privileged, confidential or insider information relevant to their registerable activities.

Category 1 -- Activities with another registered firm

Generally, we expect any activity with another registered firm to be reported, whether or not the activity at the other firm requires the individual to be registered. For example, the following roles are reportable: being an advising or dealing representative, owner, director, research analyst, compliance consultant, client relationship manager, human resources manager, or IT service provider for another registered firm.

Category 2 -- Activities with an entity that receives compensation from a registered firm

If the individual is the owner (e.g., shareholder, partner), management (e.g., director or officer), or employee of an unregistered entity that receives compensation, such as sales commissions or referral fees, from a registered firm, this activity is reportable. For example, being an employee or owner of an entity that has entered into an agreement in the form set out in Schedule 'A' of MFDA Staff Notice MSN-0072 Payment of Commissions to Unregistered Corporations is reportable.

Category 3 -- Other securities-related activities

Activities that involve raising money for an entity, such as structuring the security or derivative, preparing the offering document, soliciting investors, or promoting the sale of a security or derivative is reportable. The activity must be reported if it was carried out any time in the last 7 years.

Given the role of a director or officer in a corporation as the directing mind and management and the nature of partnerships and trusts, we would consider a director, officer, partner, or equivalent position (such as trustees) of an entity that, within the last 7 years, raised money through the issuance of securities or derivatives to be directly involved and thus would be reportable. For example, being the President of a mortgage investment entity that is raising money would be reportable. We would also consider being a director or officer of a reporting issuer to be reportable, such as being a director of a TSX-listed company.

An individual who works at an entity that is raising money through the issuance of securities or derivatives, but has no direct involvement in the capital raising activity, such as a computer programmer at a fintech start-up, would not be required to report, unless the activity falls within another reporting category.

Similarly, charitable or other fundraising activities that do not involve the issuance of securities or derivatives would not be reportable. For example, volunteering for an organization to seek charitable donations would not be reportable.

Category 4 -- Provision of financial or financial-related services

An individual is required to report certain financial and financial-related activities, whether or not compensation is received for providing the services. An individual is also expected to report if the individual is a shareholder, partner, director, or officer of an entity that provides one of those services. This includes activities where the individual is responsible for the oversight or provides independent review or expert opinion on the management of an entity's financial assets. For example, being a member of an investment committee that oversees the management of a university's endowment funds or a charity's financial capital, or being a trustee of a family trust.

Category 5 -- Positions of influence

A position of influence is defined in section 13.4.3 of National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations. All positions of influence are reportable. Please see the guidance in section 13.4.3 of the Companion Policy to National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations.

Category 6 -- Specified activities

An individual may participate in one or more activities outside of their sponsoring firm. Where an individual is involved in multiple activities, each activity on its own may not require a significant amount of time. However, if the total amount of time required to carry out all of these activities is significant, particularly where the activity is compensated, it could interfere with the individual's ability to properly carry out registrable functions. As a result, each of these activities is required to be reported when the total amount of time spent on specified activities exceeds 30 hours per month. For example, if an individual held two part-time jobs that each requires the individual to work 20 hours per month, the individual would be required to report each position separately since the total amount of time required is 40 hours per month.

When calculating the total amount of time spent on outside activities, time spent on all reportable outside activities from each category is to be included. For example, if an individual spends 20 hours per month working for the sponsoring firm, but also holds a part-time job providing bookkeeping services that requires on average 15 hours per month, and provides taxi services for 20 hours per month, then both the bookkeeping position (which is reportable under Category 4) and the taxi services should be summed up. In this scenario, the total number of hours spent on outside activities per month, on average, is 35 hours (the 20 hours per month working for the sponsoring firm is not counted). Since the total amount of time spent on specified activities exceeds 30 hours per month, the taxi position is required to be reported under Category 6. However, if the individual did not provide bookkeeping services, then the taxi services would not be required to be reported because the total amount of time spent on specified activities is less than 30 hours per month. The bookkeeping activity is reportable under Category 4 no matter how much time this activity takes or what other activities the individual undertakes.

Appendix C sets out a chart to help individuals determine whether a particular activity is reportable. For example, an individual may need to determine whether a paid part-time job in a warehouse fulfilment centre that requires on average 10 hours per month should be reported. The individual spends 15 hours per month working for the sponsoring firm, has a paid part-time job as a restaurant employee for 15 hours per month, and also volunteers at a local veterinary clinic for 10 hours per month. The position with the warehouse fulfilment centre does not fall within Categories 1 to 5, but is compensated activity and would fall within the first box of Category 6. As a result, the total amount of time working at the warehouse fulfilment centre and the restaurant should be summed up (the restaurant position would fall within item (iii) of the second box of Category 6 being other activities for which the individual is compensated). The volunteer position at the local veterinary clinic does not fall under Categories 1 to 6 since it is unpaid activity and does not need to be reported. In this scenario, the total number of hours spent on outside activities per month, on average, is 25 hours (the 20 hours per month working for the sponsoring firm is not counted). Since the total amount of time spent on specified activities is less than 30 hours per month, neither the position with the warehouse fulfilment centre nor with the restaurant are required to be reported under Category 6.

We expect individuals to determine how much time they spend on a particular activity in any given month by taking into consideration that the time spent may vary from week to week and from month to month over a year, particularly where the activity is seasonal, such as tax services. For example, if an activity requires 60 hours for 3 months, but only 5 hours for the remaining 9 months of the year, the activity on average would only require 18.75 hours per month. If this was the only outside activity the individual participates in, it would not be reportable. However, we note that even if the activity is not reportable, we would expect firms to have policies and procedures in place to address the impact of the seasonal work on the registered individual's and the firm's ability to meet their regulatory obligations.

Uncompensated activities and activities not requiring significant amounts of time

Generally, uncompensated activities that do not involve securities or financial services and are not positions of influence are not reportable and not factored in when calculating the total amount of time spent on outside activities. For example, volunteer activities, such as being a little league soccer coach or volunteering at an animal shelter, are not required to be reported as they are uncompensated. Additionally, involvement with entities with non-active operations, such as being the owner of a holding company, would likely not be reportable because time spent on this activity does not usually meet the threshold requiring more than an average of 30 hours or more per month.

Resignation and terminations (Form 33-109F4 -- Item 12 and Schedule I)

Individuals must report whether they have resigned or been terminated from a position or contract and whether, at the time of their resignation or termination, there existed allegations that the individual: (i) contravened any statutes, regulations, orders of a court or regulatory body, rules or bylaws, or failed to meet standards of conduct, (ii) failed to appropriately supervise compliance with any statutes, regulations, orders of a court or regulatory body, rules, bylaws or standards of conduct, or (iii) committed a crime. Standards of conduct may be internal to the sponsoring firm, such as a sponsoring firm's policies and procedures, or may be external to the sponsoring firm, such as the standards of conduct of an authority exercising jurisdiction over specific business activities or professions.

When providing information about resignations or terminations, individuals must disclose the day that they ceased to carry on duties for the entity or firm they resigned or were terminated from. This date may coincide with the end of the individual's employment, partnership or agency relationship. However, this date can also occur earlier, such as when an individual is subjected to an internal firm suspension or the individual's authority has otherwise been reduced or curtailed pending an internal review. Individuals should provide the date they ceased to carry on duties and not merely the end of an individual's employment, partnership or agency relationship.

Agent for service (Form 33-109F4 -- Item 18)

Item 18 Agent for service of Form 33-109F4 is a certification clause by the individual that he or she has completed the appointment for service required in each relevant jurisdiction. There is no distinct form under NI 33-109the Rule for the appointment of an agent for service for use by individuals. Please refer to the form used by the registered firm. This format is acceptable to the regulator.

2.3 Form 33-109F2(Subsection 2.2(2), Section 2.4, Subsection 2.6(2), Subsection 4.1(4))

This form is used by individuals to apply to add or to surrender a registration category, to seek review of a change in their permitted individual category or to change any information on Schedule C of a previously submitted Form 33-109F4. If an individual has ceased to have authority to act on behalf of their sponsoring firm as a registered or permitted individual in the last jurisdiction of Canada where they were so acting, they cannot submit a Form 33-109F2. Instead, the individual's sponsoring firm submits a Form 33-109F1 to notify the regulator of the termination or cessation of authority to act on behalf of the firm.

2.4 Form 33-109F5 for individuals

When an individual submits a Form 33-109F5 to update their registration information, NRD will transmit the information to the regulator in each jurisdiction in which the individual is registered or is a permitted individual. However, only the principal regulator processes the submission to update the individual's registration information on NRD, or if necessary to deny or withdraw the submission.

Form 33-109F5 should not be used by an individual applying to add or surrender a registration category or to seek review of a change in his/her permitted individual category. In this case, Form 33-109F2 is used. It should also be noted that Form 33-109F5 is not used by an individual that is registered or is a permitted individual in a jurisdiction of Canada and is seeking registration, or review as a permitted individual, in an additional jurisdiction. In this case, a Form 33-109F4 is used and is identified on NRD as Registration in an Additional Jurisdiction. This also applies to an individual adding a sponsoring firm; Form 33-109F4 is used and is identified on NRD as Registration with an Additional Sponsoring Firm.

2.5 Form 33-109F7 for reinstatement(Sections 2.3 and 2.5)

When an individual leaves a sponsoring firm and joins a new registered firm, they may submit a Form 33-109F7 to have their registration or permitted individual status automatically reinstated in one or more of the same categories and jurisdictions as before, subject to all of the conditions set out in subsection 2.3(2) or 2.5(2) of the Rule. An individual who meets all of the applicable conditions will be able to transfer directly from one sponsoring firm to another and start engaging in activities requiring registration from the first day that they submit the Form 33-109F7.If certain allegations existed at the time of the individual leaving a sponsoring firm, then regardless of whether the allegations caused or contributed to the individual leaving, the individual may not use the Form 33-109F7. In addition, at the time the individual resigned or was terminated from the former sponsoring firm, all of the information previously submitted in Form 33-109F4, including Item 12, must have been up-to-date. If these conditions are not met, then the individual must apply for reinstatement by completing on NRD a Form 33-109F4 by making the NRD submission entitled "Reactivation of Registration".

2.6 Business locations (Form 33-109F4 and Form 33-109F7)

The term "business location" is defined in section 1.1 of the Rule. If the business location specified in Item 9 of Form 33-109F4 or Item 5 of NI 33-109F7 is a residence, the individual must certify in both these forms that they give their consent for the regulator or, in Québec, the securities regulatory authority to enter the residence for the administration of securities legislationand derivatives legislation, including commodity futures legislation.

2.7 Ongoing fitness for registration

Every registrant must maintain their fitness for registration on an ongoing basis. Under securities legislation, the regulator has discretionary authority to suspend or revoke an individual's registration or to restrict it with terms and conditions at any time. The regulator may do this, for example, if it receives information through a notice of cessationtermination from an individual's former sponsoring firm or any other source that raises concerns about the individual's continued fitness for registration. Individuals will be given an opportunity to be heard before a decision is made to suspend or revoke registration or to impose terms and conditions.

PART 3 -- FORMS USED BY FIRMS

3.1 Form 33-109F6(Paragraph 2.1(a))

When a firm submits a Form 33-109F6 to apply for registration, it may pay the regulatory fees to the applicable regulators by cheque or by using the NRD function called Resubmit Fee Payment. A firm that applies in multiple jurisdictions should submit its application to the regulator in the principal jurisdiction or, if Ontario is a non-principal jurisdiction, to the regulators in the principal jurisdiction and in Ontario. For more details refer to National Policy 11204 Process for Registration in Multiple Jurisdictions.

Under section 4A.1 of Multilateral Instrument 11-102 Passport System, the principal regulator for a foreign firm is the securities regulatory authority or regulator identified in Item 2.2(b) of the firms most recent Form 33-109F6 or Form 33-109F5 Change of Registration Information if the change noted in that form relates to Item 2.2(b) of Form 33-109F6. For firms without a head office in Canada or not already registered in a jurisdiction of Canada, Item 2.2(b) of Form 33-109F6 specifies that the principal regulator is the jurisdiction of Canada in which the firm expects to conduct most of its activities that require registration as at the end of its current financial year or conducted most of its activities that require registration as at the end of its most recently completed financial year. Firms should determine whether to base the selection on where they expect to conduct most of their activities or where they conducted most of their activities the previous year based on which they feel is most appropriate.

The factors a firm should consider in identifying the principal regulator are:

• the jurisdiction in which the firm has a business location

• when applying for dealer registration or adviser registration, the jurisdiction in which the firm expects to have most of its clients as at the end of its current financial year or the jurisdiction in which most of the firm's clients were located at the end of its most recently completed financial year

• when applying for investment fund manager registration, the jurisdiction in which the firm expects to conduct most of its investment fund manager activities as at the end of its current financial year or the jurisdiction in which most of the firm's investment fund manager activities were conducted at the end of its most recently completed financial year

• when applying for investment fund manager registration and another category of registration, the jurisdiction in which firm expects to conduct most of the activities that require registration as at the end of its current financial year or conducted most of the activities that require registration as at the end of its most recently completed financial year based on the foregoing

Under section 4A.2 of Multilateral Instrument 11-102 Passport System, a securities regulatory authority or regulator has the discretion to change the principal regulator for the firm.

Changes in outstanding legal actions

Registered firms are required to provide updates on the changes in legal actions reported in item 8.3 of Form 33-109F6. This includes claims, defenses, counterclaims, and amendments. In addition, we expect registered firms to inform regulators of any decisions in the legal action that could significantly affect the firm, its business or the outcome of the legal action. Reporting of documentary discovery and adjournments is not required.

3.2 Form 33-109F5(Subsection 3.1(6))

A firm that is registered in multiple jurisdictions may submit a Form 33-109F5 to its principal regulator only to notify regulators of a change to the firm's registration information, in accordance with subsection 3.1(6) of the Rule.

3.3 Form 33-109F3(Paragraph 2.1(b); Form 33-109F4 -- Item 22)

A firm must notify the regulator of each business location in the jurisdiction. The term "business location" is defined in section 1.1 of the Rule and may include a residence where a firm's registered individuals are based for the purpose of carrying out activities that require registration.

Firms certify in Item 22 of Form 33-109F4 that if the business location is a residence, the individual conducting business from that business location has completed a Form 33-109F4 certifying that they give their consent for the regulator or, in Québec, the securities regulatory authority to enter the residence for the administration of securities legislation.

Firms submit this form through the NRD website.

3.4 Discretionary exemption for bulk transfers

Regulators will consider an application for an exemption from certain requirements in the Rule to facilitate a reorganization or combination of firms which would otherwise require a large number of submissions to change business locations and transfer individuals. The information required, and the conditions to obtain, this type of exemption application are described in the attached Appendix CAppendix D.

3.5 Form 33-109F1(Section 4.2)

Under section 4.2 of the Rule, a registered firm must notify the regulator no more than 10 days after an individual ceased to have authority to act on behalf of the firm, as a registered or permitted individual. Typically, this occurs due to the termination of the individual's employment, partnership or agency relationship with the firm. However, it also occurs when an individual is re-assigned to a different position at the firm that does not require registration or is not a permitted individual category. Form 33-109F1 is submitted through the NRD website to give notice of the cessation date and the reason for the termination or cessation.

Under paragraph 4.2(1)(b) of the Rule, the information in Item 5 [Details about the termination] of a Form 33-109F1 must be submitted unless the cessation of authority to act on behalf of the firm was caused by the death of the individual. A firm can submit the information in Item 5 either at the time of the making the initial submission on NRD, if the information is available within that 10 day period, or within 30 days of the cessation date, by making an NRD submission entitled Update / Correct Termination Information.

Under section 4.2 of the Rule, a registered firm must notify the regulator or, in Québec, the securities regulatory authority no more than 10 days after an individual ceased to have authority to act on behalf of the registered firm, as a registered individual or permitted individual. Typically, this occurs due to the cessation of the individual's employment, partnership or agency relationship with the registered firm. However, it also occurs when an individual is re-assigned to a different position at the registered firm that does not require registration or is no longer a permitted individual category. Section 4.2 requires that firms notify the regulator within 10 days of the date that the person ceased to have authority to act and not merely the end of an individual's employment, partnership or agency relationship. Please refer to the definition "cessation date". Form 33-109F1 is submitted through the NRD website to give notice of the cessation date and the reason for the cessation.

Under paragraph 4.2(1)(b) of the Rule, the information in Item 5 [Details about the cessation] of a Form 33-109F1 must be submitted unless the cessation of authority to act on behalf of the registered firm was caused by the death of the individual. A registered firm can submit the information in Item 5 either at the time of making the initial submission on NRD, if the information is available within that 10 day period, or within 30 days of the cessation date, by making an NRD submission entitled "Update / Correct Cessation Information".

PART 4 -- DUE DILIGENCE BY FIRMS

4.1 Obligations of former sponsoring firm(Subsections 4.2(3) and (4))

After submitting a Form 33-109F1 with regard to a former sponsored individual, a firm should promptly send the individual a copy of the completed Form 33-109F1. Under subsections 4.2(3) and (4) of the Rule, within 10 days of a request by a former sponsored individual, a firm must provide the individual with a copy of the Form 33-109F1 that was submitted, and if necessary, a further copy that includes the information in Item 5 of the Form 33-109F1, within 10 days of submitting that information.

4.2 Obligations of new sponsoring firm(Section 5.1)

In fulfilling its obligations under subsection 5.1(1) of the Rule, a sponsoring firm should make reasonable efforts to do all of the following:

• establish written policies and procedures to verify an individual's information prior to submitting a Form 33-109F4 or Form 33-109F7 on behalf of the individual

• document the sponsoring firm's review of an individual's information in accordance with the sponsoring firm's policies and procedures

• regularly remind registered and permitted individuals about their disclosure obligations under the Rule, such as notifying the regulator about changes to their registration information

Under subsection 5.1(2) of the Rule, within 60 days of hiring a sponsored individual, a sponsoring firm must obtain a copy of the most recent Form 33-109F1, if any, for the individual. If a sponsoring firm cannot obtain it from the sponsored individual, as a last resort the sponsored individual should request it from the regulator.

The information referred to above will assist the sponsoring firm in meeting its obligations under subsection 5.1(1) of the Rule and should inform thesponsoring firm's hiring decisions. If an individual is hired before a completed Form 33-109F1 is available and if thesponsoring firm discovers an inconsistency in the individual's disclosure to the sponsoring firm or the regulator, then the sponsoring firm should take appropriate action. All of the required information should be available within 60 days of hiring the individual, which will often fall within the individual's probation period under their employment or agency contract.

PART 5 -- COMMODITY FUTURES ACT SUBMISSIONS

5.1 Ontario

In Ontario, if a person or company is required to make a submission under both the Rule and OSC Rule 33-506 (Commodity Futures Act) Registration Information with respect to the same information, the securities regulatory authority is of the view that a single filing on a form required under either rule satisfies both requirements.

5.2 Manitoba

In Manitoba, the Rule is a rule under each of the Securities Act and the Commodity Futures Act. A single submission with respect to the same information will satisfy the requirements of both statutes.

 

Appendix A

Summary of Notice Requirements in National Instrument 33-109

Description of Change

Notice Period

Section

Form Submitted

 

Firms -- Form 33-109F6 information

by e-mail, fax or mail

 

Part 1 -- Registration details

15 days

3.1(1)(b)

Form 33-109F5

 

Part 2 -- Contact information, including head office address (except 2.4)

15 days

 

Item 2.4 -- Agent and Address for service [Items 3 and 4 of Schedule B to Form 33-109F6]

15 days

3.1(4)

Schedule B to Form 33- 109F6 Submission to jurisdiction

 

Part 3 -- Business history & structure

30 days

3.1(1)(a)

Form 33-109F5

 

Part 4 -- Registration history

10 days

3.1(1)(b)

 

Part 5 -- Financial condition

10 days

 

Part 6 -- Client relationships

10 days

 

Part 7 -- Regulatory action

10 days

 

Part 8 -- Legal action

10 days

 

Firms -- other notice requirements

in NRD format

 

Open / change of business location (other than head office)

10 days

3.2

Form 33-109F3

 

Termination / Cessation of Authority of a registered or permitted individual -- Items 1-4 -- Item 5

10 days

4.2(2)(a)

Form 33-109F1

 

Termination / Cessation of Authority of a registered or permitted individual -- Items 1-4 -- Item 5

10 days

4.2(2)(a)

Form 33-109F1

 

30 days

4.2(2)(b)

 

Individuals -- Form F4 information

in NRD format

 

Item 1 -- Name

10 days

4.1(1)(b)

Form 33-109F5

 

Item 2 -- Address

10 days

 

Item 3 -- Personal information

No update required

4.1(2)

 

Item 4 -- Citizenship

30 days

4.1(1)(a)

 

Item 5 -- Registration jurisdictions

10 days

4.1(1)(b)

 

Item 6 -- Individual categories

10 days

 

Item 7 -- Address for service

10 days

 

Item 8 -- Proficiency

10 days

 

Item 9 -- Location of employment

10 days

 

Item 10 -- Current employment

10 days

 

Item 11 -- Previous employment

30 days

4.1(1)(a)

 

Item 12 -- Terminations

10 days

 

Item 13 -- Regulatory disclosure

10 days

 

Item 14 -- Criminal disclosure

10 days

4.1(1)(b)

 

Item 15 -- Civil disclosure

10 days

 

Item 16 -- Financial disclosure

10 days

 

Item 17 -- Ownership of securities

10 days

 

Change of F4: registrant position or relationship with sponsoring firm / permitted status

10 days

4.1(4)

Form 33-109F2

 

Review of a permitted individual

10 days after appointment

2.5

Form 33-109F4 or Form 33-109F7, subject to conditions

 

Automatic reinstatement of registration subject to conditions

within 90 days of cessation date

2.3(2)

Form 33-109F7

 

Appendix A

Summary of Notice Requirements in National Instrument 33-109

<<Description of Change>>

<<Notice Period>>

<<Section>>

<<Form submitted>>

 

<<Firms -- Form 33-109F6 information>>

<<by e-mail, fax or mail>>

 

<<Part 1 -- Registration details>>

<<15 days>>

<<3.1(1)(b)>>

<<Form 33-109F5>>

 

<<Part 2 -- Contact information, including head office address (except 2.4)>>

<<15 days>>

 

<<Item 2.4 -- Agent and Address for service [Items 3 and 4 of Schedule B to Form 33-109F6]>>

<<15 days>>

<<3.1(4)>>

<<Schedule B to Form 33- 109F6 Submission to jurisdiction>>

 

<<Part 3 -- Business history & structure>>

<<30 days>>

<<3.1(1)(a)>>

<<Form 33-109F5>>

 

<<Part 4 -- Registration history (except item 4.1)>>

<<15 days>>

<<3.1(1)(b)>>

 

<<Item 4.1 -- Securities registration>>

<<30 days>>

<<3.1(1)(a)>>

 

<<Part 5 -- Financial condition (except item 5.12)>>

<<15 days>>

<<3.1(1)(b)>>

 

<<Item 5.12 -- Auditor>>

<<30 days>>

<<3.1(1)(a)>>

 

<<Part 6 -- Client relationships (except items 6.1 and 6.2)>>

<<15 days>>

<<3.1(1)(b)>>

 

<<Item 6.1 -- Client assets>>

<<30 days>>

<<3.1(1)(a)>>

 

<<Item 6.2 -- Conflicts of interest>>

 

<<Part 7 -- Regulatory action>>

<<15 days>>

<<3.1(1)(b)>>

 

<<Part 8 -- Legal action>>

<<15 days>>

<<3.1(1)(b)>>

 

<<Firms -- other notice requirements>>

<<in NRD format>>

 

<<Open / change of business location (other than head office)>>

<<15 days>>

<<3.2>>

<<Form 33-109F3>>

 

<<Cessation of Authority of a registered or permitted individual -- Items 1-4 -- Item 5>>

<<10 days>>{*}

<<4.2(2)(a)>>

<<Form 33-109F1>>

 

<<30 days>>

<<4.2(2)(b)>>

 

<<Individuals -- Form F4 information>>

<<in NRD format>>

 

<<Item 1 -- Name>>

<<15 days>>

<<4.1(1)(b)>>

<<Form 33-109F5>>

 

<<Item 2 -- Address (except items 2.1 and 2.2)>>

<<15 days>>

 

<<Item 2.1 -- Current and previous residential address>>

<<30 days>>

<<4.1(1)(a)>>

 

<<Item 2.2 -- Mailing address>>

 

<<Item 3 -- Personal information>>

<<No update required>>

<<4.1(2)>>

 

<<Item 4 -- Citizenship>>

<<30 days>>

<<4.1(1)(a)>>

 

<<Item 5 -- Registration jurisdictions>>

<<15 days>>

<<4.1(1)(b)>>

 

<<Item 6 -- Individual categories>>

<<15 days>>

 

<<Item 7 -- Address for service>>

<<15 days>>

 

<<Item 8 -- Proficiency>>

<<15 days>>

 

<<Item 9 -- Location of employment>>

<<15 days>>

 

<<Item 10 -- Reportable activities>>

<<30 days>>

 

<<Item 11 -- Previous employment>>

<<30 days>>

<<4.1(1)(a)>>

 

<<Item 12 -- Terminations>>

<<15 days>>

 

<<Item 13 -- Regulatory disclosure>>

<<15 days>>

 

<<Item 14 -- Criminal disclosure>>

<<15 days>>

<<4.1(1)(b)>>

 

<<Item 15 -- Civil disclosure>>

<<15 days>>

 

<<Item 16 -- Financial disclosure>>

<<15 days>>

 

<<Item 17 -- Ownership of securities>>

<<15 days>>

 

<<Change of F4: registrant position or relationship with sponsoring firm / permitted status>>

<<15 days>>

<<4.1(4)>>

<<Form 33-109F2>>

 

<<Review of a Permitted individual>>

<<10 days{*} after appointment>>

<<2.5>>

<<Form 33-109F4 or Form 33-109F7, subject to conditions>>

 

<<Automatic reinstatement of registration subject to conditions>>

<<within 90 days of cessation date>>

<<2.3(2)>>

<<Form 33-109F7>>

{*} The notice period for a cessation of authority of registered individuals and permitted individuals and a review of permitted individuals is within 10 days of such event.

 

Appendix B

Contact Information for the Regulators and IIROC

Part 1 provides the regulators' contact information for registrants in all categories, except for those in the jurisdictions and categories listed in Part 2

Part 2 below, provides IIROC's contact information in the jurisdictions where IIROC performs registration functions for representatives Approved Persons of investment dealers and, in some cases, for investment dealer firms

Part 1 -- Regulators' Contact Information

Alberta
British Columbia
<<e-mail: registration@asc.ca>>
<<e-mail: registration@bcsc.bc.ca>>
fax: (403) 297-4113
fax: (604) 899-6506
Alberta Securities Commission,
British Columbia Securities Commission
Suite 600, 250-5th St. SW
P.O. Box 10142, Pacific Centre
Calgary, AB T2P 0R4
701 West Georgia Street
<<Attention:>> Registration department
Vancouver, BC V7Y 1L2
Attention: Registration
 
Manitoba
New Brunswick
<<e-mail: registrationmsc@gov.mb.ca>>
<<e-mail: nrs@fcnb.ca>>
fax: (204) 945-0330
fax:(506) 658-3059
The Manitoba Securities Commission
Financial and Consumer Services Commission of New Brunswick / Commission des services financiers et des services aux consommateurs du Nouveau-Brunswick
500-400 St. Mary Avenue
Suite 300, 85 Charlotte Street
Winnipeg, MB R3C 4K5
Saint John, NB E2L 2J2
Attention: Registrations
Attention: Registration
 
Newfoundland and Labrador
Northwest Territories
<<e-mail: scon@gov.nl.ca>>
<<e-mail: SecuritiesRegistry@gov.nt.ca>>
fax: (709) 729-6187
fax: (867) 873-0243
Superintendent of Securities, Service NL
Government of the Northwest Territories
Government of Newfoundland and Labrador
Department of Justice
P.O. Box 8700, 2nd Floor, West Block
P.O. Box 1320
Confederation Building
Yellowknife, NWT X1A 2L9
St. John's, NL A1B 4J6
Attention: Exemption Review Staff
Attention: Registration Section
 
Nova Scotia
Nunavut
<<e-mail: nrs@novascotia.ca>>
<<e-mail: CorporateRegistrations@gov.nu.ca>>
fax: (902) 424-4625
fax: (867) 975-6594
Nova Scotia Securities Commission
Government of Nunavut
Suite 400, 5251 Duke Street
Department of Justice
Halifax, NS B3J 1P3
P.O. Box 1000 Station 570
Attention: Registration
Iqaluit, NU X0A 0H0
Attention: Superintendent of Securities
 
Ontario
Prince Edward Island
Telephone: (416) 593-8314
<<e-mail: ccis@gov.pe.ca>>
<<e-mail: registration@osc.gov.on.ca>>
fax: (902) 368-5283
Ontario Securities Commission
Securities Office
22[SUP]nd[/SUP] Floor
Department of Community Affairs and Attorney General
20 Queen Street West
P.O. Box 2000, 95 Rochford Street
Toronto, ON M5H 3S8
Charlottetown, PE C1A 7N8
Attention: Compliance and Registrant Regulation
Attention: Superintendent of Securities
 
Québec
Saskatchewan
<<e-mail: inscription@lautorite.qc.ca>>
<<e-mail: registrationsfsc@gov.sk.ca>>
fax : (514) 873-3090
fax: (306) 787-5871
Autorité des marchés financiers
Financial and Consumer Affairs Authority of Saskatchewan
Direction de l'encadrement des intermédiaires
Suite 601
800 square Victoria, 22e étage
1919 Saskatchewan Drive
C.P 246, Tour de la Bourse
Regina, SK S4P 4H2
Montréal (Québec) H4Z 1G3
Attention: Registration
 
Yukon
<<e-mail: securitiescorporateaffairs@gov.yk.ca>>
fax: (867) 393-6251
Government of Yukon
<<Office of the Yukon>> Superintendent of Securities
P.O. Box 2703<<C-6>>
Whitehorse, YT Y1A 2C6
Attention: Superintendent of Securities

PART 2 -- Investment Industry Regulatory Organization of Canada Contact Information

** registration of investment dealer firms and their Approved Persons **

* registration of investment dealer Approved Persons *

** Alberta -- IIROC **
**British Columbia -- IIROC**
** Saskatchewan- IIROC **
<<e-mail: registration@iiroc.ca>>
<<e-mail: registration@iiroc.ca>>
fax: 604-683-3491
fax: (403) 265-4603
1055 West Georgia Street
#2300, 355- 4[SUP]th[/SUP] Avenue SW,
Suite 2800 -- Royal Centre
Calgary, AB T2P 0J1
Vancouver, BC V6E 3R5
Attention: Registration department
Attention: Registration department
 
** Newfoundland and Labrador -- IIROC **
<<** Newfoundland and Labrador -- IIROC **>>
* Ontario -- IIROC *
<<** New Brunswick -- IIROC **>>
<<e-mail: registration@iiroc.ca>>
* Québec -- IIROC *
fax: (416) 364-9177
<<e-mail: registration@iiroc.ca>>
Suite 1600, 121 King Street West
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Appendix C

Reportable Outside Activities

No reporting of the outside activity required

 

Appendix CAppendix D

Discretionary Exemption for Bulk Transfers of Business Locations and Individuals

(1) If a registered firm is acquiring a large number of business locations (for example, as a result of an amalgamation or asset purchase) from one or more other registered firms that are located in the same jurisdiction(s) and registered in the same categories as the acquiring firm, and if a significant number of individuals are associated on NRD with the business locations, the regulator will consider granting an exemption from any or all of the following requirements:

(a) to submit a notice regarding the termination of each employment, partner, or agency relationship under section 4.2 of the Rule;

(b) to submit a registration application or a reinstatement notice for each individual seeking to be a registered individual under section 2.2 or 2.3 of the Rule;

(c) to submit a Form 33-109F4 or Form 33-109F7 for each permitted individual under section 2.5 of the Rule;

(d) to notify the regulator of a change to the business location information in Form 33-109F3 under section 3.2 of the Rule.

(2) The exemption application should be submitted by the registered firm that will acquire control of the business locations at the closing of the transaction and should be submitted well in advance of the date (transfer date) on which the business locations will be transferred. It would typically be sufficient if a firm submits the application at least 30 days before the transfer date. An application for this type of exemption should include the following information:

(a) the name and NRD number of the registered firm that will acquire control of the business locations;

(b) for each registered firm that is transferring control of the business locations;

(i) the name and NRD number of the registered firm,

(ii) the address and NRD number of each business location that is being transferred from the registered firm named in (b)(i) to the registered firm named in (a),

(iii) the date that the business locations and individuals will be transferred to the registered firm named in (a).

(3) If the exemption is granted, as soon as practicable after the transfer date, the regulator will instruct the NRD administrator to record on NRD the transfer of the business locations, registered individuals and permitted individuals.

(4) Bulk transfers involving firms that are registered in different categories or different jurisdictions may need to take additional steps. Firms involved in such a transaction should contact their principal regulator to discuss what steps are required for the firm to be eligible for a bulk transfer exemption as described above.

(5) A firm applying for this type of exemption in more than one jurisdiction should refer to National Policy 11-203 Process for Exemption Applications in Multiple Jurisdictions for guidance on the form of application and the information required. The firm may set out the information referred to in (2) as follows:

A) Registered firm that will acquire the business locations

Name:

Firm NRD number:

B) Registered firm transferring the business locations

Name:

Firm NRD number:

Business locations that will be transferred

Address of business location:

NRD number of business location:

Address of business location:

NRD number of business location:

(Repeat for each business location as necessary)

C) Date that business locations will be transferred:

 

Annex E -- Proposed Amendments to NI 31-103

ANNEX E

PROPOSED AMENDMENT TO NATIONAL INSTRUMENT 31-103 REGISTRATION REQUIREMENTS, EXEMPTIONS AND ONGOING REGISTRANT OBLIGATIONS

1. National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations is amended by this Instrument.

2. The Instrument is amended by adding the following section:

13.4.3 Restrictions on a registered individual who is in a position of influence

(1) In this section, "position of influence" means a position, other than a position with a sponsoring firm, if, due to the functions of the position or the training or specialized knowledge required for the position, an individual in that position would be considered by a reasonable person to have influence over other individuals.

(2) For greater certainty, a position of influence under subsection (1) includes the following:

(a) a leader in a religious or similar organization;

(b) a medical doctor;

(c) a nurse;

(d) a professor, instructor or teacher at a degree or diploma granting institution;

(e) a lawyer;

(f) a notary.

(3) A registered firm must not permit a registered individual of the firm who is in a position of influence to purchase or sell securities or derivatives for, or recommend securities or derivatives to,

(a) an individual who

(i) has a relationship with the registered individual arising from the position of influence, and

(ii) to a reasonable person, would be considered to be susceptible to the registered individual's influence, or

(b) a spouse, parent, brother, sister, grandparent or child of an individual described in paragraph (a).

(4) A registered individual who is in a position of influence must not purchase or sell securities or derivatives for, or recommend securities or derivatives to

(a) an individual who

(i) has a relationship with the registered individual arising from the position of influence, and

(ii) to a reasonable person, would be considered to be susceptible to the registered individual's influence, or

(b) a spouse, parent, brother, sister, grandparent or child of an individual described in paragraph (a).

3. This Instrument comes into force on •.

 

Annex F -- Proposed Changes to 31-103CP

ANNEX F

PROPOSED CHANGES TO COMPANION POLICY 31-103CP REGISTRATION REQUIREMENTS, EXEMPTIONS AND ONGOING REGISTRANT OBLIGATIONS

1. Companion Policy 31-103CP Registration Requirements, Exemptions and Ongoing Registrant Obligations is changed by this Document.

2. Section 13.4 is changed by replacing the subheading "Individuals who have outside business activities" and the 6 paragraphs that follow the subheading with the following:

Individuals who have activities outside of the sponsoring firm

(a) Firm oversight of outside activity and reportable outside activity

The regulator will take into account and require reporting of certain outside activities of a registered individual when assessing that individual's application for registration or continuing fitness for registration, as well as the firm's fitness for registration. Please see the Companion Policy to National Instrument 33-109 Registration Information for more information.

Registered firms, on the other hand, are required to have policies and procedures to identify and address material conflicts of interest and risks arising from all outside activities that their registered individuals may participate in. This assessment by registrants should not be limited to only the outside activities reportable by registered firms to regulators. In particular, registered firms and registered individuals must determine whether an outside activity is a conflict of interest and determine whether the conflict of interest is material in the circumstances. Please refer to other areas in section 13.4 of this Companion Policy for more information.

(b) Conflicts and other risks arising from outside activities

Registered individuals' activities outside of their sponsoring firm may impact a registered individual's and a registered firm's ability to deal fairly, honestly and in good faith with their clients and to meet their obligations as a registrant, and may give rise to risks in the following areas:

• Outside activities may create material existing or potential conflicts of interest between a registered individual and their clients, for example, because the compensation they receive for these activities, or the nature of the relationship between the individual and the outside entity, may cause some registered individuals to put their interests ahead of their clients' interests.

• Outside activities could interfere with the registered individual's ability to properly carry out the registrable activities. For example, if the outside activity requires the registered individual to work full-time during day-time hours, this could lead to insufficient time to properly service clients or to properly carry out the registrable activities, including remaining current on securities law and product knowledge.

• Outside activities could lead to client confusion, particularly where the outside activity relates to financial services (such as financial and estate planning, tax preparation, insurance, mortgage brokerage). The client may view the outside activity as part of the registered firm's activities. This may occur where the same premises, email address, business cards, mailing address, or telephone numbers are used. The outside business activity could expose the registered firm to complaints and litigation.

• When a registered individual in a position of influence deals with or advises clients or potential clients who may be susceptible to that influence, investor protection concerns arise. For example, the registered individual may use the position of influence to cause another individual to become a client or the other individual may be persuaded to purchase a security based upon their opinion of the registered individual and not upon the merits of the security or the other individual's investment needs and objectives. Such registrants must comply with additional requirements set out in section 13.4.3 [Restrictions on a registered individual who is in a position of influence].

• The outside activity may be prohibited by law or regulation. For example, section 4.1 prohibits a registered individual from acting for another registered firm in certain circumstances and section 11.8 prohibits tied selling.

• Where a registered individual has outside activities, the individual may improperly use information obtained from the registered firm in the outside activity. Clients may have only provided confidential information for the purposes of dealing with the registered individual at the registered firm and not for use in the outside activity. If this information is privileged, confidential or insider information, the registered individual's use of this information in the outside activities may impact the registered firm's ability to comply with securities laws.

• Outside activities may reveal registrable activities being carried on by the registered individual outside of their firm or with other unregistered persons. They may also reveal non-compliance with securities laws or otherwise objectionable conduct.

In order to be able to assess the conflicts and other risks, we expect registered firms to establish a reporting mechanism that requires their registered individuals to report their outside activities. Before approving any outside activities, registered firms are required to consider existing or potential material conflicts of interest and other risks that arise from outside activities. If the firm cannot properly address a material conflict of interest in the best interest of the client and manage the risks in accordance with prudent business practices, it should not permit the outside activity.

In addition, registered individuals are required to promptly report to their sponsoring firm any material conflict which arises between a registered individual and their client in accordance with subsection 13.4.1(2). The registered individual must avoid carrying out the outside activities if controls are not enough to address the conflict in the best interest of clients and must not engage in the outside activity until the registered firm has given its approval for the outside activity.

(c) Monitoring and supervising individuals' outside activities

A registered firm is responsible for monitoring and supervising their registered individuals. This includes the activities outside of their sponsoring firm that the registered individuals participate in.

Monitoring and supervising registered individuals' outside activities helps registered firms meet their regulatory obligations, including:

• compliance with the requirement to operate an effective compliance system under section 11.1 [Compliance system and training],

• the conflicts of interest provisions set out in section 13.4 [Identifying, addressing and disclosing material conflicts of interest -- registered firm], and

• the restrictions on clients set out in section 13.4.3 [Restrictions on a registered individual who is in a position of influence].

When the regulator reviews how a registered firm monitors and supervises their registered individuals' outside activities, we expect firms to:

• have appropriate policies and procedures to identify material conflicts of interest arising from outside activities and address these conflicts of interest in the best interest of clients, and that include a broad definition of "outside activities".

• require registered individuals to disclose to their firm and require the firm to review and approve all outside activities prior to the activities commencing.

• have policies and procedures to determine that outside activities do not:

• involve activities that are inconsistent with securities legislation, IIROC requirements or MFDA requirements, as applicable, and

• interfere with the registered individual's ability to perform their regulatory obligations and to update their knowledge and training to keep pace with new securities, services and developments in the industry that are relevant to their business.

• provide training or education on outside activities, including the need to report on changes in outside activities and the restrictions on a registered individual who is in a position of influence as to the clients the registered individual can deal with or advise.

• require registered individuals to disclose to any new sponsoring firm, and requiring that new sponsoring firm to review and approve, all outside activities prior to the registered individual joining the new sponsoring firm.

• assess whether the registered firm has the necessary information and is able to properly supervise and monitor the outside activities.

• maintain records documenting its supervision of its individuals' outside activities and storing these records so that they are available for review by regulators.

• take appropriate supervisory actions when the registered firm identifies non-compliance with their policies on outside activities, such as no or late reporting of an outside activity.

• identify existing and reasonably foreseeable material conflicts of interest and taking appropriate steps to address such conflicts in the best interest of clients.

• permit only outside activities that do not impair the ability to provide adequate client service, including, where necessary, having an alternate representative available for the client.

• make a determination that the outside activity is consistent with the registrant's duty to deal fairly, honestly and in good faith with its clients.

• implement risk management, including proper separation of the outside activity and the registerable activity.

• assess the exposure of the registered firm to complaints and litigation arising from the outside activities.

• assess whether the registered firm's knowledge of their registered individual's lifestyle is commensurate with its knowledge of the registered individual's activities and staying alert to other indicators of possible fraudulent activity. For example, if information comes to the registered firm's knowledge (including through a client complaint) that a registered individual's lifestyle is not commensurate with the registered individual's compensation by the firm, we would expect the registered firm to make further inquiries to assess the situation.

Failure to fulfil these responsibilities may be taken into consideration in assessing the firm's continued fitness for registration.

Registered firms should consider the following additional practices in relation to the monitoring and supervision of their registered individuals' outside activities:

• using standard forms and/or questionnaires to collect and assess their registered individuals' outside activities.

• having an intake method for registered individuals to disclose these outside activities to the firm.

• providing guidelines that describe what an outside activity is and the types of outside activities that are restricted or prohibited by securities laws or by the registered firm.

• having active involvement of the appropriate staff of the registered firm in the oversight of outside activities.

• performing internet searches or branch reviews to identify non-disclosed outside activities.

• having their registered individuals provide annual certifications for attesting compliance with policies relating to outside activities.

• providing monthly or quarterly reminders to their registered individuals to report changes to their outside activities.

• disclosing outside activities to clients using a standard form that is tailored for each outside activity.

• obtaining acknowledgement from clients of the registered individual's outside activities.

• obtaining written confirmation from clients that they do not have a relationship with the registered individual in their position of influence.

Because the nature of outside activities as well as the individual's registered activities may evolve over time, the registered firm is responsible to monitor and supervise outside activities in such a way that material conflicts are continually addressed in the best interest of clients and the risks are managed in accordance with prudent business practices.

3. The Companion Policy is changed by adding the following section after section 13.4:

13.4.3 Individuals in a position of influence

When considering the approval of a registered individual's outside activity, registered firms are expected to understand the nature of the activity and determine if the activity puts the registered individual in a position of influence. Additional regulatory requirements apply where the activity of a registered individual is a position of influence. These requirements do not apply where the individual is solely a permitted individual (i.e., the individual is not registered).

Under section 13.4.3, certain specific roles are considered positions of influence. For example, a leader in a religious organization or other similar organization is a person who provides leadership or guidance on the faith in a recognized capacity in the organizational structure of the faith, such as a priest, deacon, rabbi, cantor or imam. It may be a position appointed by the faith's organization or selected by the congregation. It does not include any person who is responsible for only clerical or administrative duties.

An assessment of other positions is required. Registered firms could consider the following non-exhaustive factors to determine whether the outside activity puts the registered individual in a position of influence:

• the degree of influence that the registered individual has through that position due to the functions of the position or the training or specialized knowledge required for the position,

• the degree to which a person may be confused as to whether the registered individual is acting in the capacity as a registrant or in another capacity, and

• the degree of susceptibility another person has to the registered individual in that position due to the other person's reliance on or perception of the registered individual's specialized knowledge, expertise, or role.

If both the degree of influence by the registered individual in the position of influence and the confusion or susceptibility of a person subject to that influence are considered significant, a registered firm is expected to consider the outside activity to be a position of influence.

For example, an individual who is a primary care physician would be viewed as being in a position of influence. The physician has specialized medical knowledge and training that patients would not have. Patients see the physician when they are unwell, are reliant on the physician for their health, and may view the physician favourably based on the medical treatment they received, which may make them susceptible to influence. In this scenario, the physician would not be permitted to trade or advise in securities with current or ongoing patients of the physician.

However, an assessment of other health care roles is required to determine if it is a position of influence. For example, dentists, optometrists, and technical workers at a medical facility, such as X-ray technicians and data health management coordinators, are not considered to be positions of influence because the degree of susceptibility is not significant.

A caregiver in an assisted living facility may be a position of influence. The caregiver's primary role is to provide care to residents in the assisted living facility, which includes making care decisions. The residents and their family members would be reliant on the caregiver for the quality of care received and would not easily be able to change facilities.

Below are other examples of activities that registered firms may consider as positions of influence due to the influence they carry in their specialized role, coupled with the susceptibility of the persons who receive the services:

• A correctional officer working in the criminal justice system

• A youth mentor in an organized program

• Social workers who serve a vulnerable client base (e.g., substance abuse programs, mental health care)

• An immigration consultant

An example of an activity that may not be a position of influence is an instructor for a hobby or recreational course, such as learning to paint or dance. While the instructor of a hobby or recreational course may grade students' work, the instructor does not have influence because the course is being taken for recreational or hobby purposes. The students are also not susceptible since they do not rely on the grades for future education and employment opportunities.

Elected officials, such as school trustees, would also not be considered positions of influence. While they may be influential, generally, they serve a broad base of people and may not use their position unilaterally. Therefore, the degree of susceptibility of their constituents does not rise to the level present in the examples above and in the expressly identified positions set out in paragraphs 13.4.3(1)(a) to (f) of the definition of position of influence.

Similarly, a landlord would not be considered to be in a position of influence. While the landlord has power over their tenant in relation to the tenant's ability to continue to rent the accommodation, we would not view the degree of power of the landlord and the degree of susceptibility of the tenant to meet the level of a position of influence.

Individuals who are an executor or trustee of an estate or hold a power of attorney over another person would not, in our view, be in a position of influence. In these cases, the individual has been appointed to act on behalf of an estate or another person. Their influence is limited only to that estate or person and they have a fiduciary duty to act in the best interest of the estate or person. However, there is an inherent conflict of interest for a registrant to have full control or authority over the financial affairs of a client. In our experience, this is almost always a material conflict of interest. SRO rules only permit an individual to act as an executor, trustee, or power of attorney in certain circumstances. Registrants that are members of an SRO must comply with their SRO requirements. Where the individual is not subject to SRO rules, we expect registered firms to have policies and procedures in place such that these conflicts are identified and are either avoided or otherwise addressed in the client's best interest.

A registered firm is expected to have appropriate policies and procedures in place

• to identify all registered individuals who are in a position of influence,

• to provide reasonable assurance that the registered individual does not trade or advise in securities with clients who are subject to that influence, and

• to report the position of influence as a reportable activity to regulators.

Where a registered firm has assessed that a position is not a position of influence, we expect registered firms to have documented their assessment at the time the assessment is made and have this documentation available to regulators upon request. Additionally, the conflicts of interest requirements set out in section 13.4 and 13.4.1 continue to apply to these activities. Only the requirements in section 13.4.3 would not apply.

4. These changes become effective on •.

 

Annex G -- Local Matters

ANNEX G

LOCAL MATTERS

1. Introduction

The Canadian Securities Administrators (the CSA) is proposing targeted changes to registration information requirements to provide greater clarity on the information to be submitted, to help individuals and firms (collectively, Regulated Persons) provide complete and accurate registration information, and to reduce the regulatory burden of doing so, while allowing the CSA to receive the information necessary to carry out its regulatory roles. These proposed targeted changes address issues identified by CSA staff and respond to concerns raised by Regulated Persons.

The CSA is publishing for comment (the CSA Notice and Request for Comment):

• Proposed amendments to National Instrument 33-109 Registration Information (NI 33-109), including its related forms (NI 33-109 Forms), and changes to Companion Policy 33-109CP Registration Information (33-109CP), and

• Related proposed amendment to National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations (NI 31-103) and changes to Companion Policy 31-103CP Registration Requirements, Exemptions and Ongoing Registrant Obligations (31-103CP).

We refer to the proposed amendments to NI 33-109 and NI 31-103 and changes to 33-109CP and 31-103CP collectively as the Proposed Revisions.

Please refer to the CSA Notice and Request for Comment for a discussion of the substance and purpose of Proposed Revisions.

2. Ontario-only amendments

In Ontario, the Commodity Futures Act (Ontario) (the CFA) regulates all commodity futures contracts and commodity futures options trading on commodity exchanges. The CFA, among other matters, provides for the registration of persons and companies who trade in or advise on commodity futures contracts or commodity futures options.

Ontario Securities Commission Rule 33-506 (Commodity Futures Act) Registration Information (OSC Rule 33-506) sets out the registration information requirements. It carries on a similar role as NI 33-109, but in relation to the CFA.

In addition to and consequent to the Proposed Revisions set out in the annexes to the CSA Notice, the Ontario Securities Commission (the OSC) is also publishing for comment:

• proposed consequential amendments to OSC Rule 33-506 (attached as Schedule 1 to this Annex);

• proposed changes to Companion Policy 33-506CP (Commodity Futures Act) Registration Information (33-506CP) (attached as Schedule 3 to this Annex).

Together, the amendments to OSC Rule 33-506 and changes to 33-506CP (the Ontario Amendments) are necessary to reflect the proposed adoption of the Proposed Revisions in Ontario.

3. Anticipated costs and benefits of the Proposed Revisions and Ontario Amendments

Each of the Proposed Revisions and Ontario Amendments has been analyzed as to the cost benefit in Ontario. Paragraph 143.2(2)7 of the Securities Act (Ontario) requires the OSC to provide a description of the anticipated costs and benefits of proposed amendments to a rule. Where the data was available, the information is also presented on a Canada-wide basis. Please see the analysis attached to this Annex as Schedule 5.

The hourly cost of labour is a key input in quantifying the incremental costs and benefits associated with a proposed rule change. Hourly rates may be sourced from a variety of publicly available compensation guides. While these guides provide information on staff of various positions (e.g., compliance, accounting, legal) and seniority, there is a lack of information on the compensation of individual registrants. We are considering appropriate ways to obtain this information.

The OSC invites stakeholder comment on how to achieve this goal without imposing undue burden on registrants.

4. Authority for Proposed Revisions and Ontario Amendments

Rule-making authority for the Proposed Revisions is found in paragraphs 1, 2, 3, and 7 of subsection 143(1) of the Securities Act (Ontario).

Rule-making authority for the Ontario Amendments is found in paragraphs 1, 7 and 11 of subsection 65(1) of the CFA.

5. Alternatives considered

For reasons set out in the main body of this notice, the CSA is of the view that the status quo is not satisfactory.

An alternative to the Proposed Revisions that was considered included publishing staff guidance. Staff guidance, alone, was determined not to be a sufficient response to clarify and improve the effectiveness of the information registrants are required to provide.

6. Unpublished materials

In publishing the Proposed Revisions, we have not relied on any unpublished study, report or other written materials.

 

Schedule 1

SCHEDULE 1

PROPOSED AMENDMENT TO ONTARIO SECURITIES COMMISSION RULE 33-506 (COMMODITY FUTURES ACT) REGISTRATION INFORMATION

1. Ontario Securities Commission Rule 33-506 (Commodity Futures Act) Registration Information is amended by this Instrument.

2. Section 1.1 is amended

(a) in the definition of "cessation date" by deleting ", because of the end of, or a change in, the individual's employment, partnership or agency relationship with the firm", and

(b) by replacing the definition of "Form 33-506F1" with the following:

"Form 33-506F1" means Form 33-506F1 Notice of End of Individual Registration or Permitted Individual Status;.

3. Section 2.1 is amended by replacing paragraph (a) with the following:

(a) electronically in accordance with Ontario Securities Commission Rule 11-501 Electronic Delivery of Documents to the Ontario Securities Commission, a completed Form 33-506F6, excluding questions 1.4(a), 2.6 and 6.2, and.

4. Subsection 2.3(2) is amended

(a) by replacing paragraph (b) with the following:

(b) in the case of the individual resigning or the individual's relationship with the sponsoring firm being terminated, at the time of the resignation or termination there was no allegation against the individual, in Canada or in any foreign jurisdiction, relevant to an assessment whether the individual is not suitable for reinstatement of registration or the proposed reinstatement of registration is objectionable, including, for greater certainty, an allegation of any of the following:

(i) a crime;

(ii) a contravention of any statute, regulation, or order of a court or regulatory body;

(iii) a contravention of any rule or bylaw of an SRO, of an authority exercising jurisdiction over specific business activities or professions, or of a similar organization;

(iv) a failure to meet any standard of conduct of the sponsoring firm, of any industry association, or of any authority exercising jurisdiction over specific business activities or professions;, and

(b) by adding the following paragraph:

(b.1) on or before the cessation date, the individual notified, in accordance with section 4.1, the Director of any change to the information previously submitted in the individual's Form 33-506F4;.

5. Subsection 2.4(2) is amended by replacing paragraph (c) with the following:

(c) the conditions described in paragraphs 2.3(2)(b), (b.1) and (c) are met..

6. Section 3.1 is amended

(a) by replacing subsection (1) with the following:

(1) In this section, "authorized affiliate" means, in respect of a registered firm, another registered firm that

(a) is an affiliate of the registered firm,

(b) has the same principal regulator as the registered firm.

(1.1) Subject to subsection (3), a registered firm must notify the Director of a change to any information previously submitted in Form 33-506F6 or under this subsection, as follows:

(a) for a change to information previously submitted in relation to any of the following parts or items of Form 33-506F6, within 30 days of the change:

(i) part 3 [Business history and structure];

(ii) item 4.1 [Securities registration];

(iii) item 5.12 [Auditor];

(iv) item 6.1 [Client assets];

(v) item 6.2 [Conflicts of interest];

(b) for a change to information previously submitted in relation to any other part of Form 33-506F6, within 15 days of the change.,

(b) by adding the following subsection:

(2.1) A registered firm may delegate to an authorized affiliate the duty to notify the Director under subsection (1.1) of a change to information previously submitted if all of the following apply:

(a) the change in information relates only to one or more of the following items or parts of Form 33-506F6:

(i) item 3.12 [Ownership chart];

(ii) item 4.1 [Securities registration];

(iii) item 4.3 [Membership of exchange or SRO];

(iv) item 4.5 [Refusal of registration, licensing or membership];

(v) item 4.6 [Registration for other financial products];

(vi) part 7 [Regulatory action];

(vii) part 8 [Legal action];

(b) the registered firm has filed a certificate, executed by the officer or partner authorized to certify and sign Form 33-506F5, with the Director, that confirms all of the following:

(i) the registered firm has delegated to the authorized affiliate the duty to notify the Director of a change to any information set out in paragraph (a), and

(ii) the full legal name and NRD number of the registered firm and the authorized affiliate, and

(iii) the following certification of the registered firm applies to each notice of change submitted by the authorized affiliate:

"I have read this form and understand all matters within this form, including the questions, and to the best of my knowledge and after reasonable inquiry, all of the information provided on this form is true and complete."

(c) the registered firm directs the authorized affiliate, in each notice of change submitted by the authorized affiliate, to include the full legal name and NRD number of the registered firm and to state the following:

"The registered firm has delegated to the authorized affiliate the duty to notify the Director of a change to any of the following items or parts of Form 33-109F6:

(i) item 3.12 [Ownership chart];

(ii) item 4.1 [Securities registration];

(iii) item 4.3 [Membership of exchange or SRO];

(iv) item 4.5 [Refusal of registration, licensing or membership];

(v) item 4.6 [Registration for other financial products];

(vi) part 7 [Regulatory action];

(vii) part 8 [Legal action].", and

(c) in subsection (3), by replacing "termination" with "cessation" in paragraph (b) and by adding the following paragraphs:

(e) a renewal of an insurance policy referred to in item 5.5 or in item 5.6 of Form 33-506F6, if the insurance policy has not lapsed and the only change is to extend the expiry date of the insurance policy for a period of at least one year;

(f) a change in a person or company's ownership of the firm's voting securities referred to in item 3.12 of Form 33-506F6, if the change did not result in the person or company's percentage ownership falling below or exceeding 10%, 20%, or 50% of the firm's voting securities..

7. Section 3.2 is amended by replacing "10" with "15" wherever it appears.

8. Section 3.3 is repealed.

9. Section 4.1 is amended

(a) by replacing in subsection (1) "regulator" with "Director" and "10" with "15",

(b) by replacing in subsection (2) "regulator" with "Director" and "Items 4, 8 and 11" with "Items 2.1, 2.2, 4, 10 and 11",

(c) by replacing subsection (3) with the following:

(1) Despite subsection (1), a registered individual or permitted individual is not required to notify the Director if the change relates to any of the following:

(a) information previously submitted in item 3 [Personal information] of Form 33-506F4;

(b) the individual ceasing to have authority to act on behalf of the sponsoring firm as a registered individual or be a permitted individual of the sponsoring firm if a Form 33-506F1 is required to be submitted by the sponsoring firm under subsection 4.3(1)., and

(d) by replacing paragraph (5)(a) with the following:

(a) a change in a category of permitted activities of a permitted individual,.

10. Section 4.3 is amended by replacing subsection (1) with the following:

(1) A registered firm must notify the Director if an individual ceases to have authority to act on behalf of the registered firm as a registered individual or be a permitted individual by submitting Form 33-506F1 to the Director in accordance with Ontario Securities Commission Rule 31-509 National Registration Database (Commodity Futures Act) with

(a) items 1 to 4 of the Form completed, and

(b) item 5 of the Form completed unless the reason for cessation under item 4 was death of the individual..

11. Paragraph 5.1(3)(b) is amended by replacing "regulator" with "Director".

12. Form 33-506F1 Notice of Termination of Registered Individuals and Permitted Individuals (section 4.2)is amended

(a) by replacing the title with the following

"FORM 33-506F1 Notice of End of Individual Registration or Permitted Individual Status (section 4.2)",

(b) by adding the following immediately before the heading "GENERAL INSTRUCTIONS":

WARNING -- It is an offence under securities legislation and derivatives legislation, including commodity futures legislation, to knowingly give false or misleading information to the regulator or securities regulatory authority.

CERTIFICATION

I certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where the firm is submitting this form and to any applicable self-regulatory authority (SRO) that

• I have read this form and understand all matters within this form, including the questions, and

• to the best of my knowledge and after reasonable inquiry, all of the information provided on this form is true and complete.

NRD format:

[ ] I am making this submission under authority delegated by the firm. By checking this box, I certify that the firm

(a) provided me with all of the information on this form, and

(b) makes the certification above.

Non-NRD format:

By signing below, I make the certification above.

Name of firm ______________________________

Name of authorized signing officer or partner ____________________

Title of authorized signing officer or partner ____________________

Signature of authorized signing officer or partner ____________________

Date signed ____________________

(YYYY/MM/DD)

(c) by deleting the heading "Terms" and replacing the between the heading "Terms" and "How to submit the form" with the following:

As set out in Ontario Securities Commission Rule 33-506 (Commodity Futures Act) Registration Information, "cessation date" means the last day on which an individual had authority to act as a registered individual on behalf of their sponsoring firm or the last day on which an individual was a permitted individual of their sponsoring firm.,

(d) by replacing the text between the heading "When to submit the form" and before the heading "Item 1 Terminating firm" with the following:

As set out in Ontario Securities Commission Rule 33-506 (Commodity Futures Act) Registration Information, you must submit the responses to Items 1, 2, 3 and 4 within 10 days of the cessation date.

If you are required to complete Item 5, you must submit those responses within 30 days of the cessation date. If you are submitting the responses to Item 5, in NRD format, after Items 1 to 4 have been submitted at NRD, use the NRD submission type called "Update/Correct Cessation Information" to complete Item 5 of this form.;

(e) in Item 1, by replacing in the heading "Terminating" with "Former sponsoring",

(f) in Item 2, by replacing in the heading "Terminated" with "Applicable",

(g) in Item 3, by replacing in the heading "terminated" with "applicable",

(h) by replacing Item 4 with the following:

Item 4 Date and reason for cessation

1. Cessation date ____________________

(YYYY/MM/DD)

The above date is the last day on which the individual had authority to act as a registered individual on behalf of the sponsoring firm, or the last day on which the individual was a permitted individual of the sponsoring firm.

2. Reason for cessation (check one):

Resigned -- voluntary

[ ]

 

Resigned -- at the firm's request

[ ]

 

Terminated in good standing

[ ]

 

Terminated for cause

[ ]

 

Completed temporary employment contract

[ ]

 

Retired

[ ]

 

Deceased

[ ]

 

Other

[ ]

If "Other", explain:

______________________________

(i) in Item 5, by replacing in the heading "termination" with "cessation" and by replacing the text between the heading and the sentence "Answer the following questions to the best of the firm's knowledge." with the following:

Complete Item 5 except in the case of an individual that is deceased. In the space below:

• state the reason(s) for the cessation and

• provide details if the answer to any of the following questions is "Yes".

[For NRD Format only:]

[ ] This information will be disclosed within 30 days of the cessation date

[ ] Not applicable: individual is deceased

(j) in Item 5, by replacing in question 7 "outside business activity" with "outside activity",

(k) by repealing Items 7 and 8.

13. Form 33-506F2 Change or Surrender of Individual Categories (section 2.2(2), 2.4, 2.6(2) or 4.1(4))is amended

(a) by adding the following text between the title "Form 33-506F2Change or Surrender of Individual Categories (section 2.2(2), 2.4, 2.6(2) or 4.1(4))" and the heading "GENERAL INSTRUCTIONS":

WARNING -- It is an offence under securities legislation and derivatives legislation, including commodity futures legislation, to knowingly give false or misleading information to the regulator or securities regulatory authority.

CERTIFICATION

Individual

I certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where I am submitting this form and to any applicable self-regulatory organization (SRO) that

• I have read this form and understand all matter within this form, including the questions,

• I have discussed this form with an officer, partner, branch manager or supervisor of my sponsoring firm and that to the best of my knowledge, the officer, partner, branch manager or supervisor is satisfied that I understand all matters within this form, including the questions,

• to the best of my knowledge and after reasonable inquiry, all of the information provided on this form is true and complete, and

• if applicable, I will limit my activities to those allowed by my category of registration and any SRO approval.

Firm

I certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where the firm is submitting this form and to any applicable SRO that

• the individual identified in this form will be engaged by the sponsoring firm as a registered individual or a permitted individual, and

• I have, or a branch manager, supervisor, officer or partner has, discussed this form with the individual. To the best of my knowledge, the individual understands all matters within this form, including the questions.

NRD format:

[ ] I am making this submission under authority delegated by the firm and the individual identified in this form. By checking this box, I certify that

(a) the firm provided me with all of the information on this form and makes the firm certification above, and

(b) the individual provided the firm with all of the information on this form and makes the individual certification above.

Non-NRD format:

Individual

By signing below, I make the above individual certification.

Signature of individual ______________________________

Date signed ____________________

(YYYY/MM/DD)

Firm

By signing below, I make the certification above.

Name of firm ____________________

Name of authorized signing officer or partner ____________________

Title of authorized signing officer or partner ____________________

Signature of authorized signing officer or partner ____________________

Date signed ____________________

(YYYY/MM/DD)

(b) in Item 4, by deleting "industry" in the subheading "3. Relevant securities industry experience" and by replacing the text between that subheading and "Item 5 Reason for surrender" with the following:

Do you have relevant securities experience?

Yes [ ] No [ ] N/A [ ]

If you are an individual applying for IIROC approval, select "N/A".

If "Yes", complete Schedule A.,

(c) by replacing Item 6 with the following:

Item 6 Collection and use of personal information

1. Notice of collection and use of personal information

Your personal information is collected by, or on behalf of, each securities regulatory authority and SRO set out in Schedule B. Any of the securities regulatory authorities or SROs set out in Schedule B may contact government or private bodies or agencies, individuals, corporations, employers, and other organizations, in Canada and in other countries, for information about you.

This personal information is being collected under the authority of the applicable securities legislation, derivatives legislation (including commodity futures legislation) or both of the securities regulatory authorities and pursuant to the SRO rules of an SRO set out in Schedule B. The collection, use and disclosure are done in accordance with applicable freedom of information and privacy legislation.

The principal purpose of this collection by the securities regulatory authorities is to administer, enforce, carry out their duties or exercise their powers under their respective securities legislation, derivatives legislation (including commodity futures legislation) or both, and by the SROs to administer and enforce the rules of the SROs.

The information submitted by you on this form with your consent, or collected indirectly with your authorization, may be collected

• at any time during your registration or while you are a permitted individual, or

• at the time the regulator or, in Québec, the securities regulatory authority, or SRO is informed by your sponsoring firm that you no longer have authority to act on behalf of the sponsoring firm or are not a permitted individual of the sponsoring firm.

If you have any questions about the collection, use and disclosure of this information, contact the securities regulatory authorities or SRO in any jurisdiction in which the required information is submitted. See Schedule B for details.

Note that certain information such as your name(s) (including aliases, trade names or some past names), your sponsoring firm, and other relevant registration information will be listed in a publicly available registry of registered individuals and, if applicable, on the Disciplined List.

Also note that certain securities regulatory authorities may provide or receive information to or from certain entities under separate provisions of their securities legislation or derivatives legislation (including commodity futures legislation) or both, and SROs may provide or receive information under the rules of the SROs. This consent and notice does not limit the authority, powers, obligations, or rights conferred on any of the securities regulatory authorities by legislation or regulations in effect in their jurisdiction.

2. Consent to collect and use personal information

By submitting this form, you consent to and authorize the collection, directly and indirectly, of personal information by each securities regulatory authority and SRO and to the use of your personal information as set out above.

The personal information that each securities regulatory authority or SRO collects, includes the following:

• the personal information provided in this form;

• the personal information provided by your sponsoring firm;

• registration or financial services licensing information;

• law enforcement records, including police records;

• credit records;

• bankruptcy or other insolvency records;

• employment records and information received from an employer;

• records and information received from entities you had or have an independent contractor or agency relationship with;

• personal information available online;

• records from government ministries and agencies, SROs or authorities exercising jurisdiction over specific business activities or professions; and

• records of, and used in, court proceedings, including any probation records.;

(d) by repealing Item 7,

(e) by repealing Item 8,

(f) by replacing Schedule A with the following:

Schedule A

Relevant securities experience (Item 4)

Instructions:

Some registration categories require a specified amount of experience to be obtained within specified timeframes. Please see National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations for more information.

If you are applying to be an advising representative or an associate advising representative, provide details of the activities you performed for each experience that is relevant investment management experience. Such details may include the level of responsibility; value of accounts under direct supervision; number of years of experience in performing securities research and analysis for the purpose of portfolio securities selection, portfolio construction and analysis; number of years of experience collecting know-your-client information; or number of years of experience conducting suitability assessments.

1. If you are applying

• to be an advising representative or an associate advising representative of a portfolio manager, describe the relevant investment management experience that you have gained, or

• for any other category, describe the relevant securities industry experience that you have gained.

For each description of relevant experience, provide the following information:

(a) the name of the firm or entity with which you gained this experience;

(b) your title;

(c) the start and end dates of this position;

(d) the details of the activities you performed that are relevant for the category of registration that you are applying for; and

(e) the percentage of your time in this position that was spent on activities relating to the experience.

______________________________

______________________________

______________________________

2. Indicate the continuing education activities in which you have participated during the last 36 months and that are relevant to the category of registration you are applying for:

______________________________

______________________________

______________________________

(g) in Schedule B, by replacing "Notice" in the title with "Consent and notice",

(h) in Schedule B in the portion of the form under the contact information for British Columbia, by replacing "Freedom of Information Officer" with "Registration staff" and adding "E-mail: Registration@bcsc.bc.ca" at the end,

(i) in Schedule B in the portion of the form under the contact information for Nova Scotia, by replacing "Deputy Director, Capital Markets" with "Registration",

(j) in Schedule B in the portion of the form under the contact information for Yukon, by adding "Office of the Yukon" before "Superintendent of Securities" and replacing "(867) 667-5314" with "(867) 667-5466", and

(k) in Schedule B in the portion of the form under the contact information for Northwest Territories, by deleting "Deputy" after "Attention:".

14. Form 33-506F3 Business Locations Other Than Head Office (section 3.2)is amended

(a) by adding the following text between the title "Form 33-506F3Business Locations Other Than Head Office (section 3.2)" and "GENERAL INSTRUCTIONS":

WARNING -- It is an offence under securities legislation and derivatives legislation, including commodity futures legislation, to knowingly give false or misleading information to the regulator or securities regulatory authority.

CERTIFICATION

I certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where the firm is submitting this form and to any applicable self-regulatory organization (SRO) that

• I have read this form and understand all matters within this form, including the questions,

• if the business location specified in this form is a residence, the individual conducting business from that business location has completed a Form 33-506F4 Registration of Individuals and Review of Permitted Individuals certifying that they give their consent

• for the regulator or, in Québec, the securities regulatory authority in each jurisdiction where this form is submitted to enter the residence for the administration of securities legislation and derivatives legislation, including commodity futures legislation, and

• where applicable, for the SRO to enter the residence for the administration of the rules of the SRO, and

• to the best of my knowledge and after reasonable inquiry, all of the information provided on this form is true and complete.

NRD format:

[ ] I am making this submission under authority delegated by the firm.

[ ] By checking this box, I certify that

(a) the firm provided me with all of the information on this form,

(b) the firm makes the certification above, and

(c) the firm has obtained the individual's consent

• for the regulator or, in Québec, the securities regulatory authority in each jurisdiction where this form is submitted to enter the residence for the administration of securities legislation and derivatives legislation, including commodity futures legislation; and

• where applicable, for the SRO to enter the residence for the administration of the rules of the SRO, where the individual is conducting business from the residence.

Non-NRD format:

By signing below, I make the certification above.

Name of firm ______________________________

Name of authorized signing officer or partner ____________________

Title of authorized signing officer or partner ____________________

Signature of authorized signing officer or partner ____________________

Date signed ____________________

(YYYY/MM/DD)

(b) by repealing Item 4,

(c) by repealing Item 5,

(d) by repealing Item 6, and

(e) by repealing Schedule A.

15. Form 33-506F4 Registration of Individuals and Review of Permitted Individuals (section 2.2)is amended

(a) by adding the following text between the title "Form 33-506F4Registration of Individuals and Review of Permitted Individuals (section 2.2)" and "GENERAL INSTRUCTIONS":

WARNING -- It is an offence under securities legislation and derivatives legislation, including commodity futures legislation, to knowingly give false or misleading information to the regulator or securities regulatory authority.

CERTIFICATION

Individual

I certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where I am submitting this form and to any applicable self-regulatory organization (SRO) that

• I have read this form and understand all matters within this form, including the questions,

• I have discussed this form with an officer, partner, branch manager or supervisor of my sponsoring firm and that to the best of my knowledge, the officer, partner, branch manager or supervisor is satisfied that I understand all matters within this form, including the questions,

• to the best of my knowledge and after reasonable inquiry, all of the information provided on this form is true and complete,

• if applicable, I will limit my activities to those allowed by my category of registration and any SRO approval, and

• if the business location specified in this form is a residence, I hereby give my consent

• for the regulator or, in Québec, the securities regulatory authority in each jurisdiction where I am submitting this form to enter that residence for the administration of securities legislation and derivatives legislation, including commodity futures legislation, and

• where applicable, for the SRO to enter that residence for the administration of the rules of the SRO.

Firm

I certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where the firm is submitting this form and to any applicable SRO that

• the individual identified in this form will be engaged by the sponsoring firm as a registered individual or a permitted individual, and

• I have, or a branch manager, supervisor, officer or partner has, discussed this form with the individual. To the best of my knowledge, the individual understands all matters within this form, including the questions.

NRD format:

[ ] I am making this submission under authority delegated by the firm and the individual identified in this form. By checking this box, I certify that

(a) the firm provided me with all of the information on this form and makes the firm certification above, and

(b) the individual provided the firm with all of the information on this form and makes the individual certification above.

Non-NRD format:

Individual

By signing below, I make the above individual certification.

Signature of individual ____________________

Date signed ____________________

(YYYY/MM/DD)

Firm

By signing below, I make the firm certification above.

Name of firm ______________________________

Name of authorized signing officr or partner ____________________

Title of authorized signing officer or partner ____________________

Signature of authorized signing officer or partner ____________________

Date signed ____________________

(YYYY/MM/DD)

(b) in Item 5, by replacing the portion of the form in section 2 with the following:

2. Check each jurisdiction where you are seeking registration or, if you are seeking review as a permitted individual, check each jurisdiction where your sponsoring firm is registered:

[ ] All jurisdictions

[ ] Alberta

[ ] British Columbia

[ ] Manitoba

[ ] New Brunswick

[ ] Newfoundland and Labrador

[ ] Northwest Territories

[ ] Nova Scotia

[ ] Nunavut

[ ] Ontario

[ ] Prince Edward Island

[ ] Québec

[ ] Saskatchewan

[ ] Yukon,

(c) in Item 8, by replacing the portion of the form after the subheading "1. Course, examination or designation information and other education" and before the subheading "2. Student numbers" with the following:

Complete Schedule E to state each course, examination and designation that

• is required for registration or approval, and

• you have successfully completed or, if you are an IIROC applicant, have been exempted from.

[ ] Check here if you are not required under securities legislation or derivatives legislation, or the rules of an SRO to satisfy any course, examination or designation requirements.,

(d) in Item 8, by deleting "industry" in the subheading "4. Relevant securities industry experience" and replacing the text between that subheading and "Item 9 Location of employment" with the following:

If you are an individual applying for IIROC approval, select "N/A".

Do you have relevant securities experience?

Yes [ ] No [ ] N/A [ ]

If "Yes", complete Schedule F.,

(e) by replacing Item 10 with the following:

Item 10 Reportable activities

1. Activities with your sponsoring firm

Instructions: Describe all of your roles and responsibilities with your sponsoring firm, whether these roles and responsibilities are securities related or not (e.g., sale of securities, review of marketing materials, IT helpdesk, negotiation of employment contracts, sales of banking and insurance products and services). Include any other information about your position with your sponsoring firm that is relevant for the regulator or, in Québec, the securities regulatory authority to know (e.g., if your role is specialized).

Complete a Schedule G with respect to your roles and responsibilities with your sponsoring firm.

2. Reportable outside activities

Instructions: Consider all of the activities that you participate in outside of your sponsoring firm, whether or not you receive compensation for such activities and whether or not any such activity is business related. If any of the categories below describes one or more activities that you participate in, complete a separate Schedule G for each activity or entity.

Category 1 -- Activities with another registered firm

Instructions: Report activities with registered firms, other than your sponsoring firm. All activities in this category are reportable, whether or not you receive compensation for such activities. Major shareholder means a shareholder who, in total, directly or indirectly owns voting securities carrying 10 percent or more of the votes carried by all outstanding voting securities.

If you are a director, officer, employee, contractor, consultant, agent, or service provider of a registered firm other than your sponsoring firm, or hold any other equivalent position with or for that registered firm, or are a major shareholder or partner of that registered firm, complete a separate Schedule G for the registered firm.

Category 2 -- Activities with an entity that receives compensation from a registered firm

If you are a director, officer, employee, contractor, consultant, or agent of a specified entity, or hold any other equivalent position with or for a specified entity, or are a shareholder or partner of a specified entity, complete a separate Schedule G for the specified entity.

For the purposes of this category, "specified entity" means an entity that receives compensation from a registered firm for activities that you provide for your sponsoring firm or another registered firm.

Category 3 -- Other securities related activities

Instructions: All activities in this category are reportable, whether or not you receive compensation for such activities.

If you have been at any time in the last 7 years directly involved in raising money for an entity through the issuance of securities or derivatives or promoting the sale of an entity's securities or derivatives outside of your activities with your sponsoring firm or another registered firm, complete a separate Schedule G for each entity for which you performed these activities.

Directors and officers of reporting issuers and of entities that have been at any time in the last 7 years raising money through the issuance of securities or derivatives are considered to be directly involved in raising money for that entity.

Category 4 -- Provision of financial or financial-related services

Instructions: All activities in this category are reportable, whether or not you receive compensation for such activities. Major shareholder means a shareholder who, in total, directly or indirectly owns voting securities carrying 10 percent or more of the votes carried by all outstanding voting securities.

Complete a separate Schedule G for each activity, as applicable, if you are

• an insurance broker or agent,

• providing loan or deposit products and services,

• carrying out a money service business,

• a mortgage broker, agent or administrator,

• preparing tax returns or providing tax advice,

• providing financial planning or financial advice, including estate planning,

• providing corporate finance services, including services provided in the capacity of a comptroller, treasurer and chief financial officer,

• advising on credit/debt restructuring,

• a pension consultant,

• providing advice on mergers and acquisitions services,

• providing accounting or bookkeeping services,

• providing oversight or independent review or expert opinion on the management of an entity's financial assets, or

• providing banking or insurance services.

Also complete a separate Schedule G for each activity, as applicable, if you are a director or officer, or hold any other equivalent position with or for, or are a major shareholder or active partner of, an entity that provides one or more of the services in the above list.

Category 5 -- Positions of influence

Instructions: All positions of influence (e.g., medical doctor, leader in a religious organization) are reportable, whether or not you receive compensation for such activities. For more information on positions of influence, see section 13.4.3 of National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations and section 13.4.3 of the Companion Policy to National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations.

Complete a separate Schedule G for each position of influence that you hold.

Category 6 -- Specified activities

Complete a separate Schedule G for activities not included in Categories 1 to 5 if the total time spent by you on specified activities exceeds, on average, 30 hours per month.

For this purpose, "specified activities" means all of the following:

• activities to which any of Categories 1 to 5 apply;

• activities for which you receive compensation or where you have a reasonable expectation of compensation;

• all other activities (whether or not you are compensated) for which you are a director or officer of, or hold an equivalent position with or for the entity, or are a partner or shareholder of the entity.,

(f) by replacing Item 12 with the following:

Item 12 Resignations and terminations

Instructions: Disclose any allegation that existed at the time of your termination or resignation, regardless of whether the allegation caused or contributed to your resignation or termination.

Have you ever resigned or been terminated from a position or contract when, at the time of your resignation or termination, there existed an allegation that you:

1. Contravened any statutes, regulations, orders of a court or regulatory body, rules or bylaws or failed to meet any standards of conduct of a sponsoring firm, of any industry association or of any authority exercising jurisdiction over specific business activities or professions?

Yes [ ] No [ ]

If "Yes", complete Schedule I, Item 12.1.

2. Failed to appropriately supervise compliance with any statutes, regulations, orders of a court or regulatory body, rules or bylaws or with standards of conduct of a sponsoring firm, of any industry association or of any authority exercising jurisdiction over specific business activities or professions?

Yes [ ] No [ ]

If "Yes", complete Schedule I, Item 12.2.

3. Committed a crime?

Yes [ ] No [ ]

If "Yes", complete Schedule I, Item 12.3.,

(g) in question 3(a) of Item 13, by adding ", doctor, mortgage broker or agent" after "teacher" and before ")",

(h) in question 3(c) of Item 13, by deleting "professional",

(i) in Item 14, by replacing the text between the heading "Item 14 Criminal disclosure" and before the sentence "You are not required to disclose:" with the following:

You must disclose all offences, including:

• a criminal offence under the laws of Canada such as the Criminal Code (Canada), the Income Tax Act (Canada), theCompetition Act (Canada), the Immigration and Refugee Protection Act (Canada) and theControlled Drugs and Substances Act (Canada), even if

• a record suspension has been ordered under the Criminal Records Act (Canada), or

• you have been granted an absolute or conditional discharge under the Criminal Code (Canada),

• a criminal offence under the laws of any foreign jurisdiction (such as U.S. federal and state criminal offences), and

• a criminal offence, with respect to questions 14.2 and 14.4,

• of which you or any entity when you were a partner, director, officer or major shareholder of that entity has been found guilty, or

• for which you or any entity when you were a partner, director, officer or major shareholder of that entity have participated in the alternative measures program, a diversion program, or any alternative resolution program within the previous three years, even if a record suspension has been ordered under the Criminal Records Act (Canada).,

(j) in question 3 of Item 14, by replacing "firm" with "entity",

(k) in question 4 of Item 14, by replacing "firm" with "entity",

(l) in Item 15, by replacing "a firm" with "an entity" wherever it appears,

(m) by replacing Item 16 with the following:

Item 16 Financial disclosure

By submitting this form you consent to the collection by the regulator of your financial personal information through the use of bankruptcy and insolvency records and other means (See Item 20 -- Collection and use of personal financial information).

1. Bankruptcies, insolvencies, consumer proposals and creditor arrangements

Instructions: You must provide the following information even if the event occurred more than 7 years ago.

The information is required to be reported even if you or the entity has been discharged or released from bankruptcy.

A proceeding, arrangement or compromise with creditors includes the appointment of a receiver, receiver-manager, administrator or trustee.

Under the laws of any jurisdiction, including any foreign jurisdiction, have any of the following events ever occurred to you or to any entity when you were a partner, director, officer or major shareholder of the entity:

a) a bankruptcy, a filing for bankruptcy or a proceeding governing an event similar to a bankruptcy?

Yes [ ] No [ ]

If "Yes", complete Schedule M, Item 16.1(a).

b) a proposal, including a consumer proposal, under any legislation relating to bankruptcy or insolvency or any similar proceeding?

Yes [ ] No [ ]

If "Yes", complete Schedule M, Item 16.1(b).

c) proceedings under any legislation relating to the winding up or dissolution of the entity, or under the Companies' Creditors Arrangement Act (Canada)?

Yes [ ] No [ ]

If "Yes", complete Schedule M, Item 16.1(c).

d) any proceedings, arrangement or compromise with creditors?

Yes [ ] No [ ]

If "Yes", complete Schedule M, Item 16.1(d).

2. Debt obligations

During the past 10 years

• have you failed to meet a financial obligation of $10,000 or more as it came due, or,

• to the best of your knowledge, has any entity, while you were a partner, director, officer or major shareholder of that entity, failed to meet any financial obligation of $10,000 or more as it came due?

Yes [ ] No [ ]

If "Yes", complete Schedule M, Item 16.2.

3. Surety bond or fidelity bond

Have you ever been refused for a surety or fidelity bond?

Yes [ ] No [ ]

If "Yes", complete Schedule M, Item 16.3.

4. Garnishments, unsatisfied judgments or directions to pay

Has any governmental authority or court, in any jurisdiction, ever issued any of the following against

• you regarding your indebtedness, or

• to the best of your knowledge, the indebtedness of an entity where you are or were a partner, director, officer or major shareholder:

Yes

No

 

Garnishment

[ ]

[ ]

 

Unsatisfied judgment

[ ]

[ ]

 

Direction to pay

[ ]

[ ]

If "Yes", complete Schedule M, Item 16.4.,

(n) by replacing Item 20 with the following:

Item 20 Collection and use of personal information

1. Notice of collection and use of personal information

Your personal information is collected by, or on behalf of, each securities regulatory authority and SRO set out in Schedule O. Any of the securities regulatory authorities or SROs set out in Schedule O may contact government or private bodies or agencies, individuals, corporations, employers, and other organizations, in Canada and in other countries, for information about you.

This personal information is being collected under the authority of the applicable securities legislation, derivatives legislation (including commodity futures legislation) or both of the securities regulatory authorities and pursuant to the SRO rules of an SRO set out in Schedule O. The collection, use and disclosure are done in accordance with applicable freedom of information and privacy legislation.

The principal purpose of this collection by the securities regulatory authorities is to administer, enforce, carry out their duties or exercise their powers under their respective securities legislation, derivatives legislation (including commodity futures legislation) or both, and by the SROs to administer and enforce the rules of the SROs.

The information submitted by you in this form with your consent, or collected indirectly with your authorization, may be collected

• at the time of your application,

• at any time during your registration or while you are a permitted individual, or

• at the time the regulator or, in Québec, the securities regulatory authority, or SRO is informed by your sponsoring firm that you no longer have authority to act on behalf of the sponsoring firm or are not a permitted individual of the sponsoring firm.

If you have any questions about the collection, use, and disclosure of this information, contact the securities regulatory authority or SRO in any jurisdiction in which the required information is submitted. See Schedule O for details.

Note that certain information such as your name(s) (including aliases, trade names or some past names), your sponsoring firm, and other relevant registration information will be listed in a publicly available registry of registered individuals and, if applicable, on the Disciplined List.

Also note that certain securities regulatory authorities may provide or receive information to or from certain entities under separate provisions of their securities legislation or derivatives legislation (including commodity futures legislation) or both, and SROs may provide or receive information under the rules of the SROs. This consent and notice does not limit the authority, powers, obligations, or rights conferred on any of the securities regulatory authorities by legislation or regulations in effect in their jurisdiction.

2. Consent to collect and use personal information

By submitting this form, you consent to and authorize the collection, directly and indirectly, of personal information by each securities regulatory authority and SRO and to the use of your personal information as set out above.

The personal information that each securities regulatory authority or SRO collects, includes the following:

• the personal information provided in this form;

• the personal information provided by your sponsoring firm;

• registration or financial services licensing information;

• law enforcement records, including police records;

• credit records;

• bankruptcy or other insolvency records;

• employment records and information received from an employer;

• records and information received from entities you had or have an independent contractor or agency relationship with;

• personal information available online;

• records from government ministries and agencies, SROs or authorities exercising jurisdiction over specific business activities or professions; and

• records of, and used in, court proceedings, including any probation records.,

(o) by repealing Item 21,

(p) by repealing Item 22,

(q) in Schedule C, by replacing the text between the subheading "Approval categories" and before the subheading "Additional approval categories" with the following:

[ ] Executive

[ ] Director (Industry)

[ ] Director (Non-Industry)

[ ] Supervisor

[ ] Investor

[ ] Registered Representative

[ ] Investment Representative

[ ] Portfolio Manager

[ ] Associate Portfolio Manager

[ ] Trader,

(r) in Schedule E, by adding the following text between the heading "Item 8.1 Course, examination or designation information and other education" and the table:

Below, state each course, examination and designation that

• is required for registration or approval, and

• you have successfully completed.

*For IIROC applicants only - If applicable, please indicate the date of any exemption granted for any course, examination, designation or other education required for approval.,

(s) in the table to Schedule E, by adding "*" at the end of "Date exempted" and by adding "*" at the end of "Regulator / securities regulatory authority granting the exemption",

(t) by replacing Item 8.4 in Schedule F with the following:

Item 8.4 Relevant securities experience

Instructions:

Some registration categories require a specified amount of experience be obtained within specified timeframes. Please see National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations for more information.

If you are applying to be an advising representative or an associate advising representative, provide details of the activities you performed for each experience that is relevant investment management experience. Such details may include the level of responsibility; value of accounts under direct supervision; number of years of experience in performing securities research and analysis for the purpose of portfolio securities selection, portfolio construction and analysis; number of years of experience collecting know-your-client information; or number of years of experience conducting suitability assessments.

1. If you are applying

• to be an advising representative or an associate advising representative of a portfolio manager, describe the relevant investment management experience that you have gained, or

• for any other position, describe the relevant securities industry experience that you have gained.

For each description of relevant experience, provide the following information:

(a) the name of the firm or entity with which you gained this experience;

(b) your title;

(c) the start and end dates of this experience;

(d) the details of the activities you performed that are relevant for the category of registration that you are applying for; and

(e) the percentage of your time in this position that was spent on activities relating to the experience.

______________________________

______________________________

______________________________

2. Indicate the continuing education activities in which you have participated during the last 36 months and that are relevant to the category of registration you are applying for:

______________________________

______________________________

______________________________

(u) by replacing Schedule G with the following:

Schedule G

Reportable activities (Item 10)

1. Start date ____________________

(YYYY/MM/DD)

2. Sponsoring firm or other entity information

[ ] Check here if the reportable activity is with your sponsoring firm.

If the reportable activity is with your sponsoring firm, you are not required to indicate the firm's name and address but are required to provide the name and title of your immediate supervisor. For all other types of reportable activity, enter all of the information below:

Name of business or employer: ______________________________

Address of business or employer: ____________________

(number, street, city, province, territory or state, country)

Name and title of your immediate supervisor: ____________________

3. Description of the reportable activity and your roles and responsibilities

Instructions: If you are completing this schedule in relation to your activities with your sponsoring firm, for (e) below, provide the title(s) you will use once registered, and if you are already registered, provide the title(s) you use as of the date of this filing.

(a) Describe the entity that you carry on the activity with or for, including the nature of the entity's business.

(b) Is the entity listed on an exchange?

(c) Describe your relationship with the entity.

(d) Describe all of your roles and responsibilities relating to the activity.

______________________________

(e) Provide all title(s) you use for the activity.

______________________________

4. Number of work hours per month

How many hours per month do you spend on this activity? ____________________

5. Conflicts of interest

Instructions: Complete this section if you have reportable activity outside your sponsoring firm. Do not complete this section if your reportable activity is solely with your sponsoring firm.

Take into consideration existing and reasonably foreseeable material conflicts of interest and existing and potential client confusion.

(a) Does the activity give rise to any material conflicts of interest between the client and the sponsoring firm or you? Does the activity give rise to client confusion? If no material conflicts of interest or client confusion are expected, explain why.

______________________________

______________________________

______________________________

(b) Describe (i) the material conflicts of interest, and (ii) how these conflicts will be addressed in the best interest of the client.

______________________________

(c) Describe (i) the client confusion, and (ii) how the client confusion will be addressed.

______________________________

______________________________

______________________________

(d) Does your sponsoring firm and the entity have procedures for identifying and addressing material conflicts of interest? If so, confirm you are complying with both sets of procedures.

______________________________

(e) State the name and title of the individual at your sponsoring firm who has reviewed and approved the activity.

______________________________

______________________________

______________________________

(v) in Schedule H, by deleting "If you are seeking registration in a category of registration that requires specific experience, include details of that experience. Examples include level of responsibility, value of accounts under direct supervision, number of years of that experience and research experience, and percentage of time spent on each activity.",

(w) by replacing Schedule I with the following:

Schedule I

Resignations and terminations (Item 12)

Item 12.1

For each allegation of violation of any statute, regulation, order of a court or regulatory body, rule or bylaw or failure to meet any standard of conduct of a sponsoring firm, of any industry association or of any authority exercising jurisdiction over specific business activities or professions, state below (1) the name of the firm from which you resigned or were terminated, (2) whether you resigned or were terminated, (3) the date you ceased to carry on duties, (4) the circumstances relating to your resignation or termination, (5) details of the allegation (regardless of whether the allegation caused or contributed to your resignation or termination), including the statutes, regulations, orders, rules or bylaws allegedly contravened or standards of conduct allegedly not met, (6) details of how the allegation was addressed, and (7) any details of the resignation, termination or allegation relevant to the determination of your suitability for registration or whether your registration is otherwise objectionable.

______________________________

Item 12.2

For each allegation of failure to supervise compliance with any statute, regulation, order, rule or bylaw or with any standard of conduct of a sponsoring firm, of any industry association or of any authority exercising jurisdiction over specific business activities or professions, state below, (1) the name of the firm from which you resigned or were terminated, (2) whether you resigned or were terminated, (3) the date you ceased to carry on duties, (4) the circumstances relating to your resignation or termination, (5) details of the allegation of failure to supervise (regardless of whether the allegation caused or contributed to your resignation or termination), (6) details of how the allegation was addressed, and (7) any details of the resignation, termination, or allegation relevant to the determination of your suitability for registration or whether your registration is otherwise objectionable.

______________________________

Item 12.3

For each allegation that you committed a crime, state below (1) the name of the firm from which you resigned or were terminated, (2) whether you resigned or were terminated, (3) the date you ceased to carry on duties, (4) the circumstances relating to your resignation or termination, (5) details of the allegation (regardless of whether the allegation caused or contributed to your resignation or termination), (6) details of how the allegation was addressed, and (7) any details of the resignation, termination, or allegation relevant to the determination of your suitability for registration or whether your registration is otherwise objectionable.

______________________________

(x) in Schedule J by replacing the portion of the form in part (c) after the heading "Item 13.2 SRO Regulation" with the following:

c) For each order or disciplinary proceeding, state below (1) the name of the firm, (2) the SRO that issued the order or that is, or was, conducting the proceeding, (3) the date any notice of proceeding was issued, (4) the date any order or settlement was made, (5) a summary of any notice, order or settlement, including any sanctions imposed, (6) whether you are or were a partner, director, officer or major shareholder of the firm and named individually in the order or disciplinary proceeding, and (7) any details of the order or disciplinary proceeding relevant to the determination of your suitability for registration or whether your registration is otherwise objectionable.

______________________________

(y) in Schedule J by replacing the portion of the form after the heading "Item 13.3 Non-securities regulation" with the following:

Item 13.3 Non-securities regulation

a) For each registration or licence, state below (1) the party who is, or was, registered or licensed, (2) if applicable, the employer or entity for whom you performed the registrable or licensable activity, (3) with which regulatory authority, or under what legislation, the party is, or was, registered or licensed, (4) the type or category of registration or licence, and (5) the period that the party held the registration or licence, and (6) the licence number.

______________________________

b) For each registration or licence refused, state below (1) the party that was refused registration or licensing, (2) if applicable, the employer or entity for whom you performed the registrable or licensable activity, (3) with which regulatory authority, or under what legislation, the registration or licence was refused, (4) the type or category of registration or licence refused, (5) the date of the refusal, and (6) the reasons for the refusal.

______________________________

c) For each order or disciplinary proceeding, indicate below (1) the party against whom the order was made or the proceeding taken, (2) the regulatory authority that made the order or that is, or was, conducting the proceeding, or under what legislation the order was made or the proceeding is being, or was conducted, (3) the date any notice of proceeding was issued, (4) the date any order or settlement was made, (5) a summary of any notice, order or settlement (including any sanctions imposed), (6) whether you are or were a partner, director, officer or major shareholder of the entity and named individually in the order or disciplinary proceeding and (7) any details of the order or disciplinary proceeding relevant to the determination of your suitability for registration or whether your registration is otherwise objectionable.

______________________________

(z) in Schedule K, by replacing "firm" with "entity" wherever it occurs,

(aa) in Schedule L, by replacing "a firm" with "an entity" wherever it occurs,

(bb) by replacing Schedule M with the following:

Schedule M

Financial disclosure (Item 16)

Item 16.1 Bankruptcies, insolvencies, consumer proposals and creditor arrangements

Instructions: Proposals includes consumer proposals.

(a) For each event, state below (1) the date of your bankruptcy, filing for bankruptcy or a proceeding governing an event similar to a bankruptcy, (2) the person or entity about whom this disclosure is being made, (3) any amounts currently owing, (4) the creditors, (5) the status of the matter, (6) a summary of any disposition or settlement, (7) date of discharge or release, if applicable, and (8) any details of the bankruptcy, filing for bankruptcy or similar proceeding relevant to the determination of your suitability for registration or whether your registration is otherwise objectionable.

______________________________

(b) For each event, state below (1) the date of the proposal, (2) the person or firm about whom this disclosure is being made, (3) any amounts currently owing, (4) the creditors, (5) the status of the matter, (6) a summary of any disposition or settlement, and (7) any details of the proposal relevant to the determination of your suitability for registration or whether your registration is otherwise objectionable.

______________________________

(c) For each event, state below (1) the date of the proceeding, (2) the person or entity about whom this disclosure is being made, (3) any amounts currently owing, (4) the creditors, (5) the status of the matter, (6) a summary of any disposition or settlement, and (7) any details of the proceeding relevant to the determination of your suitability for registration or whether your registration is otherwise objectionable.

______________________________

(d) For each proceeding, arrangement or compromise with creditors, state below (1) the date of proceeding, arrangement or compromise, (2) the person or entity about whom this disclosure is being made, (3) any amounts currently owing, (4) the creditors, (5) the status of the matter, (6) a summary of any disposition or settlement, and (7) any details of the proceeding, arrangement or compromise relevant to the determination of your suitability for registration or whether your registration is otherwise objectionable.

______________________________

Item 16.2 Debt obligation

For each event, state below (1) the person or entity that failed to meet its financial obligation, (2) the amount that was owing at the time the person or entity failed to meet its financial obligation, (3) the person or entity to whom the amount is, or was, owing, (4) any relevant dates (for example, when payments are due or when final payment was made), (5) any amounts currently owing, and (6) any details of the debt obligation relevant to the determination of your suitability for registration or whether your registration is otherwise objectionable, including why the obligation has not been met/satisfied.

______________________________

Item 16.3 Surety bond or fidelity bond

For each bond refused, state below (1) the name of the bonding company, (2) the address of the bonding company, (3) the date of the refusal, and (4) the reasons for the refusal.

______________________________

Item 16.4 Garnishments, unsatisfied judgments or directions to pay

For each garnishment, unsatisfied judgment or direction to pay regarding your indebtedness or the indebtedness of an entity where you are or were a partner, director, officer or major shareholder, indicate below (1) the amount that was owing at the time the garnishment, judgment or direction to pay was rendered, (2) the person or entity to whom the amount is, or was, owing, (3) any relevant dates (for example, when payments are due or when final payment was made), (4) why the indebtedness has not been met or satisfied, (5) the percentage of earnings to be garnished or the amount to be paid, (6) any amounts currently owing, and (7) any details of the garnishment, unsatisfied judgement or direction to pay relevant to the determination of your suitability for registration or whether your registration is otherwise objectionable.

______________________________

(cc) in Schedule N, by replacing the text between the sentence "b) State the market value (approximate, if necessary) of any subordinated debentures or bonds of the firm to be held by you or any other subordinated loan to be made by you to the firm:" and the sentence "f) Is a person other than you the beneficial owner of the shares, bonds, debentures, partnership units or notes held by you?" with the following:

c) If another person or entity has provided you with funds to invest in the firm, provide the name of the person or entity and state the relationship between you and that person or entity:

______________________________

d) Is the payment of the funds to be invested (or proposed to be invested) guaranteed directly or indirectly by any person or entity?

Yes [ ] No [ ]

If "Yes", provide the name of the person or entity and state the relationship between you and that person or entity:

______________________________

e) Have you directly or indirectly given up any rights relating to these securities or this partnership interest, or do you, when you are registered or approved as a result of the review of this form, intend to give up any of these rights (including by hypothecation, pledging or depositing as collateral the securities or partnership interest with any entity or person)?

Yes [ ] No [ ]

If "Yes", provide the name of the person or entity, state the relationship between you and that person or entity and describe the rights that have been or will be given up:

______________________________

(dd) in Schedule O, by replacing "Notice" in the title with "Consent and notice",

(ee) in Schedule O in the portion of the form under the contact information for British Columbia, by replacing "Freedom of Information Officer" with "Registration staff" and adding "E-mail: Registration@bcsc.bc.ca" at the end,

(ff) in Schedule O in the portion of the form under the contact information for Nova Scotia, by replacing "Deputy Director, Capital Markets" with "Registration",

(gg) in Schedule O in the portion of the form under the contact information for Yukon, by adding "Office of the Yukon" before "Superintendent of Securities" and replacing "(867) 667-5314" with "(867) 667-5466", and

(hh) in Schedule O in the portion of the form under the contact information for Northwest Territories, by deleting "Deputy" after "Attention:".

16. Form 33-506F5 Change of Registration Information (section 3.1 and 4.1)is amended

(a) by adding after the following text between the title "Form 33-506F5Change of Registration Information (section 3.1 and 4.1)" and before "GENERAL INSTRUCTIONS":

WARNING -- It is an offence under securities legislation and derivatives legislation, including commodity futures legislation, to knowingly give false or misleading information to the regulator or securities regulatory authority.

CERTIFICATION

1. Form 33-506F4: Use the following certification when making changes to Form 33-506F4

Individual

I certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where I am submitting this form and to any applicable self-regulatory organization (SRO) that

• I have read this form,

• I have read Form 33-506F4 and understand all matters within this form, including its questions,

• I have discussed Form 33-506F4 with an officer, partner, branch manager or supervisor of my sponsoring firm and that to the best of my knowledge, the officer, partner, branch manager or supervisor is satisfied that I understand all matters within Form 33-506F4, including the questions in Form 33-506F4,

• to the best of my knowledge and after reasonable inquiry, all of the information provided on this form is true, complete and accurate, including information required to be disclosed by Form 33-506F4 that I am not changing with this form,

• if applicable, I will limit my activities to those allowed by my category of registration and any SRO approval, and

• if the business location specified in this form is a residence, I hereby give my consent

• for the regulator or, in Québec, the securities regulatory authority in each jurisdiction where I am submitting this form to enter that residence for the administration of securities legislation and derivatives legislation, including commodity futures legislation, and

• where applicable, for the SRO to enter that residence for the administration of the rules of the SRO.

Firm

I certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where the firm is submitting this form and to any applicable SRO that

• the individual identified in this form will be engaged by the sponsoring firm as a registered individual or a permitted individual, and

• I have, or a branch manager, supervisor, officer or partner has, discussed this form with the individual. To the best of my knowledge, the individual understands all matters within this form, including the questions.

NRD format:

[ ] I am making this submission under authority delegated by the firm and the individual identified in this form. By checking this box, I certify that

(a) the firm provided me with all of the information on this form, and makes the firm certification above, and

(b) the individual provided the firm with all of the information on this form and makes the individual certification above.

Non-NRD format:

Individual

By signing below, I make the above individual certification.

Signature of individual ______________________________

Date signed ____________________

(YYYY/MM/DD)

Firm

By signing below, I make the firm certification above.

Name of firm ______________________________

Name of authorized signing officer or partner ____________________

Title of authorized signing officer or partner ____________________

Signature of authorized signing officer or partner ____________________

Date signed ____________________

(YYYY/MM/DD)

2. Form 33-506F6: Use the following certification when making changes to Form 33-506F6

By signing below, I certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where the firm is submitting this form and to any applicable SRO that

• I have read this form and understand all matters within this form, including the questions, and to the best of my knowledge and after reasonable inquiry, all of the information provided on this form is true and complete.

Name of firm ______________________________

Name of authorized signing officer or partner ____________________

Title of authorized signing officer or partner ____________________

Signature of authorized signing officer or partner ____________________

Date signed ____________________

(YYYY/MM/DD)

(b) by replacing Item 3 with the following:

Item 3 Collection and use of personal information

1. Notice of collection and use of personal information

Your personal information is collected by, or on behalf of, each securities regulatory authority and SRO set out in Schedule A. Any of the securities regulatory authorities or SROs set out in Schedule A may contact government or private bodies or agencies, individuals, corporations, employers, and other organizations, in Canada and in other countries, for information about you.

This personal information is being collected under the authority of the applicable securities legislation, derivatives legislation (including commodity futures legislation) or both of the securities regulatory authorities and pursuant to the SRO rules of an SRO set out in Schedule A. The collection, use and disclosure are done in accordance with applicable freedom of information and privacy legislation.

The principal purpose of this collection by the securities regulatory authorities is to administer, enforce, carry out their duties or exercise their powers under their respective securities legislation, derivatives legislation (including commodity futures legislation) or both, and by the SROs to administer and enforce the rules of the SROs.

The information submitted by you in this form with your consent, or collected indirectly with your authorization, may be collected

• at any time during your registration or while you are a permitted individual, or

• at the time the regulator or, in Québec, the securities regulatory authority, or SRO is informed by your sponsoring firm that you no longer have authority to act on behalf of the sponsoring firm or are not a permitted individual of the sponsoring firm.

If you have any questions about the collection, use, and disclosure of this information, contact the securities regulatory authorities or SRO in any jurisdiction in which the required information is submitted. See Schedule A for details.

Note that certain information such as your name(s) (including aliases, trade names or some past names), your sponsoring firm, and other relevant registration information will be listed in a publicly available registry of registered individuals and, if applicable, on the Disciplined List.

Also note that certain securities regulatory authorities may provide or receive information to or from certain entities under separate provisions of their securities legislation or derivatives legislation (including commodity futures legislation) or both, and SROs may provide or receive information under the rules of the SROs. This consent and notice does not limit the authority, powers, obligations or rights conferred on any of the securities regulatory authorities by legislation or regulations in effect in their jurisdiction.

2. Consent to collect and use personal information

By submitting this form, you consent to and authorize the collection, directly and indirectly, of personal information by each securities regulatory authority and SRO and to the use of your personal information as set out above.

The personal information that each securities regulatory authority or SRO collects, includes the following:

• the personal information provided in this form;

• the personal information provided by your sponsoring firm;

• registration or financial services licensing information;

• law enforcement records, including police records;

• credit records;

• bankruptcy or other insolvency records;

• employment records and information received from an employer;

• records and information received from entities you had or have an independent contractor or agency relationship with;

• personal information available online;

• records from government ministries and agencies, SROs or authorities exercising jurisdiction over specific business activities or professions; and

• records of, and used in, court proceedings, including any probation records.,

(c) by repealing Item 4,

(d) by repealing Item 5,

(e) in Schedule A, by replacing "Notice" in the title with "Consent and notice",

(f) in Schedule A in the portion of the form under the contact information for British Columbia, by replacing "Freedom of Information Officer" with "Registration staff" and adding "E-mail: Registration@bcsc.bc.ca" at the end,

(g) in Schedule A in the portion of the form under the contact information for Nova Scotia, by replacing "Deputy Director, Capital Markets" with "Registration",

(h) in Schedule A in the portion of the form under the contact information for Yukon, by adding "Office of the Yukon" before "Superintendent of Securities" and replacing "(867) 667-5314" with "(867) 667-5466", and

(i) in Schedule A in the portion of the form under the contact information for Northwest Territories, by deleting "Deputy" after "Attention:".

17. Form 33-506F6 Firm Registration is amended

(a) by replacing the text between "Contents of the form" and "You are also required to submit the following supporting documents with your completed form:" with the following:

This form consists of the following:

Certification

Part 1 -- Registration details

Part 2 -- Contact information

Part 3 -- Business history and structure

Part 4 -- Registration history

Part 5 -- Financial condition

Part 6 -- Client relationships

Part 7 -- Regulatory action

Part 8 -- Legal action

Part 9 -- [repealed]

Schedule A -- Contact information for consent and notice of collection and use of personal information

Schedule B -- Submission to jurisdiction and appointment of agent for service

Schedule C -- Form 31-103F1 Calculation of excess working capital,

(b) by replacing the last two paragraphs under the heading "How to complete and submit the form" with the following:

In most of this form, answers are required to questions that apply only to Canadian provinces and territories; you will find that the questions are referenced to "jurisdictions" or "jurisdiction of Canada". These refer to all provinces and territories of Canada. However, the questions in Part 4 -- Registration History and Part 7 -- Regulatory Action are to be answered in respect of any jurisdiction in the world.

It is an offence under securities legislation and derivatives legislation, including commodity futures legislation, to knowingly give false or misleading information to the regulator or securities regulatory authority.

(c) by replacing the text between "Collection and use of personal information" and "Part 1 -- Registration details" with the following:

In obtaining information about the firm, each securities regulatory authority and SRO set out in Appendix A may receive and collect personal information about individuals, if any, associated with the firm and its directors, officers, partners, employees, contractors and agents.

This may include the collection of

• the personal information provided in this form,

• registration or financial services licensing information,

• personal information available online,

• records from government ministries and agencies, SROs or authorities exercising jurisdiction over specific business activities or professions, or

• records of, and used in, court proceedings, including any probation records.

Any of the securities regulatory authorities or SROs set out in Schedule A may contact government or private bodies or agencies, individuals, corporations, employers, and other organizations, in Canada and in other countries, for information about the individual.

This personal information is being collected under the authority of the applicable securities legislation, derivatives legislation (including commodity futures legislation) or both of the securities regulatory authorities and pursuant to the SRO rules of an SRO set out in Schedule A. The collection, use and disclosure are done in accordance with applicable freedom of information and privacy legislation.

The principal purpose of this collection by the securities regulatory authorities is to administer, enforce, carry out their duties or exercise their powers under their respective securities legislation, derivatives legislation (including commodity futures legislation) or both, and for the SROs to administer and enforce the rules of the SROs.

The information may be collected

• at the time of the firm's application,

• at any time during the firm's registration, or

• at the time the regulator or, in Québec, the securities regulatory authority, or SRO is informed by the firm that it is surrendering its registration.

If you or anyone referred to in this form has any questions about the collection, use, and disclosure of this information, you or they can contact the regulator or, in Québec, the securities regulatory authority, or SRO in any jurisdiction in which the required information is submitted. See Schedule A for details.

Note that certain registration information about the firm and its registered individuals will be listed in a publicly available registry, including names used by the firm, the address of the firm's head office, whether the firm is on the Disciplined List, the jurisdictions and categories in which the firm is registered, and whether any terms and conditions have been imposed on the firm's registration, and the firm's registered individuals.

Also note that certain securities regulatory authorities may provide or receive information to or from certain entities under separate provisions of their securities legislation or derivatives legislation (including commodity futures legislation) or both, and SROs may provide or receive information under the rules of the SROs. This consent and notice does not limit the authority, powers, obligations, or rights conferred on any of the securities regulatory authorities by legislation or regulations in effect in their jurisdiction.

WARNING: It is an offence under securities legislation and derivatives legislation, including commodity futures legislation, to knowingly give false or misleading information to the regulator or securities regulatory authority.

CERTIFICATION

By signing this form, I

1. certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where the firm is submitting this form and to any applicable self-regulatory organization (SRO) that

• I have read this form,

• the firm has submitted and filed all information required to be submitted and filed under securities legislation and/or derivatives legislation in the principal jurisdiction of Canada where the firm is seeking registration, and

• to the best of my knowledge and after reasonable inquiry, all of the information provided on this form is true and complete,

2. authorize the principal regulator to give each non-principal regulator and, where applicable, SRO access to any information the firm has submitted or filed with the principal regulator under securities legislation or derivatives legislation or both in relation to the firm's registration in that jurisdiction,

3. acknowledge that the regulator or, in Québec, the securities regulatory authority, and SRO may collect and provide personal information about the individuals referred to in this form under Collection and Use of Personal Information, and

4. confirm that the individuals referred to in this form have been notified that their personal information is disclosed on this form, the legal reason for doing so, how it will be used and who to contact for more information.

Name of firm ______________________________

Name of authorized signing officer or partner ____________________

Title of authorized signing officer or partner ____________________

Signature of authorized signing officer or partner ____________________

Date signed ____________________,

(YYYY/MM/DD)

(d) in item 2.4, by replacing "a completed Schedule B" with "an executed Schedule B",

(e) by replacing item 3.10 with the following:

3.10 Permitted Individuals

List all permitted individuals of the firm.

State why the individual is considered a permitted individual (e.g., director, partner, officer, shareholder, or a permitted individual as described in paragraph (c) of the definition of "permitted individual" in section 1.1 of Ontario Securities Commission Rule 33-506 (Commodity Futures Act) Registration Information).

Name

Type of Permitted Individual

NRD number, if applicable

 

______________

______________

______________

 

______________

______________

______________

 

______________

______________

______________

 

______________

______________

______________

 

______________

______________

______________

(f) by replacing item 3.12 with the following:

3.12 Ownership chart

Attach a chart showing the firm's structure and ownership. Include all parents, specified affiliates and specified subsidiaries. Indicate which of the parents, specified affiliates and specified subsidiaries are registered under securities legislation in any jurisdiction of Canada and provide their NRD number.

Include the name of the person or company, and class, type, amount and percentage ownership of the firm's voting securities.,

(g) in item 4.6, by replacing the table after the sentence "If yes, provide the following information for each registration or licence:" with the following:

Name of entity

 

Type of licence or registration

 

Licence number

 

Regulator/organization

 

Date of registration (yyyy/mm/dd)

Expiry date, if applicable (yyyy/mm/dd)

 

Jurisdiction

(h) in item 5.13(b), by replacing "an interim financial report" with "interim financial information (as set out in subsection 12.11 of NI 31-103)",

(i) by repealing Part 9,

(j) in Schedule A in the portion of the form under the contact information for British Columbia, by replacing "Freedom of Information Officer" with "Registration staff" and adding "E-mail: Registration@bcsc.bc.ca" at the end,

(k) in Schedule A in the portion of the form under the contact information for Nova Scotia, by replacing "Deputy Director, Capital Markets" with "Registration",

(l) in Schedule A in the portion of the form under the contact information for Yukon, by adding "Office of the Yukon" before "Superintendent of Securities" and replacing "(867) 667-5314" with "(867) 667-5466",

(m) in Schedule A in the portion of the form under the contact information for Northwest Territories, by deleting "Deputy" after "Attention:",

(n) in Schedule B, by replacing the portion of the Form in point 7 with the following:

7. Until six years after the Firm ceases to be registered, the Firm must file a new executed Submission to jurisdiction and appointment of agent for service in this form

a. no later than the 15th day after the date this Submission to jurisdiction and appointment of agent for service is terminated, and

b. no later than the 15th day after any change in the name or address of the Agent for Service., and

(o) in Schedule C, by replacing "CICA Handbook" with "CPA Canada Handbook".

18. Form 33-506F7 Reinstatement of Registered Individuals and Permitted Individuals (sections 2.3 and 2.5(2))is amended

(a) by adding the following text between the title "Form 33-506F7Reinstatement of Registered Individuals and Permitted Individuals (sections 2.3 and 2.5(2))" and "GENERAL INSTRUCTIONS":

WARNING -- It is an offence under securities legislation and derivatives legislation, including commodity futures legislation, to knowingly give false or misleading information to the regulator or securities regulatory authority.

CERTIFICATION

Individual

I certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where I am submitting this form and to any applicable self-regulatory organization (SRO) that

• I have read this form and understand all matters within this form, including the questions,

• I have discussed this form with an officer, partner, branch manager or supervisor of my sponsoring firm and that to the best of my knowledge, the officer, partner, branch manager or supervisor is satisfied that I understand all matters within this form, including the questions,

• to the best of my knowledge and after reasonable inquiry, all of the information provided on this form is true and complete,

• if applicable, I will limit my activities to those allowed by my category of registration and any SRO approval,

• the new sponsoring firm understands that if the individual's reinstatement of registration was subject to any terms and conditions that were unsatisfied when the individual left the individual's former sponsoring firm, those terms and conditions remain in effect and the new sponsoring firm agrees to assume any ongoing obligations that apply to the sponsoring firm in respect of the individual under those terms and conditions, and

• if the business location specified in this form is a residence, I hereby give my consent

• for the regulator or, in Québec, the securities regulatory authority in each jurisdiction where I am submitting this form to enter that residence for the administration of securities legislation and derivatives legislation, including commodity futures legislation, and

• where applicable, for the SRO to enter that residence for the administration of the rules of the SRO.

Firm

I certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where the firm is submitting this form and to any applicable SRO that

• the individual identified in this form will be engaged by the new sponsoring firm as a registered individual or a permitted individual,

• I have, or a branch manager, supervisor, officer or partner has, discussed this form with the individual. To the best of my knowledge, the individual understands all matters within this form, including the questions, and

• the new sponsoring firm understands that if the individual's reinstatement of registration was subject to any undischarged terms and conditions when the individual left their former sponsoring firm, those terms and conditions remain in effect, and agrees to assume any ongoing obligations that apply to the sponsoring firm in respect of the individual under those terms and conditions.

NRD format:

[ ] I am making this submission under authority delegated by the firm and the individual identified in this form. By checking this box, I certify that

(a) the firm provided me with all of the information on this form and makes the firm certification above, and

(b) the individual provided the firm with all of the information on this form and makes the individual certification above.

Non-NRD format:

Individual

By signing below, I make the above individual certification.

Signature of individual ______________________________

Date signed ____________________

(YYYY/MM/DD)

Firm

By signing below, I make the firm certification above.

Name of firm ______________________________

Name of authorized signing officer or partner ____________________

Title of authorized signing officer or partner ____________________

Signature of authorized signing officer or partner ____________________

Date signed ____________________,

(YYYY/MM/DD)

(b) by replacing the General Instructions with the following:

GENERAL INSTRUCTIONS

Complete and submit this form to the relevant regulator(s) or, in Québec, the securities regulatory authority, or self-regulatory organization (SRO) if

• an individual has left a sponsoring firm and is seeking to reinstate their registration in one or more of the same categories or reinstate their same status of permitted individual as before with a sponsoring firm, and

• the new sponsoring firm is registered in the same category of registration in which the individual's former sponsoring firm was registered.

You only need to complete and submit one form regardless of the number of registration categories or permitted individual statuses you are seeking to be reinstated in.

An individual may reinstate the individual's registration or permitted individual status by submitting this form. This form must not be used unless all of the following apply:

1. this form is submitted on or before the 90th day after the cessation date of the individual's employment, partnership or agency relationship with the individual's former sponsoring firm;

2. the information in the individual's Form 33-506F4 was up-to-date as of the cessation date of the individual's employment, partnership or agency relationship with the individual's former sponsoring firm;

3. there have been no changes to the information previously submitted in respect of

• Item 13 (Regulatory Disclosure), other than changes to Item 13.3(a),

• Item 14 (Criminal Disclosure),

• Item 15 (Civil Disclosure), and

• Item 16 (Financial Disclosure)

of the individual's Form 33-506F4 since the individual left their former sponsoring firm;

4. at the time of resignation or termination with the individual's former sponsoring firm, there were no allegations against the individual, in Canada or in any foreign jurisdiction, relevant to an assessment whether the individual is not suitable for reinstatement of registration or the proposed reinstatement of registration is objectionable, including, for greater certainty, an allegation against the individual of any of the following:

• a crime,

• a contravention of any statute, regulation, or order of a court or regulatory body,

• a contravention of any rule or bylaw of an SRO, of an authority exercising jurisdiction of specific business activities or professions, or of a similar organization, or

• a failure to meet any standard of conduct of the sponsoring firm, of any industry association or of any authority exercising jurisdiction over specific business activities or professions.

If you do not meet all of the above conditions, then you must apply for reinstatement by completing on NRD a Form 33-506F4 by making the NRD submission entitled "Reactivation of Registration".,

(c) in Item 2, by replacing the portion of the Form in section 2 with the following:

2. Check each province or territory in which you are seeking reinstatement of registration or, if you are seeking reinstatement as a permitted individual, check each province or territory where your sponsoring firm is registered:

[ ] All jurisdictions

[ ] Alberta

[ ] British Columbia

[ ] Manitoba

[ ] New Brunswick

[ ] Newfoundland and Labrador

[ ] Northwest Territories

[ ] Nova Scotia

[ ] Nunavut

[ ] Ontario

[ ] Prince Edward Island

[ ] Québec

[ ] Saskatchewan

[ ] Yukon,

(d) by replacing Item 7 with the following:

Item 7 Reportable activities

Name of your new sponsoring firm: ______________________________

1. Activities with your sponsoring firm

Instructions: Describe all of your roles and responsibilities with your sponsoring firm, whether these roles and responsibilities are securities related or not (e.g., sale of securities, review of marketing materials, IT helpdesk, negotiation of employment contracts, sales of banking and insurance products and services). Include any other information about your position with your sponsoring firm that is relevant for the regulator or, in Québec, the securities regulatory authority to know (e.g., if your role is specialized).

Complete a Schedule D with respect to your roles and responsibilities with your sponsoring firm.

2. Reportable outside activities

Instructions: Consider all of the activities that you participate in outside of your sponsoring firm, whether or not you receive compensation for such activities and whether or not any such activity is business related. If any of the categories below describes one or more activities that you participate in, complete a separate Schedule D for each activity or entity.

Category 1 -- Activities with another registered firm

Instructions: Report activities with registered firms, other than your sponsoring firm. All activities in this category are reportable, whether or not you receive compensation for such activities. Major shareholder means a shareholder who, in total, directly or indirectly owns voting securities carrying 10 percent or more of the votes carried by all outstanding voting securities.

If you are a director, officer, employee, contractor, consultant, agent, or a service provider of a registered firm other than your sponsoring firm, or hold any other equivalent position with or for that registered firm, or are a major shareholder or partner of that registered firm, complete a separate Schedule D for the registered firm.

Category 2 -- Activities with an entity that receives compensation from a registered firm

If you are a director, officer, employee, contractor, consultant, or agent of a specified entity, or hold any other equivalent position with or for a specified entity, or are a shareholder or partner of a specified entity, complete a separate Schedule D for the specified entity.

For the purposes of this category, "specified entity" means an entity that receives compensation from a registered firm for activities that you provide for your sponsoring firm or another registered firm.

Category 3 -- Other securities related activities

Instructions: All activities in this category are reportable, whether or not you receive compensation for such activities.

If you have been at any time in the last 7 years directly involved in raising money for an entity through the issuance of securities or derivatives or promoting the sale of an entity's securities or derivatives outside of your activities with your sponsoring firm or another registered firm, complete a separate Schedule D for each entity for which you performed these activities.

Directors and officers of reporting issuers and of entities that have been at any time in the last 7 years raising money through the issuance of securities or derivatives are considered to be directly involved in raising money for that entity.

Category 4 -- Provision of financial or financial-related services

Instructions: All activities in this category are reportable, whether or not you receive compensation for such activities. Major shareholder means a shareholder who, in total, directly or indirectly owns voting securities carrying 10 percent or more of the votes carried by all outstanding voting securities.

Complete a separate Schedule D for each activity, as applicable, if you are

• an insurance broker or agent,

• providing loan or deposit products and services,

• carrying out a money service business,

• a mortgage broker, agent or administrator,

• preparing tax returns or providing tax advice,

• providing financial planning or financial advice, including estate planning,

• providing corporate finance services, including services provided in the capacity of a comptroller, treasurer and chief financial officer,

• advising on credit/debt restructuring,

• a pension consultant,

• providing advice on mergers and acquisitions services,

• providing accounting or bookkeeping services,

• providing oversight or independent review or expert opinion on the management of an entity's financial assets, or

• providing banking or insurance services.

Also complete a separate Schedule D for each activity, as applicable, if you are a director or officer, or hold any other equivalent position with or for, or are a major shareholder or active partner of, an entity that provides one or more of the services in the above list.

Category 5 -- Positions of influence

Instructions: All positions of influence (e.g., medical doctor, leader in a religious organization) are reportable, whether or not you receive compensation for such activities. For more information on positions of influence, see section 13.4.3 of National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations and section 13.4.3 of the Companion Policy to National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations.

Complete a separate Schedule D for each position of influence that you hold.

Category 6 -- Specified activities

Complete a separate Schedule D for activities not included in Categories 1 to 5 if the total time spent by you on specified activities exceeds, on average, 30 hours per month.

For this purpose, "specified activities" means all of the following:

• activities to which any of Categories 1 to 5 apply;

• activities for which you receive compensation or where you have a reasonable expectation of compensation;

• all other activities (whether or not you are compensated) for which you are a director or officer of, or hold an equivalent position with or for the entity, or are a partner or shareholder of the entity.,

(e) in Item 9, by replacing section 2 with the following:

2. Check the box below -- I am eligible to file this Form 33-506F7, only if you satisfy all of the following conditions:

(a) the information in your Form 33-506F4 was up-to-date when you left your sponsoring firm;

(b) there are no changes to any of the disclosure items under Item 9.1 above;

(c) at the time of your resignation or termination, there was no allegation against you, in Canada or in any foreign jurisdiction, relevant to an assessment whether you are not suitable for reinstatement of registration or your proposed reinstatement of registration is objectionable, including, for greater certainty, an allegation against you of

• a crime,

• a contravention of any statute, regulation, or order of a court or regulatory body,

• a contravention of any rule or bylaw of an SRO, or an authority exercising jurisdiction over specific business activities or professions, or of a similar organization, or

• a failure to meet any standard of conduct of the sponsoring firm, of any industry association, or of any authority exercising jurisdiction over specific business activities or professions.

If you do not meet the above conditions for selecting the box 'I am eligible to file this Form 33-506F7', then you must apply for reinstatement by completing on NRD a Form 33-506F4 by making the NRD submission entitled "Reactivation of Registration". If you are submitting a Form 33-506F4 in a format other than NRD format you must complete the entire form.

[ ] I am eligible to file this Form 33-506F7.,

(f) by replacing Item 10 with the following:

Item 10 Submission to jurisdiction and collection and use of personal information

1. Submission to jurisdiction

By submitting this form, you agree to be subject to the securities legislation or derivatives legislation or both of each jurisdiction of Canada, and to the bylaws, regulations, rules, rulings and policies (collectively referred to as "rules" in this form) of the SROs to which you have submitted this form. This includes the jurisdiction of any tribunals or any proceedings that relate to your activities as a registrant or a partner, director or officer of a registrant under that securities legislation or derivatives legislation or both or as an approved person under SRO rules.

2. Notice of collection and use of personal information

Your personal information is collected by, or on behalf of, each securities regulatory authority and SRO set out in Schedule F. Any of the securities regulatory authorities or SROs set out in Schedule F may contact government or private bodies or agencies, individuals, corporations, employers, and other organizations, in Canada and in other countries, for information about you.

This personal information is being collected under the authority of the applicable securities legislation, derivatives legislation (including commodity futures legislation) or both of the securities regulatory authorities and pursuant to the SRO rules of an SRO set out in Schedule F. The collection, use and disclosure are done in accordance with applicable freedom of information and privacy legislation.

The principal purpose of this collection by the securities regulatory authorities is to administer, enforce, carry out their duties or exercise their powers under their respective securities legislation, derivatives legislation (including commodity futures legislation) or both, and by the SROs to administer and enforce the rules of the SROs.

The information submitted by you in this form with your consent, or collected indirectly with your authorization, may be collected

• at the time of your application,

• at any time during your registration or while you are a permitted individual, or

• at the time the regulator or, in Québec, the securities regulatory authority, or SRO is informed by your sponsoring firm that you no longer have authority to act on behalf of the sponsoring firm or are no longer a permitted individual of the sponsoring firm.

If you have any questions about the collection, use, and disclosure of this information, contact the securities regulatory authority or SRO in any jurisdiction in which the required information is submitted. See Schedule F for details.

Note that certain information such as your name(s) (including aliases, trade names or some past names), your sponsoring firm, and other relevant registration information will be listed in a publicly available registry of registered individuals and, if applicable, on the Disciplined List.

Also note that certain securities regulatory authorities may provide or receive information to or from certain entities under separate provisions of their securities legislation or derivatives legislation (including commodity futures legislation) or both, and SROs may provide or receive information under the rules of the SROs. This consent and notice does not limit the authority, powers, obligations or rights conferred on any of the securities regulatory authorities by legislation or regulations in effect in their jurisdiction.

3. Consent to collect and use personal information

By submitting this form, you consent to and authorize the collection, directly and indirectly, of personal information by each securities regulatory authority and SRO and to the use of your personal information as set out above.

The personal information that each securities regulatory authority or SRO collects, includes the following:

• the personal information provided in this form;

• the personal information provided by your sponsoring firm;

• registration or financial services licensing information;

• law enforcement records, including police records;

• credit records;

• bankruptcy or other insolvency records;

• employment records and information received from an employer;

• records and information received from entities you had or have an independent contractor or agency relationship with;

• personal information available online;

• records from government ministries and agencies, SROs or authorities exercising jurisdiction over specific business activities or professions; and

• records of, and used in, court proceedings, including any probation records.,

(g) by repealing Item 11,

(h) by repealing Item 12,

(i) in Schedule B, by replacing the portion of the form after the subheading "Approval categories" and before the subheading "Additional approval categories" with the following:

[ ] Executive

[ ] Director (Industry)

[ ] Director (Non-Industry)

[ ] Supervisor

[ ] Investor

[ ] Registered Representative

[ ] Investment Representative

[ ] Portfolio Manager

[ ] Associate Portfolio Manager

[ ] Trader,

(j) by replacing Schedule D with the following:

Schedule D

Reportable activities (Item 7)

1. Start date ____________________

(YYYY/MM/DD)

2. Sponsoring firm or other entity information

[ ] Check here if the reportable activity is with your sponsoring firm.

If the reportable activity is with your sponsoring firm, you are not required to indicate the firm's name and address but are required to provide the name and title of your immediate supervisor. For all other types of reportable activity, enter all of the information below:

Name of business or employer: ______________________________

Address of business or employer: ____________________

(number, street, city, province, territory or state, country)

Name and title of your immediate supervisor: ____________________

3. Description of the reportable activity and your roles and responsibilities

Instructions: If you are completing this schedule in relation to your activities with your sponsoring firm, for (e) below, provide the title(s) you will use once registered, and if you are already registered, provide the title(s) you use as of the date of this filing.

(a) Describe the entity that you carry on the activity with or for, including the nature of the entity's business.

(b) Is the entity listed on an exchange?

(c) Describe your relationship with the entity.

(d) Describe all of your roles and responsibilities relating to the activity.

______________________________

(e) Provide all title(s) you use for the activity.

______________________________

4. Number of work hours per month

How many hours per month do you spend on this activity? _____________

5. Conflicts of interest

Instructions: Complete this section if you have reportable activity outside your sponsoring firm. Do not complete this section if your reportable activity is solely with your sponsoring firm.

Take into consideration existing and reasonably foreseeable material conflicts of interest and existing and potential client confusion.

(a) Does the activity give rise to any material conflicts of interest between the client and the sponsoring firm or you? Does the activity give rise to client confusion? If no material conflicts of interest or client confusion are expected, explain why.

______________________________

______________________________

______________________________

(b) Describe (i) the material conflicts of interest, and (ii) how these conflicts will be addressed in the best interest of the client.

______________________________

(c) Describe (i) the client confusion, and (ii) how the client confusion will be addressed.

______________________________

______________________________

______________________________

(d) Does your sponsoring firm and the entity have procedures for identifying and addressing material conflicts of interest? If so, confirm you are complying with both sets of procedures.

______________________________

(e) State the name and title of the individual at your sponsoring firm who has reviewed and approved the activity.

______________________________

______________________________

______________________________

(k) in Schedule E, by replacing the text between the sentence "b) State the market value (approximate, if necessary) of any subordinated debentures or bonds of the firm to be held by you or any other subordinated loan to be made by you to the firm:" and the sentence "f) Is a person other than you the beneficial owner of the shares, bonds, debentures, partnership units or notes held by you?" with the following:

c) If another person or entity has provided you with funds to invest in the firm, provide the name of the person or entity and state the relationship between you and that person or entity:

______________________________

d) Is the payment of the funds to be invested (or proposed to be invested) guaranteed directly or indirectly by any person or entity?

Yes [ ] No [ ]

If "Yes", provide the name of the person or entity and state the relationship between you and that person or entity:

______________________________

e) Have you directly or indirectly given up any rights relating to these securities or this partnership interest, or do you, when you are registered or approved as a result of the review of this form, intend to give up any of these rights (including by hypothecation, pledging or depositing as collateral the securities or partnership interest with any entity or person)?

Yes [ ] No [ ]

If "Yes", provide the name of the person or entity, state the relationship between you and that person or entity and describe the rights that have been or will be given up:

______________________________

(l) in Schedule F, by replacing "Notice" in the title with "Consent and notice",

(m) in Schedule F in the portion of the form under the contact information for British Columbia, by replacing "Freedom of Information Officer" with "Registration staff" and adding "E-mail: Registration@bcsc.bc.ca" at the end,

(n) in Schedule F in the portion of the form under the contact information for Nova Scotia, by replacing "Deputy Director, Capital Markets" with "Registration",

(o) in Schedule F in the portion of the form under the contact information for Yukon, by adding "Office of the Yukon" before "Superintendent of Securities" and replacing "(867) 667-5314" with "(867) 667-5466", and

(p) in Schedule F in the portion of the form under the contact information for Northwest Territories, by deleting "Deputy" after "Attention:".

19. This Instrument comes into force on •.

 

Schedule 2

SCHEDULE 2

BLACKLINE OF ONTARIO SECURITIES COMMISSION RULE 33-506 (COMMODITY FUTURES ACT) REGISTRATION INFORMATION

TABLE OF CONTENTS

PART TITLE

 

PART 1 DEFINITIONS AND INTERPRETATION

1.1

Definitions

1.2

Interpretation

 

PART 2 APPLICATION FOR REGISTRATION AND REVIEW OF PERMITTED INDIVIDUALS

2.1

Dealer and adviser registration

2.2

Individual applicants

2.3

Reinstatement

2.4

Permitted individuals

2.5

Securities Act registrants

 

PART 3 CHANGES TO REGISTERED FIRM INFORMATION

3.1

Changes to Form 33-506F6 information

3.2

Changes to business locations

3.3

Changes to other registration information

 

PART 4 CHANGES TO REGISTERED INDIVIDUAL AND PERMITTED INDIVIDUAL INFORMATION

4.1

Changes to Form 33-506F4 information

4.2

[Repealed]

4.3

Termination <<Cessation>> of employment, etc.

 

PART 5 DUE DILIGENCE AND RECORD-KEEPING

5.1

Sponsoring firm obligations

 

PART 6 [LAPSED]

 

PART 7 EXEMPTION

7.1

Exemption

 

PART 8 EFFECTIVE DATE

8.1

[Lapsed]

8.2

Effective Date

 

FORM 33-506F1 NOTICE OF TERMINATION OF REGISTERED INDIVIDUALS<<END OF INDIVIDUAL REGISTRATION OR PERMITTED INDIVIDUAL STATUS>> AND PERMITTED INDIVIDUALS

FORM 33-506F2 CHANGE OR SURRENDER OF INDIVIDUAL CATEGORIES

FORM 33-506F3 BUSINESS LOCATIONS OTHER THAN HEAD OFFICE

FORM 33-506F4 REGISTRATION OF INDIVIDUALS AND REVIEW OF PERMITTED INDIVIDUALS

FORM 33-506F5 CHANGE OF REGISTRATION INFORMATION

FORM 33-506F6 FIRM REGISTRATION

FORM 33-506F7 REINSTATEMENT OF REGISTERED INDIVIDUALS AND PERMITTED INDIVIDUALS

 

ONTARIO SECURITIES COMMISSION RULE 33-506 (Commodity Futures Act) Registration Information

PART 1 DEFINITIONS AND INTERPRETATION

1.1 Definitions -- In this Rule

"business location" means a location where the firm carries out an activity that requires registration, and includes a residence if regular and ongoing activity that requires registration is carried out from the residence or if records relating to an activity that requires registration are kept at the residence;

"cessation date" means the last day on which an individual had authority to act as a registered individual on behalf of their sponsoring firm or was a permitted individual of their sponsoring firm, because of the end of, or a change in, the individual's employment, partnership, or agency relationship with the firm;

"designated rating organization" has the same meaning as in National Instrument 44-101 Short Form Prospectus Distributions;

"DRO affiliate" has the same meaning as in National Instrument 25-101 Designated Rating Organizations;

"firm" means a person or company that is registered, or is seeking registration, as a dealer, adviser or investment fund manager;

"Form 33-506F1" means Form 33-506F1 Notice of Termination of Registered Individuals and Permitted Individuals;

"Form 33-506F1" means Form 33-506F1 Notice of End of Individual Registration or Permitted Individual Status;

"Form 33-506F2" means Form 33-506F2 Change or Surrender of Individual Categories;

"Form 33-506F3" means Form 33-506F3 Business Locations other than Head Office;

"Form 33-506F4" means Form 33-506F4 Registration of Individuals and Review of Permitted Individuals;

"Form 33-506F5" means Form 33-506F5Change of Registration Information;

"Form 33-506F6" means Form 33-506F6Firm Registration;

"Form 33-506F7" means Form 33-506F7 Reinstatement of Registered Individuals and Permitted Individuals;

"former sponsoring firm" means the registered firm for which an individual most recently acted as a registered individual or permitted individual;

"NRD submission number" means the unique number generated by NRD to identify each NRD submission;

"permitted individual" means

(a) a director, chief executive officer, chief financial officer, or chief operating officer of a firm, or a functional equivalent of any of those positions, or

(b) an individual who has beneficial ownership of, or direct or indirect control or direction over, 10 percent or more of the voting securities of a firm; or

(c) a trustee, executor, administrator, or other personal or legal representative, that has direct or indirect control or direction over 10 percent or more of the voting securities of a firm;

"registered firm" means a person or company that is registered as a dealer or adviser;

"registered individual" means an individual who is registered to trade or advise on behalf of a registered firm;

"sponsoring firm" means,

(a) for a registered individual, the registered firm on whose behalf the individual trades or advises,

(b) for an individual applying for registration, the firm on whose behalf the individual proposes to trade or advise,

(c) for a permitted individual of a registered firm, the registered firm, or

(d) for a permitted individual of a firm that is applying for registration, the applicant firm.

"successor credit rating organization" has the same meaning as in National Instrument 44-101 Short Form Prospectus Distributions;

1.2 Interpretation -- Terms defined in Ontario Securities Commission Rule 31-509 National Registration Database (Commodity Futures Act) and used in this Rule have the respective meanings ascribed to those terms in Ontario Securities Commission Rule 31-509 National Registration Database (Commodity Futures Act).

PART 2 APPLICATION FOR REGISTRATION AND REVIEW OF PERMITTED INDIVIDUALS

2.1 Dealer and Adviser Registration -- Except as provided in subsection 2.5(1), an applicant for registration as a dealer or adviser must submit to the Director,

(a) in paper format, a completed Form 33-506F6, excluding questions 1.4(a), 2.6 and 6.2; and

(a) electronically in accordance with Ontario Securities Commission Rule 11-501 Electronic Delivery of Documents to the Ontario Securities Commission, a completed Form 33-506F6, excluding questions 1.4(a), 2.6 and 6.2, and

(b) in accordance with Ontario Securities Commission Rule 31-509 National Registration Database (Commodity Futures Act), a completed Form 33-506F3 for each business location of the applicant, other than the applicant's head office.

2.2 Individual Applicants

(1) An individual who applies for registration under securities legislation must make the application by submitting to the regulator in accordance with Ontario Securities Commission Rule 31-509 National Registration Database (Commodity Futures Act) a completed Form 33-506F4.

(2) Despite subsection (1), a permitted individual of a registered firm who applies to become a registered individual with the firm must make the application by submitting to the regulator in accordance with Ontario Securities Commission Rule 31-509 National Registration Database (Commodity Futures Act) a completed Form 33-506F2.

2.3 Reinstatement

(1) An individual who applies for reinstatement of registration must submit a completed Form 33-506F4 to the Director in accordance with Ontario Securities Commission Rule 31-509 National Registration Database (Commodity Futures Act), unless the individual submits a completed Form 33-506F7 in accordance with subsection (2).

(2) An individual who applies for reinstatement of registration must submit a completed Form 33-506F7 to the Director in accordance with Ontario Securities Commission Rule 31-509 National Registration Database (Commodity Futures Act), if all of the following apply:

(a) the Form 33-506F7 is submitted in on or before the 90th day after the cessation date;

(b) the individual's employment, partnership or agency relationship with the former sponsoring firm did not end because the individual was asked by the firm to resign, resigned voluntarily, or was dismissed, following an allegation against the individual of any of the following:

(i) criminal activity;

(ii) a breach of securities legislation;

(iii) a breach of a rule of an SRO;

(b) in the case of the individual resigning or the individual's relationship with the sponsoring firm being terminated, at the time of the resignation or termination there was no allegation against the individual, in Canada or in any foreign jurisdiction, relevant to an assessment whether the individual is not suitable for reinstatement of registration or the proposed reinstatement of registration is objectionable, including, for greater certainty, an allegation of any of the following:

(i) a crime;

(ii) a contravention of any statute, regulation, or order of a court or regulatory body;

(iii) a contravention of any rule or bylaw of an SRO, of an authority exercising jurisdiction over specific business activities or professions, or of a similar organization;

(iv) a failure to meet any standard of conduct of the sponsoring firm, of any industry association, or of any authority exercising jurisdiction over specific business activities or professions;

(b.1) on or before the cessation date, the individual notified, in accordance with section 4.1, the Director of any change to the information previously submitted in the individual's Form 33-506F4;

(c) after the cessation date there have been no changes to the information previously submitted in respect of any of the following items of the individual's Form 33-506F4:

(i) item 13 [Regulatory disclosure] (other than Item 13.3(a));

(ii) item 14 [Criminal disclosure];

(iii) item 15 [Civil disclosure];

(iv) item 16 [Financial disclosure];

(d) the individual is seeking reinstatement with a sponsoring firm in one or more of the same categories of registration in which the individual was registered on the cessation date;

(e) the new sponsoring firm is registered in the same category of registration in which the individual's former sponsoring firm was registered.

2.4 Permitted Individuals

(1) Subject to subsection (2), a permitted individual must submit to the Director in accordance with Ontario Securities Commission Rule 31-509 National Registration Database (Commodity Futures Act) a completed Form 33-506F4 within the later of

(a) 10 days after becoming a permitted individual; and

(b) the date the sponsoring firm applies for registration.

(2) An individual who has ceased to be a permitted individual of a former sponsoring firm may submit to the Director a completed Form 33-506F7 if all of the following apply:

(a) the Form 33-506F7 is submitted in accordance with Ontario Securities Commission Rule 31-509 National Registration Database (Commodity Futures Act)

(i) no more than 10 days after becoming a permitted individual of the new sponsoring firm, and

(ii) no more than 90 days after the cessation date;

(b) the individual holds the same permitted individual status that they held with the former sponsoring firm;

(c) the conditions described in paragraphs (b) and (c) of subsection 2.3(2) apply.

(c) the conditions described in paragraphs 2.3(2)(b), (b.1) and (c) are met.

2.5 Securities Act Registrants

(1) If an applicant for registration under section 2.1 is registered under the Securities Act, the applicant is not required to submit a completed Form 33-506F3 under subsection 2.1(b) for any business location of the applicant that is recorded on NRD.

(2) Despite subsection 2.2(1), if an individual applies to become a registered individual and is recorded on NRD with his or her sponsoring firm as registered under the Securities Act, the individual must make the application by submitting to the Director, in accordance with Ontario Securities Commission Rule 31-509 National Registration Database (Commodity Futures Act), a completed Form 33-506F2.

PART 3 CHANGES TO REGISTERED FIRM INFORMATION

3.1 Changes to Form 33-506F6 Information

(1) Subject to subsection (3), a registered firm must notify the regulator of a change to any information previously submitted in Form 33-506F6 or under this subsection, as follows:

(a) for a change previously submitted in relation to part 3 of the Form 33-506F6, within 30 days of the change;

(b) for a change previously submitted in relation to any other part of the Form 33-506F6, within 10 days of the change.

(1) In this section, "authorized affiliate" means, in respect of a registered firm, another registered firm that

(a) is an affiliate of the registered firm,

(b) has the same principal regulator as the registered firm.

(1.1) Subject to subsection (3), a registered firm must notify the Director of a change to any information previously submitted in Form 33-506F6 or under this subsection, as follows:

(a) for a change to information previously submitted in relation to any of the following parts or items of Form 33-506F6, within 30 days of the change:

(i) part 3 [Business history and structure];

(ii) item 4.1 [Securities registration];

(iii) item 5.12 [Auditor];

(iv) item 6.1 [Client assets];

(v) item 6.2 [Conflicts of interest];

(b) for a change to information previously submitted in relation to any other part of the Form 33-506F6, within 15 days of the change.

(2) A notice of change referred to in subsection (1) must be made by submitting a completed Form 33-506F5.

(2.1) A registered firm may delegate to an authorized affiliate the duty to notify the Director under subsection (1.1) of a change to information previously submitted if all of the following apply:

(a) the change in information relates only to one or more of the following items or parts of Form 33-506F6:

(i) item 3.12 [Ownership chart];

(ii) item 4.1 [Securities registration];

(iii) item 4.3 [Membership of exchange or SRO];

(iv) item 4.5 [Refusal of registration, licensing or membership];

(v) item 4.6 [Registration for other financial products];

(vi) part 7 [Regulatory action];

(vii) part 8 [Legal action]

(b) the registered firm has filed a certificate, executed by the officer or partner authorized to certify and sign Form 33-506F5, with the Director, that confirms all of the following:

(i) the registered firm has delegated to the authorized affiliate the duty to notify the Director of a change to any information set out in paragraph (a), and

(ii) the full legal name and NRD number of the registered firm and the authorized affiliate, and

(iii) the following certification of the registered firm applies to each notice of change submitted by the authorized affiliate:

"I have read this form and understand all matters within this form, including the questions, and to the best of my knowledge and after reasonable inquiry, all of the information provided on this form is true and complete."

(c) the registered firm directs the authorized affiliate, in each notice of change submitted by the authorized affiliate, to include the full legal name and NRD number of the registered firm and to state the following:

"The registered firm has delegated to the authorized affiliate the duty to notify the Director of a change to any of the following items or parts of Form 33-109F6:

(i) item 3.12 [Ownership chart];

(ii) item 4.1 [Securities registration];

(iii) item 4.3 [Membership of exchange or SRO];

(iv) item 4.5 [Refusal of registration, licensing or membership];

(v) item 4.6 [Registration for other financial products];

(vi) part 7 [Regulatory action];

(vii) part 8 [Legal action]."

(3) A notice of change is not required under subsection (1) if the change relates to any of the following:

(a) a business location other than the head office of the firm if the firm submits a completed Form 33-506F3 under section 3.2;

(b) a terminationcessation, or a change, of a registered firm's employment, partnership or agency relationship with an officer, partner or director of the registered firm if the firm submits a completed Form 33-506F1 under subsection 4.3(1);

(c) the addition of an officer, partner, or director to the registered firm if that individual

(i) submits a completed Form 33-506F4 under subsection 2.2(1) or 2.5(1), or

(ii) submits a completed Form 33-506F7 under sections 2.3 or 2.5(2);

(d) The information in the supporting documents referred to in any of the following items of Form 33-506F6:

(i) item 3.3 [Business documents];

(ii) item 5.1 [Calculation of excess working capital];

(iii) item 5.7 [Directors' resolution approving insurance];

(iv) item 5.13 [Audited financial statements];

(v) item 5.14 [Letter of direction to auditors];

(e) a renewal of an insurance policy referred to in item 5.5 or in item 5.6 of Form 33-506F6, if the insurance policy has not lapsed and the only change is to extend the expiry date of the insurance policy for a period of at least one year;

(f) a change in a person or company's ownership of the firm's voting securities referred to in item 3.12 of Form 33-506F6, if the change did not result in the person or company's percentage ownership falling below or exceeding 10%, 20%, or 50% of the firm's voting securities.

3.2 Changes to Business Locations

(1) A registered firm must notify the Director of the opening of a business location, other than a new head office, by submitting in accordance with Ontario Securities Commission Rule 31-509 National Registration Database (Commodity Futures Act) a completed Form 33-506F3 within 10 15 days of the opening of the business location.

(2) A registered firm must notify the Director of a change to any information previously submitted in Form 33-506F3 by submitting in accordance with Ontario Securities Commission Rule 31-509 National Registration Database (Commodity Futures Act) a completed Form 33-506F3 within 1510 days of the change.

3.3 [Repealed]Changes to Other Registration Information -- A registered firm must notify the regulator of a change in its auditor or financial year-end within 7 days of the change.

PART 4 CHANGES TO REGISTERED INDIVIDUAL AND PERMITTED INDIVIDUAL INFORMATION

4.1 Changes to Form 33-506F4 Information

(1) Subject to subsections (2) and (3), a registered individual or permitted individual must notify the regulator Director of a change to any information previously submitted in Form 33-506F4, in Form 33-506F7, or under this subsection, within 1510 days of the change.

(2) Despite subsection (1), a registered individual or permitted individual must notify the regulator Director of a change to information previously submitted in Items 4, 8 and 11 Items 2.1, 2.2, 4, 10 and 11 of Form 33-506F4, or under this subsection, within 30 days of the change.

(3) Despite subsection (1), a registered individual or permitted individual is not required to notify the regulator of a change to information previously submitted in Item 3 [personal information] of Form 33-506F4

(3) Despite subsection (1), a registered individual or permitted individual is not required to notify the Director if the change relates to any of the following:

(a) information previously submitted in item 3 [Personal information] of Form 33-506F4;

(b) the individual ceasing to have authority to act on behalf of the sponsoring firm as a registered individual or be a permitted individual of the sponsoring firm if a Form 33-506F1 is required to be submitted by the sponsoring firm under subsection 4.3(1).

(4) A notice of change under subsection (1) or (2) must be made by submitting a completed Form 33-506F5 to the Director in accordance with Ontario Securities Commission Rule 31-509 National Registration Database (Commodity Futures Act).

(5) Despite subsection (4), a notice of change referred to in this section must be made by submitting a completed Form 33-506F2 to the Director in accordance with Ontario Securities Commission Rule 31-509 National Registration Database (Commodity Futures Act) if the change relates to

(a) an individual's status as a permitted individual of the sponsoring firma change in a category of permitted activities of a permitted individual,

(b) the removal or the addition of a category of registration,

(c) the surrender of registration in one or more non-principal jurisdictions, or

(d) any information on Schedule C of Form 33-506F4.

4.2 [Repealed]

4.3 Termination Cessation of Employment, etc.

(1) A registered firm must notify the Director of the end of, or a change in, a sponsored individual's employment, partnership, or agency relationship with a firm if the individual ceases to have authority to act on behalf of the firm as a registered individual or permitted individual by submitting a Form 33-506F1 to the Director in accordance with Ontario Securities Commission Rule 31-509 National Registration Database (Commodity Futures Act) with

(a) items 1 through 4 completed, and

(b) item 5 completed unless the reason for termination under item 4 was death of the individual.

(1) A registered firm must notify the Director if an individual ceases to have authority to act on behalf of the registered firm as a registered individual or be a permitted individual by submitting Form 33-506F1 to the Director in accordance with Ontario Securities Commission Rule 31-509 National Registration Database (Commodity Futures Act) with

(a) items 1 to 4 of the Form completed, and

(b) item 5 of the Form completed unless the reason for cessation under item 4 was death of the individual.

(2) A registered firm must submit to the Director the information required under

(a) paragraph (1)(a), within 10 days of the cessation date, and

(b) paragraph (1)(b), within 30 days of the cessation date.

(3) A registered firm must, within 10 days of a request from an individual for whom the registered firm was the former sponsoring firm, provide to the individual a copy of the Form 33-506F1 that the registered firm submitted under subsection (1) in respect of that individual.

(4) If a registered firm completed and submitted the information in item 5 of a Form 33-506F1 in respect of an individual who made a request under subsection (3) and that information was not included in the initial copy provided to the individual, the registered firm must provide to that individual a further copy of the completed Form 33-506F1, including the information in item 5, within the later of

(a) 10 days after the request by the individual under subsection (3), and

(b) 10 days after the submission pursuant to paragraph (2)(b).

PART 5 DUE DILIGENCE AND RECORD-KEEPING

5.1 Sponsoring Firm Obligations

(1) A sponsoring firm must make reasonable efforts to ensure the truth and completeness of information that is submitted in accordance with this Instrument for any individual.

(2) A sponsoring firm must obtain from each individual who is registered to act on behalf of the firm, or who is a permitted individual of the firm, a copy of the Form 33-506F1 most recently submitted by the individual's former sponsoring firm in respect of that individual, if any, within 60 days of the firm becoming the individual's sponsoring firm.

(3) A sponsoring firm must retain all documents used by the firm to satisfy its obligation under subsection (1) as follows:

(a) in the case of a registered individual, for no less than 7 years after the individual ceases to be registered to act on behalf of the firm;

(b) in the case of an individual who applied for registration but whose registration was refused by the regulatorDirector, for no less than 7 years after the individual applied for registration; or

(c) in the case of a permitted individual, for no less than 7 years after the individual ceases to be a permitted individual with the firm.

(4) Without limiting the generality of subsection (3), if a registered individual, an individual applying for registration, or a permitted individual appoints an agent for service, the sponsoring firm must keep the original Appointment of Agent for Service executed by the individual for the period of time set out in paragraph (3)(b).

(5) A sponsoring firm that retains a document under subsection (3) or (4) in respect of an NRD submission must record the NRD submission number on the first page of the document.

PART 6 [Lapsed]

PART 7 EXEMPTION

7.1 Exemption -- The Director may grant an exemption from this Rule, in whole or in part, subject to such conditions or restrictions as may be imposed in the exemption.

PART 8 EFFECTIVE DATE

8.1 [Lapsed]

8.2 Effective Date -- This Rule comes into force when National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations comes into force.

 

FORM 33-506F1 NOTICE OF TERMINATION OF REGISTERED INDIVIDUALS AND PERMITTED INDIVIDUALSFORM 33-506F1 NOTICE OF END OF INDIVIDUAL REGISTRATION OR PERMITTED INDIVIDUAL STATUS (section 4.2)

WARNING -- It is an offence under securities legislation and derivatives legislation, including commodity futures legislation, to knowingly give false or misleading information to the regulator or securities regulatory authority.

CERTIFICATION

I certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where the firm is submitting this form and to any applicable self-regulatory authority (SRO) that

I have read this form and understand all matters within this form, including the questions, and

to the best of my knowledge and after reasonable inquiry, all of the information provided on this form is true and complete.

NRD format:

[ ] I am making this submission under authority delegated by the firm. By checking this box, I certify that the firm

(a) provided me with all of the information on this form, and

(b) makes the certification above.

Non-NRD format:

By signing below, I make the certification above.

Name of firm ____________________

Name of authorized signing officer or partner ____________________

Title of authorized signing officer or partner ____________________

Signature of authorized signing officer or partner ____________________

Date signed ____________________ (YYYY/MM/DD)

GENERAL INSTRUCTIONS

Complete and submit this form to notify the relevant regulator(s) or, in Québec, the securities regulatory authority, or self-regulatory organization (SRO) that a registered individual or permitted individual has left their sponsoring firm or has ceased to act in a registerable capacity or as a permitted individual.

Terms

In this form, "cessation date" (or "effective date of termination") means the last day on which an individual had authority to act as a registered individual on behalf of their sponsoring firm or the last day on which an individual was a permitted individual of their sponsoring firm, because of the end of, or a change in, the individual's employment, partnership, or agency relationship with the firm.As set out in Ontario Securities Commission Rule 33-506 (Commodity Futures Act) Registration Information, "cessation date" means the last day on which an individual had authority to act as a registered individual on behalf of their sponsoring firm or the last day on which an individual was a permitted individual of their sponsoring firm.

How to submit the form

Submit this form at the National Registration Database (NRD) website in NRD format at www.nrd.ca.

If you are relying on the temporary hardship exemption in section 5.1 of Ontario Securities Commission Rule 31-509 National Registration Database (Commodity Futures Act), you may submit this form in a format other than NRD format.

When to submit the form

You must submit the responses to Item 1, Item 2, Item 3 and Item 4 within 10 days of the effective date of termination.

If you are required to complete Item 5, you must submit those responses within 30 days of the cessation date. If you are submitting the responses to Item 5, in NRD format, after Items 1 to 4 have been submitted at NRD, use the NRD submission type called "Update/Correct Termination Information" to complete Item 5 of this form.

As set out in Ontario Securities Commission Rule 33-506 (Commodity Futures Act) Registration Information, you must submit the responses to Items 1, 2, 3 and 4 within 10 days of the cessation date.

If you are required to complete Item 5, you must submit those responses within 30 days of the cessation date. If you are submitting the responses to Item 5, in NRD format, after Items 1 to 4 have been submitted at NRD, use the NRD submission type called "Update/Correct Cessation Information" to complete Item 5 of this form.

Item 1 TerminatingFormer sponsoring firm

1. Name

2. NRD number

Item 2 Terminated Applicable individual

1. Name

2. NRD number

Item 3 Business location of the terminated applicable individual

1. Business location address

2. NRD number

Item 4 Date and reason for termination

1. Cessation date / Effective date of termination ________________________________________

(YYYY/MM/DD)

This is the last day that the individual had authority to act in a registerable capacity on behalf of the firm, or the last day that the individual was a permitted individual.

2. Reason for termination / cessation (check one):

Resigned -- voluntary

[ ]

 

Resigned -- at the firm's request

[ ]

 

Dismissed in good standing

[ ]

 

Dismissed for cause

[ ]

 

Completed temporary employment contract

[ ]

 

Retired

[ ]

 

Deceased

[ ]

 

Other

[ ]

If "Other", explain: ____________________

Item 4 Date and reason for cessation

1. Cessation date ____________________ (YYYY/MM/DD)

The above date is the last day on which the individual had authority to act as a registered individual on behalf of the sponsoring firm, or the last day on which the individual was a permitted individual of the sponsoring firm.

2. Reason for cessation (check one):

<<Resigned -- voluntary>>

[ ]

 

<<Resigned -- at the firm's request>>

[ ]

 

<<Terminated in good standing>>

[ ]

 

<<Terminated for cause>>

[ ]

 

<<Completed temporary employment contract>>

[ ]

 

<<Retired>>

[ ]

 

<<Deceased>>

[ ]

 

<<Other>>

[ ]

If "Other", explain:

____________________

Item 5 Details about the terminationcessation

Complete Item 5 except where the individual is deceased. In the space below:

• state the reason(s) for the cessation / termination and

• provide details if the answer to any of the following questions is "Yes".

[For NRD Format only:]

[ ] This information will be disclosed within 30 days of the effective date of termination

[ ] Not applicable: individual is deceased

Complete Item 5 except in the case of an individual that is deceased. In the space below:

state the reason(s) for the cessation and

provide details if the answer to any of the following questions is "Yes".

[For NRD Format only:]

[ ] This information will be disclosed within 30 days of the effective cessation date

[ ] Not applicable: individual is deceased

Answer the following questions to the best of the firm's knowledge.

In the past 12 months:

Yes

No

 

1.

Was the individual charged with any criminal offence?

[ ]

[ ]

 

2.

Was the individual the subject of any investigation by any securities or financial industry regulator?

[ ]

[ ]

 

3.

Was the individual subject to any significant internal disciplinary measures at the firm or at any affiliate of the firm related to the individual's activity as a registrant?

[ ]

[ ]

 

4.

Were there any written complaints, civil claims and/or arbitration notices filed against the individual or against the firm about the individual's securities-related activities that occurred while the individual was registered or a permitted individual authorized to act on behalf of the firm?

[ ]

[ ]

 

5.

Does the individual have any undischarged financial obligations to clients of the firm?

[ ]

[ ]

 

6.

Has the firm or any affiliate of the firm suffered significant monetary loss or harm to its reputation as a result of the individual's actions?

[ ]

[ ]

 

7.

Did the firm or any affiliate of the firm investigate the individual relating to possible material violations of fiduciary duties, regulatory requirements or the compliance policies and procedures of the firm or any affiliate of the firm? Examples include making unsuitable trades or investment recommendations, stealing or borrowing client money or securities, hiding losses from clients, forging client signatures, money laundering, deliberately making false representations and engaging in undisclosed outside business activity<<outside activity>>.

[ ]

[ ]

 

8.

Did the individual repeatedly or materially fail to follow compliance policies and procedures of the firm or any affiliate of the firm?

[ ]

[ ]

 

9.

Did the individual engage in discretionary management of client accounts or otherwise engage in registerable activity without appropriate registration or without the firm's authorization?

[ ]

[ ]

Reasons/Details: ____________________

Item 6 [repealed]

Item 7 [repealed] Warning

It is an offence under securities legislation and derivatives legislation, including commodity futures legislation, to give false or misleading information on this form.

Item 8 [repealed] Certification

Certification-NRD format:

[ ] I am making this submission as agent for the firm. By checking this box, I certify that the firm provided me with all of the information on this form.

Certification-Format other than NRD format:

By signing below I certify to the regulator or, in Québec, the securities regulatory authority, in each jurisdiction where I am submitting this form for the firm, either directly or through the principal regulator, that:

• I have read this form and understand the questions, and

• all of the information provided on this form is true and complete.

Name of firm

Name of authorized signing officer or partner ____________________

Title of authorized signing officer or partner ____________________

Signature of authorized signing officer or partner ____________________

Date signed ________________________ (YYYY/MM/DD)

 

Schedule A

[repealed]

 

FORM 33-506F2 CHANGE OR SURRENDER OF INDIVIDUAL CATEGORIES (section 2.2(2), 2.5(2) or 4.1(5))

WARNING -- It is an offence under securities legislation and derivatives legislation, including commodity futures legislation, to knowingly give false or misleading information to the regulator or securities regulatory authority.

CERTIFICATION

Individual

I certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where I am submitting this form and to any applicable self-regulatory organization (SRO) that

I have read this form and understand all matters within this form, including the questions,

I have discussed this form with an officer, partner, branch manager or supervisor of my sponsoring firm and that to the best of my knowledge, the officer, partner, branch manager or supervisor is satisfied that I understand all matters within this form, including the questions,

to the best of my knowledge and after reasonable inquiry, all of the information provided on this form is true and complete, and

if applicable, I will limit my activities to those allowed by my category of registration and any SRO approval.

Firm

I certify to the regulator or, in Québec, the securities regulatory authority in each jurisdiction where the firm is submitting this form and to any applicable SRO, if applicable, that

the individual identified in this form will be engaged by the sponsoring firm as a registered individual or a permitted individual, and

I have, or a branch manager, supervisor, officer or partner has, discussed this form with the individual. To the best of my knowledge, the individual understands all matters within this form, including the questions.

NRD format:

[ ] I am making this submission under authority delegated by the firm and the individual identified in this form. By checking this box, I certify that

(a) the firm provided me with all of the information on this form and makes the firm certification above, and

(b) the individual provided the firm with all of the information on this form and makes the individual certification above.

Non-NRD format:

Individual

By signing below, I make the above individual certification.

Signature of individual ____________________

Date signed ____________________ (YYYY/MM/DD)

Firm

By signing below, I make the certification above.

Name of firm ____________________

Name of authorized signing officer or partner ____________________

Title of authorized signing officer or partner ____________________

Signature of authorized signing officer or partner ____________________

Date signed ____________________ (YYYY/MM/DD)

GENERAL INSTRUCTIONS

Complete and submit this form to notify the relevant regulator(s) or, in Québec, the securities regulatory authority, or self-regulatory organization (SRO) that a registered individual or permitted individual seeks to add and/or remove individual registration categories or permitted activities or provide notice of other changes to the information on Schedule C of Form 33-506F4.

Terms

In this form, "you", "your" and "individual" mean the registered individual or permitted individual who is seeking to add and/or remove registration categories or permitted activities.

How to submit this form

Submit this form at the National Registration Database (NRD) website in NRD format at www.nrd.ca.

If you are relying on the temporary hardship exemption in section 5.1 of Ontario Securities Commission Rule 31-509 National Registration Database (Commodity Futures Act), you may submit this form in a format other than NRD format.

Item 1 Individual

Name of individual ____________________

NRD number of individual ____________________

Item 2 Registration jurisdictions

1. Are you filing this form under the passport system / interface for registration?

Choose "No" if you are registered in

(a) only one jurisdiction of Canada

(b) more than one jurisdiction of Canada and you are requesting a surrender in a non-principal jurisdiction or jurisdictions, but not in your principal jurisdiction, or

(c) more than one jurisdiction of Canada and you are requesting a change only in your principal jurisdiction.

Yes [ ] No [ ]

2. Check each jurisdiction where you are seeking the change or surrender.

[ ]

Alberta

 

[ ]

British Columbia

 

[ ]

Manitoba

 

[ ]

New Brunswick

 

[ ]

Newfoundland and Labrador

 

[ ]

Northwest Territories

 

[ ]

Nova Scotia

 

[ ]

Nunavut

 

[ ]

Ontario

 

[ ]

Prince Edward Island

 

[ ]

Québec

 

[ ]

Saskatchewan

 

[ ]

Yukon

Item 3 Removing categories

What categories are you seeking to remove?

______________________________

Item 4 Adding categories

1. Categories

What categories are you seeking to add?

______________________________

2. Professional liability insurance (Québec mutual fund dealers and Québec scholarship plan dealers)

If you are seeking registration as a representative of a mutual fund dealer or of a scholarship plan dealer in Québec, are you covered by your sponsoring firm's professional liability insurance?

Yes [ ] No [ ]

If "No", state:

The name of your insurer _________________________________________________________________________________

Your policy number __________________________________________

3. Relevant securities industry experience

If you have not been registered in the last 36 months and you passed the required examination more than 36 months ago, do you consider that you have gained 12 months of relevant securities industry experience during the 36-month period?

Yes [ ] No [ ] N/A [ ]

If you are an individual applying for IIROC approval, select "N/A".

If "Yes", complete Schedule A.

Do you have relevant securities experience?

Yes [ ] No [ ] N/A [ ]

If you are an individual applying for IIROC approval, select "N/A".

If "Yes", complete Schedule A.

Item 5 Reason for surrender

If you are seeking to remove a registration category or permitted activity, state the reason for the surrender in the local jurisdiction.

______________________________

Item 6 Notice of collection and use of personal information

The personal information required under this form is collected on behalf of, and used by, the securities regulatory authorities in the jurisdictions set out in Schedule B to administer and enforce certain provisions of their securities legislation or derivatives legislation or both.

The personal information required under this form is also collected by and used by the SRO set out in Schedule B to administer and enforce its by-laws, regulations, rules, rulings and policies.

By submitting this form, the individual consents to the collection by the securities regulatory authorities or applicable SRO of this personal information, and any police records, records from other government or non-governmental regulators or SROs, credit records and employment records about the individual that the securities regulatory authorities or applicable SRO may need to complete their review of the information submitted in this form relating to the individual's continued fitness for registration or approval, if applicable, in accordance with the legal authority of the securities regulatory authorities while the individual is registered with or approved by it. Securities regulatory authorities or SROs may contact government and private bodies or agencies, individuals, corporations and other organizations for information about the individual.

If you have any questions about the collection and use of this information, contact the securities regulatory authorities or applicable SRO in any jurisdiction in which the required information is submitted. See Schedule B for details. In Québec, you can also contact the Commission d'accès à l'information at 1-888-528-7741 or visit its website at www.cai.gouv.qc.ca.

Item 6 Collection and use of personal information

1. Notice of collection and use of personal information

Your personal information is collected by, or on behalf of, each securities regulatory authority and SRO set out in Schedule B. Any of the securities regulatory authorities or SROs set out in Schedule B may contact government or private bodies or agencies, individuals, corporations, employers, and other organizations, in Canada and in other countries, for information about you.

This personal information is being collected under the authority of the applicable securities legislation, derivatives legislation (including commodity futures legislation) or both of the securities regulatory authorities and pursuant to the SRO rules of an SRO set out in Schedule B. The collection, use and disclosure are done in accordance with applicable freedom of information and privacy legislation.

The principal purpose of this collection by the securities regulatory authorities is to administer, enforce, carry out their duties or exercise their powers under their respective securities legislation, derivatives legislation (including commodity futures legislation) or both, and by the SROs to administer and enforce the rules of the SROs.

The information submitted by you on this form with your consent, or collected indirectly with your authorization, may be collected:

at any time during your registration or while you are a permitted individual, or

at the time the regulator or, in Québec, the securities regulatory authority, or SRO is informed by your sponsoring firm that you no longer have authority to act on behalf of the sponsoring firm or are not a permitted individual of the sponsoring firm.

If you have any questions about the collection, use and disclosure of this information, contact the securities regulatory authorities or SRO in any jurisdiction in which the required information is submitted. See Schedule B for details.

Note that certain information such as your name(s) (including aliases, trade names or some past names), your sponsoring firm, and other relevant registration information will be listed in a publicly available registry of registered individuals and, if applicable, on the Disciplined List.

Also note that certain securities regulatory authorities may provide or receive information to or from certain entities under separate provisions of their securities legislation or derivatives legislation (including commodity futures legislation) or both, and SROs may provide or receive information under the rules of the SROs. This consent and notice does not limit the authority, powers, obligations, or rights conferred on any of the securities regulatory authorities by legislation or regulations in effect in their jurisdiction.

2. Consent to collect and use personal information

By submitting this form, you consent to and authorize the collection, directly and indirectly, of personal information by each securities regulatory authority and SRO and to the use of your personal information as set out above.

The personal information that each securities regulatory authority or SRO collects, includes the following:

the personal information provided in this form;

the personal information provided by your sponsoring firm;

registration or financial services licensing information;

law enforcement records, including police records;

credit records;

bankruptcy or other insolvency records;

employment records and information received from an employer;

records and information received from entities you had or have an independent contractor or agency relationship with;

personal information available online;

records from government ministries and agencies, SROs or authorities exercising jurisdiction over specific business activities or professions; and

records of, and used in, court proceedings, including any probation records.

Item 7 [repealed] Warning

It is an offence under securities legislation and derivatives legislation, including commodity futures legislation, to give false or misleading information on this form.

Item 8 [repealed]Certification

Certification-NRD format:

I confirm I have discussed the questions in this form with an officer, branch manager or supervisor of my sponsoring firm. To the best of my knowledge and belief, the officer, branch manager or supervisor was satisfied that I fully understood the questions. I will limit my activities to those permitted by my category of registration.

[ ] I am making this submission as agent for the individual identified in this form. By checking this box, I certify that the individual provided me with all of the information on this form.

Certification-Format other than NRD format:

By signing below:

1. I certify to the regulator or, in Québec, the securities regulatory authority, in each jurisdiction where I am submitting this form, either directly or through the principal regulator, that:

• I have read this form and understand the questions, and

• all of the information provided on this form is true, and complete.

2. I confirm I have discussed the questions in this form with an officer, branch manager or supervisor of my sponsoring firm. To the best of my knowledge and belief, the officer, branch manager or supervisor was satisfied that I fully understood the questions. I will limit my activities to those permitted by my category of registration.

Signature of individual ____________________

Date signed ____________________ (YYYY/MM/DD)

By signing below, I certify to the regulator or, in Québec, the securities regulatory authority, in each jurisdiction where I am submitting this form for the individual, either directly or through the principal regulator, that:

1. the individual identified in this form will be engaged by the firm as a registered individual, or a non registered individual, and

2. I have, or a branch manager or supervisor or another officer or partner has, discussed the questions set out in this form with the individual. To the best of my knowledge and belief, the individual fully understands the questions.

Name of firm

______________________________

Name of authorized signing officer or partner

______________________________

Title of authorized signing officer or partner

______________________________

Signature of authorized signing officer or partner

______________________________

Date signed ____________________ (YYYY/MM/DD)

 

Schedule A

Relevant securities industry experience (Item 4)

Describe your responsibilities in areas relating to the category you are applying for, including the title(s) you have held, as well as start and end dates:

______________________________

______________________________

______________________________

What is the percentage of your time devoted to these activities?

_____ %

Indicate the continuing education activities in which you have participated during the last 36 months and that are relevant to the category of registration you are applying for:

______________________________

______________________________

______________________________

 

Schedule A

Relevant securities experience (Item 4)

Instructions:

Some registration categories require a specified amount of experience to be obtained within specified timeframes. Please see National Instrument 31-103 Registration Requirements, Exemptions and Ongoing Registrant Obligations for more information.

If you are applying to be an advising representative or an associate advising representative, provide details of the activities you performed for each experience that is relevant investment management experience. Such details may include the level of responsibility; value of accounts under direct supervision; number of years of experience in performing securities research and analysis for the purpose of portfolio securities selection, portfolio construction and analysis; number of years of experience collecting know-your-client information; or number of years of experience conducting suitability assessments.

1. If you are applying

to be an advising representative or an associate advising representative of a portfolio manager, describe the relevant investment management experience that you have gained, or

for any other category, describe the relevant securities industry experience that you have gained.

For each description of relevant experience, provide the following information:

(a) the name of the firm or entity with which you gained this experience;

(b) your title;

(c) the start and end dates of this position;

(d) the details of the activities you performed that are relevant for the category of registration that you are applying for; and

(e) the percentage of your time in this position that was spent on activities relating to the experience.

______________________________

______________________________

______________________________

2. Indicate the continuing education activities in which you have participated during the last 36 months and that are relevant to the category of registration you are applying for:

______________________________

______________________________

______________________________

 

Schedule B

Contact information for Noticeconsent and notice of collection and use of personal information

Alberta
Nunavut
Alberta Securities Commission
Government of Nunavut
Suite 600, 250-5th St. SW
Department of Justice
Calgary, AB T2P 0R4
P.O. Box 1000 Station 570
Attention: Information Officer
Iqaluit, NU X0A 0H0
Telephone: (403) 297-6454
Attention: Superintendent of Securities
Telephone: (867) 975-6590
 
British Columbia
Ontario
British Columbia Securities Commission
Ontario Securities Commission
P.O. Box 10142, Pacific Centre
22[SUP]nd[/SUP] Floor
701 West Georgia Street
20 Queen Street West
Vancouver, BC V7Y 1L2
Toronto, ON M5H 3S8
Attention: Freedom of Information Officer<<Registration staff>>
Attention: Compliance and Registrant Regulation
Telephone: (604) 899-6500 or (800) 373-6393 (in Canada)
Telephone: (416) 593-8314
<<E-mail: Registration@bcsc.bc.ca>>
E-mail: registration@osc.gov.on.ca
 
Manitoba
Prince Edward Island
The Manitoba Securities Commission
Securities Office
500 -- 400 St. Mary Avenue
Department of Community Affairs and Attorney General
Winnipeg, MB R3C 4K5
P.O. Box 2000
Attention: Director of Reg