Personal Information First Name Middle Name Last Name SIN # - - Date of Birth Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2024 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901 1900 Home Address (Apt / P.O. Box / Street Number) City Province Alberta British Columbia Prince Edward Island Manitoba Newfoundland New Brunswick Nova Scotia Nunavut Ontario Quebec Saskatchewan Northwest Territories Yukon Postal Code Home Phone Number ( ) Business Phone Number ( ) Own/Rent Own Rent Other Monthly Payment Martial Status Married Divorced Single Separated Common Law Widower # of Dependents (including spouse) Bank Name Bank Address Savings Account # Chequing Account # Have you every borrowed? Yes no if yes - where? When? Amount? Previous IndCom Client? Yes no When? Amount?

Financial Profile Assets Liabilities Cash Bank Loans Cash - Term Deposit Mortgage Life Insurance CSV Credit Cards (Please itemize) Retirement Accounts 1. Marketable Securities 2. Accounts and Loans Receivable (Please itemize) 3. 1. Other Obligations (Please itemize) 2. 1. 3. 2. Automobiles (B) Total Liabilities 1. (C) Net Worth (A minus B) 2. Sundry Obligations Real Estate Are you supporting contingent obligations not listed above? Business Interest Yes no Other Assets (Please itemize) If yes, please indicate liability and provide details on amount, 1. to whom and nature of obligations below 2. 1. 3. 2. (A) Total Assets 3.

Present Annual Income and Expenses Income Expenses Gross Income - annual salary or wages Expenses - mortgage/rental payments Commissions and bonuses Real Estate Taxes Dividends and interest Federal & Provincial Income Taxes Rental Income Insurance Premiums Other Income (Please itemize) Credit Cards 1. Consumer Loan Payments 2. Alimony, child support, or maintenance payments Subtotal Other Expenses (Please itemize) Spouse annual income 1. 2. Other Income (Please itemize) 3. 1. 4. 2. Total Annual Income Total Annual Expenses

Employment Information Occupation / Job Title Employer Name Employer Phone Number ( ) Employer Address Employer City Employer Province Alberta British Columbia Prince Edward Island Manitoba Newfoundland New Brunswick Nova Scotia Nunavut Ontario Quebec Saskatchewan Northwest Territories Yukon Years with Employer 0 Years 1 Years 2 Years 3 Years 4 Years 5 Years 6 Years 7 Years 8 Years 9 Years 10 + Years Months with Employer 0 Months 1 Months 2 Months 3 Months 4 Months 5 Months 6 Months 7 Months 8 Months 9 Months 10 Months 11 Months Previous Occupation / Job Title Previous Employer Name Previous Employer Phone Number ( ) Previous Employer Address Previous Employer City Previous Employer Province Alberta British Columbia Prince Edward Island Manitoba Newfoundland New Brunswick Nova Scotia Nunavut Ontario Quebec Saskatchewan Northwest Territories Yukon Years with Previous Employer 0 Years 1 Years 2 Years 3 Years 4 Years 5 Years 6 Years 7 Years 8 Years 9 Years 10 + Years Months with Previous Employer 0 Months 1 Months 2 Months 3 Months 4 Months 5 Months 6 Months 7 Months 8 Months 9 Months 10 Months 11 Months

Data on Spouse First Name Initial Last Name SIN # - - Date of Birth Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2024 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901 1900 Occupation / Job Title Employer Name Employer Phone Number ( ) Employer Address Employer City Employer Province Alberta British Columbia Prince Edward Island Manitoba Newfoundland New Brunswick Nova Scotia Nunavut Ontario Quebec Saskatchewan Northwest Territories Yukon Years with Employer 0 Years 1 Years 2 Years 3 Years 4 Years 5 Years 6 Years 7 Years 8 Years 9 Years 10 + Years Months with Employer 0 Months 1 Months 2 Months 3 Months 4 Months 5 Months 6 Months 7 Months 8 Months 9 Months 10 Months 11 Months Occupation / Job Title Employer Name Employer Phone Number ( ) Employer Address Employer City Employer Province Alberta British Columbia Prince Edward Island Manitoba Newfoundland New Brunswick Nova Scotia Nunavut Ontario Quebec Saskatchewan Northwest Territories Yukon Years with Employer 0 Years 1 Years 2 Years 3 Years 4 Years 5 Years 6 Years 7 Years 8 Years 9 Years 10 + Years Months with Employer 0 Months 1 Months 2 Months 3 Months 4 Months 5 Months 6 Months 7 Months 8 Months 9 Months 10 Months 11 Months

General Information Have you ever had an asset repossessed? Yes no Details: Are you involved in any claims or lawsuits? Yes no Details: Have you ever declared bankruptcy? Yes no Details: Do you own any back taxes? Yes no Details:

Schedule B - Real Estate Street Name & Number City Province Legal Description % Ownership Title in name of Date acquired Purchase Price Market Value Gross Annual Rental Income Net Monthly Income Annual Taxes, Insurance, Maintenance & Misc   1st. 2nd. Name of Mortgage Holder (e.g. financial institution) Amount of Mortgage Annual Mortgage Payment

Schedule C - Individual and Group Life Insurance   1. 2. Insurance Company Beneficiary Face Amount Policy Loans Cash Surrender Value

Schedule D - Retirement Accounts (Tax sheltered investments)   1. 2. Quantity Administor (Fin. Instituion, broker, etc) Description (RRSP,RHOSP,DSP,pension fund, etc)   1. 2. In name of whom Current Value Per Unit Total Current Value

Schedule E - Business Interests   1. 2. List all business in which are an owner % Owned Position/Title   1. 2. Net Worth of Business Type of Business Year Established

Schedule F - Bank Loans (Exclude real estate loans)   1. 2. Lender Purpose Date of Loan   1. 2. Payment Monthly Quarterly Annually Monthly Quarterly Annually Collateral Description Original Amount Outstanding Balance

Notes Additional Notes

Co-Applicant Personal Information First Name Middle Name Last Name SIN # - - Date of Birth Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2024 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901 1900 Home Address (Apt / P.O. Box / Street Number) City Province Alberta British Columbia Prince Edward Island Manitoba Newfoundland New Brunswick Nova Scotia Nunavut Ontario Quebec Saskatchewan Northwest Territories Yukon Postal Code Home Phone Number ( ) Business Phone Number ( ) Own/Rent Own Rent Other Monthly Payment Martial Status Married Divorced Single Separated Common Law Widower # of Dependents (including spouse) Bank Name Bank Address Savings Account # Chequing Account # Have you every borrowed? Yes no if yes - where? When? Amount? Previous IndCom Client? Yes no When? Amount?

Co-Applicant Financial Profile Assets Liabilities Cash Bank Loans Cash - Term Deposit Mortgage Life Insurance CSV Credit Cards (Please itemize) Retirement Accounts 1. Marketable Securities 2. Accounts and Loans Receivable (Please itemize) 3. 1. Other Obligations (Please itemize) 2. 1. 3. 2. Automobiles (B) Total Liabilities 1. (C) Net Worth (A minus B) 2. Sundry Obligations Real Estate Are you supporting contingent obligations not listed above? Business Interest Yes no Other Assets (Please itemize) If yes, please indicate liability and provide details on amount, 1. to whom and nature of obligations below 2. 1. 3. 2. (A) Total Assets 3.

Co-Applicant Present Annual Income and Expenses Income Expenses Gross Income - annual salary or wages Expenses - mortgage/rental payments Commissions and bonuses Real Estate Taxes Dividends and interest Federal & Provincial Income Taxes Rental Income Insurance Premiums Other Income (Please itemize) Credit Cards 1. Consumer Loan Payments 2. Alimony, child support, or maintenance payments Subtotal Other Expenses (Please itemize) Spouse annual income 1. 2. Other Income (Please itemize) 3. 1. 4. 2. Total Annual Income Total Annual Expenses

Co-Applicant Employment Information Occupation / Job Title Employer Name Employer Phone Number ( ) Employer Address Employer City Employer Province Alberta British Columbia Prince Edward Island Manitoba Newfoundland New Brunswick Nova Scotia Nunavut Ontario Quebec Saskatchewan Northwest Territories Yukon Years with Employer 0 Years 1 Years 2 Years 3 Years 4 Years 5 Years 6 Years 7 Years 8 Years 9 Years 10 + Years Months with Employer 0 Months 1 Months 2 Months 3 Months 4 Months 5 Months 6 Months 7 Months 8 Months 9 Months 10 Months 11 Months Previous Occupation / Job Title Previous Employer Name Previous Employer Phone Number ( ) Previous Employer Address Previous Employer City Previous Employer Province Alberta British Columbia Prince Edward Island Manitoba Newfoundland New Brunswick Nova Scotia Nunavut Ontario Quebec Saskatchewan Northwest Territories Yukon Years with Previous Employer 0 Years 1 Years 2 Years 3 Years 4 Years 5 Years 6 Years 7 Years 8 Years 9 Years 10 + Years Months with Previous Employer 0 Months 1 Months 2 Months 3 Months 4 Months 5 Months 6 Months 7 Months 8 Months 9 Months 10 Months 11 Months

Co-Applicant Data on Spouse First Name Initial Last Name SIN # - - Date of Birth Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2024 2023 2022 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901 1900 Occupation / Job Title Employer Name Employer Phone Number ( ) Employer Address Employer City Employer Province Alberta British Columbia Prince Edward Island Manitoba Newfoundland New Brunswick Nova Scotia Nunavut Ontario Quebec Saskatchewan Northwest Territories Yukon Years with Employer 0 Years 1 Years 2 Years 3 Years 4 Years 5 Years 6 Years 7 Years 8 Years 9 Years 10 + Years Months with Employer 0 Months 1 Months 2 Months 3 Months 4 Months 5 Months 6 Months 7 Months 8 Months 9 Months 10 Months 11 Months Occupation / Job Title Employer Name Employer Phone Number ( ) Employer Address Employer City Employer Province Alberta British Columbia Prince Edward Island Manitoba Newfoundland New Brunswick Nova Scotia Nunavut Ontario Quebec Saskatchewan Northwest Territories Yukon Years with Employer 0 Years 1 Years 2 Years 3 Years 4 Years 5 Years 6 Years 7 Years 8 Years 9 Years 10 + Years Months with Employer 0 Months 1 Months 2 Months 3 Months 4 Months 5 Months 6 Months 7 Months 8 Months 9 Months 10 Months 11 Months

Co-Applicant General Information Have you ever had an asset repossessed? Yes no Details: Are you involved in any claims or lawsuits? Yes no Details: Have you ever declared bankruptcy? Yes no Details: Do you own any back taxes? Yes no Details:

Co-Applicant Schedule B - Real Estate Street Name & Number City Province Legal Description % Ownership Title in name of Date acquired Purchase Price Market Value Gross Annual Rental Income Net Monthly Income Annual Taxes, Insurance, Maintenance & Misc   1st. 2nd. Name of Mortgage Holder (e.g. financial institution) Amount of Mortgage Annual Mortgage Payment

Co-Applicant Schedule C - Individual and Group Life Insurance   1. 2. Insurance Company Beneficiary Face Amount Policy Loans Cash Surrender Value

Co-Applicant Schedule D - Retirement Accounts (Tax sheltered investments)   1. 2. Quantity Administor (Fin. Instituion, broker, etc) Description (RRSP,RHOSP,DSP,pension fund, etc)   1. 2. In name of whom Current Value Per Unit Total Current Value

Co-Applicant Schedule E - Business Interests   1. 2. List all business in which are an owner % Owned Position/Title   1. 2. Net Worth of Business Type of Business Year Established

Co-Applicant Schedule F - Bank Loans (Exclude real estate loans)   1. 2. Lender Purpose Date of Loan   1. 2. Payment Monthly Quarterly Annually Monthly Quarterly Annually Collateral Description Original Amount Outstanding Balance

Notes Additional Notes