Identification Verification Form

Anti-money laundering legislation requires all financial institutions to obtain and maintain data to confirm the identity of their clients prior to opening an account for them.

To the Agent appointed to verify identity: A mortgage and/or HELOC account will be opened for the clients. Tangerine

has appointed you to be its agent for the purpose of verifying the identity of each borrower prior to advancing the funds, in accordance with the Proceeds of Crime (Money Laundering) and Terrorist Financing Act.

Please also verify the identity of any person executing a mortgage and/or HELOC document as an attorney pursuant to a Power of Attorney.

Record the identification particulars and return the signed and completed form to Tangerine prior to advancing the funds. You are required to review two original identification documents, at least one of which contains a photograph and is found on List A. The other may be from either List A or List B.

List A.

1

 Driver’s license


PLEASE READ NOTES BELOW

 Current Canadian or Foreign Passport

 Certificate of Canadian Citizenship/Certification of Naturalization

 Permanent Resident Card

 Certificate of Indian Status issued by the Government of Canada

2

 Provincial health insurance card

 Firearms License

 Age of Majority Card with a signature and photograph issued by a Provincial Government

 A document or card with signature and photograph issued by any of the following:

The Insurance Corporation of British Columbia

 Alberta Registries

 Saskatchewan Government Insurance

The Department of Service Nova Scotia and Municipal Relations

The Department of Transportation and Public Works of the Province of Prince Edward Island

 Service New Brunswick

The Department of Government Services and Lands of the Province of Newfoundland and Labrador

The Department of Transportation of the Northwest Territories

The Department of Community Government and Transportation of the Territory of Nunavut

List B.

 Birth certificate issued in Canada

 Employee identity card with a photograph from an employer well known in the community

 Old Age Security card issued by the Government of Canada

 Signed automated banking machine (ABM) card or client card issued by a member of the Canadian Payments Association

 Signed credit card issued by a member of the Canadian Payments Association

 Signed Canadian Institute for the Blind (CNIB) client card with a photograph

3

 Social Insurance Number (SIN) card issued by the Government of Canada

NOTES:

1

In Quebec, driver’s license may not be requested but can be used if offered.

2

In Manitoba, Ontario, Nova Scotia and Prince Edward Island, provincial health card may not be used for identification purposes; in

Quebec, provincial health card may not be requested but can be used if offered.

3

The Social Insurance Number card may not be requested but can be used if offered.

Identification Verification Form

Client Name: / Client Number:
Current Address: / Date of Birth (mm/dd/yyyy):
Client name as it appears on the Document: / Document Expiry Date (mm/dd/yyyy):
Name/Type of Document (List A) / Reference Number: / Place of Issuance (province where applicable):
Client name as it appears on the Document: / Document Expiry Date (mm/dd/yyyy):
Name/Type of Document (List A or B) / Reference Number: / Place of Issuance (province where applicable):
Client Name: / Client Number:
Current Address: / Date of Birth (mm/dd/yyyy):
Client name as it appears on the Document: / Document Expiry Date (mm/dd/yyyy):
Name/Type of Document (List A) / Reference Number: / Place of Issuance (province where applicable):
Client name as it appears on the Document : / Document Expiry Date (mm/dd/yyyy):
Name/Type of Document (List A or or B) / Reference Number: / Place of Issuance (province where applicable):

Kindly Ensure:

Any changes/amendments to the information on this form are initialed by the Agent/Solicitor.

Please include expiry dates where applicable and ensure that dates are valid and not expired.

EXPIRED DOCUMENTS WILL NOT BE ACCEPTED.

All names on the identification supplied by the client are verified against our instructions to you.

Please complete this form in full including your; name, address and signature.

(Please use additional forms if there are more than two clients)

I, (Please print)

Address of Agent/Solicitor:


hereby attest I have been appointed as an agent/solicitor of

Tangerine to verify the identity of the clients on the Tangerine Instruction Package. I have completed my due diligence and verify the above noted clients are one and the same as per Tangerine’s Instructions and as identified within the identification documentation provided. I understand that the Mortgage funds cannot be released until Tangerine has received and validated the ID form.

Date:


Signature: