Form 630, Individual Identification Information Record Instructions

Provide the jurisdiction or province/state that issued the third party’s registration or incorporation number, if applicable. Fill only if the 'Is the transaction being conducted on behalf of a third party according to the client?' is 'Yes'.

Provide the country that issued the third party’s registration or incorporation number, if applicable. Fill only if the 'Is the transaction being conducted on behalf of a third party according to the client?' is 'Yes'.

Provide an optional description of your business dealings with the client and include information that would help you anticipate the types of transactions and activities the client may conduct.

Enter the name of the Canadian credit bureau that holds the credit file.

Provide the reference number associated with the credit file.

Enter the first line of the name of the Canadian credit bureau holding the individual’s credit file used to verify their identity.

Enter the second line of the name of the Canadian credit bureau holding the individual’s credit file used to verify their identity, if needed for long names.

Provide a detailed explanation of the enhanced measures applied for high-risk clients to monitor the business relationship and keep their information up to date.

Please provide the name of the financial institution or source where the financial account is held. Fill only if 'Confirm Financial Account' is 'Yes'.

Please specify the type of financial account being verified, such as checking, savings, or investment. Fill only if 'Confirm Financial Account' is 'Yes'.

Please enter the full account number for the financial account being verified. Fill only if 'Confirm Financial Account' is 'Yes'.

Check this box to confirm the individual's name and a financial account as one of the two required independent sources for identity verification.

Specify the type of identification document if it is not a driver's license or passport. Fill only if 'Other' is 'Yes'.

Enter the unique identification number found on the government-issued photo ID.

Provide the country that issued the identification document.

Provide the specific federal, provincial, or territorial jurisdiction that issued the identification document.

Enter the expiration date of the identification document.

Check this box if the identification document presented is a Driver license.

Check this box if the identification document presented is a Passport.

Check this box if the identification document presented is an 'Other' type not listed, and provide an explanation.

Enter the city, province or territory and postal code corresponding to the individual’s address.

Enter the individual’s date of birth in day/month/year format to verify identity.

Please provide the complete address of the property involved in the transaction.

Please enter the full name of the sales representative or broker involved.

Please provide the date when the information was verified or the credit file was consulted.

Please provide the full legal name of the individual.

Please provide the complete residential address of the individual.

Please provide the date of birth of the individual.

Please describe the principal business or occupation of the individual.

Provide additional details regarding the information asked from the unrepresented individual to ascertain their identity.

Provide a detailed explanation of other measures taken to ascertain the individual's identity. Fill only if 'Other, explain' is 'Yes'.

Enter the date on which the above measures were taken.

Check this box if you asked the unrepresented individual for information to ascertain their identity.

Check this box if other measures were taken to ascertain the individual's identity, and then provide a detailed explanation in the field provided.

Specify any measures taken to monitor the business relationship that go beyond simply keeping correspondence on file.

Provide the account number from the document or source that confirms the individual's name and address. Fill only if 'Confirm the individual's name and address by referring to a document or source containing the individual's name and address' is 'Yes'.

Provide the account number from a second document or source that confirms the individual's name and address. Fill only if 'Confirm the individual's name and address by referring to a document or source containing the individual's name and address' is 'Yes'.

Check this box if you have confirmed the individual's name and address by referring to a document or source that contains this information.

Enter the name of the document or source used to confirm the individual's name and date of birth. Fill only if 'Confirm Name and Date of Birth' is 'Yes'.

Enter the account number associated with the document or source used for name and date of birth verification. Fill only if 'Confirm Name and Date of Birth' is 'Yes'.

Check this box if you are confirming the individual's name and date of birth by referring to a document or source containing this information.

Provide details for the 'other' property type for which you are acting as an agent for purchase or sale. Fill only if 'Other, please specify' is 'Yes'.

Check this box if the agent is acting for the purchase or sale of a residential property.

Check this box if the agent is acting for the purchase or sale of a commercial property.

Check this box if the agent is acting for the purchase or sale of a property type not listed, and then specify the type in the provided space.

Check this box if the agent is acting for the purchase or sale of a residential property that is intended to generate income.

Check this box if the agent is acting for the purchase or sale of land designated for commercial use.

Check this box if, prior to this transaction, you previously worked with this client or had a personal relationship with them.

Check this box if, prior to this transaction, you did not previously work with this client and did not have a personal relationship with them.

Check this box if the client has attempted to conceal their identity in any way.

Check this box if the client has not attempted to conceal their identity.

Check this box if your brokerage has previously filed a suspicious transaction or terrorist property report on this client.

Check this box if your brokerage has NOT previously filed a suspicious transaction or terrorist property report on this client.

Check this box if the transaction seems unusual in light of the client's occupation.

Check this box if the transaction does not seem unusual in light of the client's occupation.

Check this box if the transaction involves a third party. Fill only if 'Is the transaction being conducted on behalf of a third party according to the client?' is 'Yes'.

Check this box if the transaction does not involve a third party. Fill only if 'Is the transaction being conducted on behalf of a third party according to the client?' is 'No'.

Check this box if it is possible that the transaction involves a third party.

Check this box if you identified the client in a non-face-to-face setting.

Check this box if you did not identify the client in a non-face-to-face setting.

Check this box if the client did not provide any part of the deposit in cash.

Check this box if the client provided some or all of the deposit in cash.

Check this box if the transaction seems unusual in light of the client's past transactions with the brokerage.

Check this box if the transaction does not seem unusual in light of the client's past transactions with the brokerage.

Check this box if there is anything else unusual about the client or the transaction.

Check this box if there is nothing else unusual about the client or the transaction.

Check this box if, to your knowledge, the client has a criminal history regarding illegal drug trafficking, bribery, fraud, forgery, murder, robbery, counterfeit money, stock manipulation, tax evasion or copyright infringement.

Check this box if, to your knowledge, the client does not have a criminal history regarding illegal drug trafficking, bribery, fraud, forgery, murder, robbery, counterfeit money, stock manipulation, tax evasion or copyright infringement.

Check this box if, to your knowledge, the client possibly has a criminal history regarding illegal drug trafficking, bribery, fraud, forgery, murder, robbery, counterfeit money, stock manipulation, tax evasion or copyright infringement.

Check this box if, to your knowledge, there is no concern about money laundering or terrorist financing in the geographic location of the property or your brokerage location.

Check this box if, to your knowledge, there is a concern about money laundering or terrorist financing in the geographic location of the property or your brokerage location.

Check this box if, to your knowledge, there is a possible concern about money laundering or terrorist financing in the geographic location of the property or your brokerage location.

Check this box if the client lives within 10 km of an international border or 5 km of an international airport.

Check this box if the client does not live within 10 km of an international border or 5 km of an international airport.

Check this box if the client is a Canadian citizen or permanent resident.

Check this box if the client is not a Canadian citizen and not a permanent resident.

Check this box if the client's status as a Canadian citizen or permanent resident is unknown.

Check this box if the client is a domestic PEP or a family member/close associate of one.

Check this box if the client is not a domestic PEP or a family member/close associate of one.

Check this box if the client is a foreign Politically Exposed Person (PEP) or Head of International Organization (HIO), or a family member or close associate of one.

Check this box if the client is not a foreign Politically Exposed Person (PEP) or Head of International Organization (HIO), and is not a family member or close associate of one.

Check this box if the client is subject to a Ministerial Directive.

Check this box if the client is not subject to a Ministerial Directive.

Check this box if you are aware of any other connection to the client and a high-risk country.

Check this box if you are not aware of any other connection to the client and a high-risk country.

Check this box if you are possibly aware of any other connection to the client and a high-risk country.

Provide a detailed explanation of why the unrepresented individual did not provide the requested information, leading to the unsuccessful measures.

Provide a detailed explanation for other reasons why the measures taken to ascertain identity were unsuccessful. Fill only if 'Other, explain:' is 'Yes'.

Check this box if the unrepresented individual failed to provide the information requested to ascertain their identity.

Check this box if the measures taken to ascertain identity were unsuccessful for a reason not listed, and then provide a specific explanation.

Check this box if the response to Question 1 in Part 1 was 'Yes', indicating a prior personal or professional relationship with the client, to apply a score of 1. Fill only if 'Yes' is selected.

Check this box if the response to Question 1 in Part 1 was 'No', indicating no prior personal or professional relationship with the client, to apply a score of 2. Fill only if 'No' is selected.

Check this box if the response to Question 1 in Part 1 was 'Possibly', indicating a potential prior personal or professional relationship with the client, to apply a score of 3.

Check this box if the response to Question 10 in Part 1 was 'Yes', assigning a risk score of 1. Fill only if 'Yes' is selected.

Check this box if the response to Question 10 in Part 1 was 'No', assigning a risk score of 2. Fill only if 'No' is selected.

Check this box if the response to Question 10 in Part 1 was 'Unknown' or 'Possibly', assigning a risk score of 3.

Check this box if the answer to Question 11 in Part 1 was 'Yes' and you are selecting the corresponding score value for 'Yes'. Fill only if 'Yes' is selected.

Check this box if the answer to Question 11 in Part 1 was 'No' and you are selecting the corresponding score value for 'No'. Fill only if 'No' is selected.

Check this box if the answer to Question 11 in Part 1 falls under the 'Unknown/Possibly' category and you are selecting the corresponding score value.

Check this box if you answered 'No' to Question 12 in Part 1, indicating the transaction did not seem unusual in light of the client's occupation. This selection contributes 1 point to the risk score. Fill only if 'No' is selected.

Check this box if you answered 'Unknown' or 'Possibly' to Question 12 in Part 1, indicating uncertainty about whether the transaction seemed unusual in light of the client's occupation. This selection contributes 2 points to the risk score.

Check this box if you answered 'Yes' to Question 12 in Part 1, indicating the transaction seemed unusual in light of the client's occupation. This selection contributes 3 points to the risk score. Fill only if 'Yes' is selected.

Select this if the answer to Question 13, 'Does the transaction involve a third party?', is 'No'. This option adds 1 point to the risk score. Fill only if 'No' is selected.

Select this if the answer to Question 13, 'Does the transaction involve a third party?', is 'Unknown' or 'Possibly'. This option adds 2 points to the risk score.

Select this if the answer to Question 13, 'Does the transaction involve a third party?', is 'Yes'. This option adds 3 points to the risk score. Fill only if 'Yes' is selected.

Select this if you answered 'Yes' to Question 14 in Part 1, indicating the client was identified in a non-face-to-face setting, and you want to add 1 point to the total risk score. Fill only if 'Yes' is selected.

Select this if you answered 'No' to Question 14 in Part 1, indicating the client was not identified in a non-face-to-face setting, and you want to add 2 points to the total risk score. Fill only if 'No' is selected.

Select this if the response to Question 14 in Part 1 is 'Unknown' or 'Possibly', and you want to add 3 points to the total risk score.

Check this box if the client provided some or all of the deposit in cash. Fill only if 'Yes' is selected.

Check this box if the client did not provide any of the deposit in cash. Fill only if 'No' is selected.

Check this box if it is unknown whether the client provided some or all of the deposit in cash, or if it is possibly the case.

Check this box if the answer to Question 16 in Part 1 was 'Yes' to add 1 point to the total risk score. Fill only if 'Yes' is selected.

Check this box if the answer to Question 16 in Part 1 was 'No' to add 2 points to the total risk score. Fill only if 'No' is selected.

Check this box if the answer to Question 16 in Part 1 was 'Unknown/Possibly' to add 3 points to the total risk score.

Check this box if your answer to question 17 ('Is there anything else unusual about the client or the transaction?') is Yes, to indicate a score of 1. Fill only if 'Part 1 – Question 17: Yes' is selected.

Check this box if your answer to question 17 ('Is there anything else unusual about the client or the transaction?') is No, to indicate a score of 2. Fill only if 'Part 1 – Question 17: No' is selected.

Check this box if your answer to question 17 ('Is there anything else unusual about the client or the transaction?') is Unknown or Possibly, to indicate a score of 3.

Check this box if the client has a criminal history related to illegal drug trafficking, bribery, fraud, forgery, murder, robbery, counterfeit money, stock manipulation, tax evasion, or copyright infringement. Fill only if 'Yes' is selected.

Check this box if the client does not have a criminal history related to illegal drug trafficking, bribery, fraud, forgery, murder, robbery, counterfeit money, stock manipulation, tax evasion, or copyright infringement. Fill only if 'No' is selected.

Check this box if it is possibly true, or unknown, whether the client has a criminal history related to illegal drug trafficking, bribery, fraud, forgery, murder, robbery, counterfeit money, stock manipulation, tax evasion, or copyright infringement.

Check this box if your answer to question 3 in Part 1 was 'Yes'. Fill only if 'Yes' is selected.

Check this box if your answer to question 3 in Part 1 was 'No'. Fill only if 'No' is selected.

Check this box if your answer to question 3 in Part 1 was 'Possibly'.

Check this box if the client lives within 10 km of an international border or 5 km of an international airport, contributing 1 point to the total risk score. Fill only if 'Yes' is selected.

Check this box if the client does not live within 10 km of an international border or 5 km of an international airport, contributing 2 points to the total risk score. Fill only if 'No' is selected.

Check this box if it is unknown or possibly true that the client lives within 10 km of an international border or 5 km of an international airport, contributing 3 points to the total risk score.

Check this box if the client is a Canadian citizen or permanent resident (Q5 Yes) to assign 1 point to the risk score. Fill only if 'Question 5 – Yes' is selected.

Check this box if it is unknown whether the client is a Canadian citizen or permanent resident (Q5 Unknown) to assign 2 points to the risk score. Fill only if 'Unknown' is selected.

Check this box if the client is not a Canadian citizen or permanent resident (Q5 No) to assign 3 points to the risk score. Fill only if 'No' is selected.

Select this option if the client is a domestic PEP or a family member/close associate of one, assigning a risk score of 1. Fill only if 'Yes' is selected.

Select this option if the client is not a domestic PEP and is not a family member/close associate of one, assigning a risk score of 2. Fill only if 'No' is selected.

Select this option if it is unknown or possibly true that the client is a domestic PEP or a family member/close associate of one, assigning a risk score of 3.

Check this box if the answer to Question 7 in Part 1 is 'Yes', indicating the client is a foreign PEP or HIO or a family member/close associate of one, and you want to select the score of 1. Fill only if 'Yes' is selected.

Check this box if the answer to Question 7 in Part 1 is 'No', indicating the client is not a foreign PEP or HIO or a family member/close associate of one, and you want to select the score of 2. Fill only if 'No' is selected.

Check this box if the answer to Question 7 in Part 1 is 'Unknown' or 'Possibly', indicating uncertainty about whether the client is a foreign PEP or HIO or a family member/close associate of one, and you want to select the score of 3.

Check this box if the client is subject to a Ministerial Directive. Fill only if 'Yes' is selected.

Check this box if the client is not subject to a Ministerial Directive. Fill only if 'No' is selected.

Check this box if it is unknown or possibly true that the client is subject to a Ministerial Directive.

Check this box if your answer to Part 1, Question 9, regarding other connections to the client and a high-risk country, is 'Yes'. Fill only if 'Yes' is selected.

Check this box if your answer to Part 1, Question 9, regarding other connections to the client and a high-risk country, is 'No'. Fill only if 'No' is selected.

Check this box if your answer to Part 1, Question 9, regarding other connections to the client and a high-risk country, is 'Possibly' or 'Unknown'.

Provide a detailed explanation of why you suspect your client may be acting on behalf of a third party. Fill only if 'No' is 'No'.

Check this box if the client states that the transaction is being conducted on behalf of a third party.

Check this box if the client states that the transaction is NOT being conducted on behalf of a third party.

Enter the full name of the third party. Fill only if 'Yes' is 'Yes'.

Enter the full address of the third party. Fill only if 'Yes' is 'Yes'.

Enter the telephone number of the third party. Fill only if 'Yes' is 'Yes'.

Provide the date of birth of the third party, if applicable. Fill only if 'Yes' is 'Yes'.

Enter the nature of the principal business or occupation of the third party. Fill only if 'Yes' is 'Yes'.

Continue to enter the nature of the principal business or occupation of the third party on this line, if necessary. Fill only if 'Yes' is 'Yes'.

Enter the registration or incorporation number, and the jurisdiction and country that issued that number, if applicable. Fill only if 'Yes' is 'Yes'.

Describe the relationship between the third party and the client. Fill only if 'Yes' is 'Yes'.

Continue to describe the relationship between the third party and the client on this line, if necessary. Fill only if 'Yes' is 'Yes'.

Enter the street number, street name and unit information for the transaction property.

Enter the city, province and postal code for the transaction property.