This form contains 133 fields organized into 20 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
A. BASIC TRANSACTION INFORMATION
Transaction Property Address Text
Please provide the full street address of the property involved in the transaction.
Max length: 85 characters
Sales Representative/Broker Name Text
Please enter the full name of the sales representative or broker involved in the transaction.
Max length: 81 characters
Account 1 Details
Account 1 Number Text
Please provide the account number for Account 1. Fill only if 'an account is affected by the transaction'.
Max length: 38 characters
Depends on: Amount of Funds, Amount of Funds, Third Fund Amount
Account 1 Holder Name Text
Please provide the full name of the account holder for Account 1. Fill only if 'an account is affected by the transaction'.
Max length: 31 characters
Depends on: Amount of Funds, Amount of Funds, Third Fund Amount
Account 1 Type Other Explanation Text
Please explain the type of account if 'Other' is selected for Account 1. Fill only if 'Other' is selected.
Max length: 61 characters
Depends on: Other
Chequing Checkbox
Check this box if Account 1 is a chequing account. Fill only if 'an account is affected by the transaction'.
Depends on: Amount of Funds, Amount of Funds, Third Fund Amount
Saving Checkbox
Check this box if Account 1 is a saving account. Fill only if 'an account is affected by the transaction'.
Depends on: Amount of Funds, Amount of Funds, Third Fund Amount
Trust Checkbox
Check this box if Account 1 is a trust account. Fill only if 'an account is affected by the transaction'.
Depends on: Amount of Funds, Amount of Funds, Third Fund Amount
Other Checkbox
Check this box if Account 1 is an account type other than chequing, saving, or trust, and provide an explanation. Fill only if 'an account is affected by the transaction'.
Depends on: Amount of Funds, Amount of Funds, Third Fund Amount
Account 2 Details
Account Number Text
Please provide the account number for Account 2. Fill only if 'an account is affected by the transaction'.
Max length: 38 characters
Depends on: Amount of Funds, Amount of Funds, Third Fund Amount
Account Holder Name Text
Please provide the full name of the account holder for Account 2. Fill only if 'an account is affected by the transaction'.
Max length: 31 characters
Depends on: Amount of Funds, Amount of Funds, Third Fund Amount
Other Account Type Explanation Text
Please explain the type of account if 'Other' was selected for Account 2. Fill only if 'Other, explain' is selected.
Max length: 61 characters
Depends on: Other, explain
Chequing Checkbox
Check this box if Account 2 is a Chequing account. Fill only if 'an account is affected by the transaction'.
Depends on: Amount of Funds, Amount of Funds, Third Fund Amount
Saving Checkbox
Check this box if Account 2 is a Saving account. Fill only if 'an account is affected by the transaction'.
Depends on: Amount of Funds, Amount of Funds, Third Fund Amount
Trust Checkbox
Check this box if Account 2 is a Trust account. Fill only if 'an account is affected by the transaction'.
Depends on: Amount of Funds, Amount of Funds, Third Fund Amount
Other, explain Checkbox
Check this box if Account 2 is another type of account not listed and provide an explanation. Fill only if 'an account is affected by the transaction'.
Depends on: Amount of Funds, Amount of Funds, Third Fund Amount
Account 3 Details
Account 3 Number Text
Please enter the identifying number for Account 3. Fill only if 'an account is affected by the transaction'.
Max length: 38 characters
Depends on: Amount of Funds, Amount of Funds, Third Fund Amount
Account 3 Holder Name Text
Please enter the full name of the account holder for Account 3. Fill only if 'an account is affected by the transaction'.
Max length: 31 characters
Depends on: Amount of Funds, Amount of Funds, Third Fund Amount
Account 3 Other Type Explanation Text
Please provide an explanation for the 'Other' type of Account 3. Fill only if 'Account 3 Other' is selected.
Max length: 61 characters
Depends on: Account 3 Other
Account 3 Chequing Checkbox
Check this box if Account 3 is a Chequing account. Fill only if 'an account is affected by the transaction'.
Depends on: Amount of Funds, Amount of Funds, Third Fund Amount
Account 3 Saving Checkbox
Check this box if Account 3 is a Saving account. Fill only if 'an account is affected by the transaction'.
Depends on: Amount of Funds, Amount of Funds, Third Fund Amount
Account 3 Trust Checkbox
Check this box if Account 3 is a Trust account. Fill only if 'an account is affected by the transaction'.
Depends on: Amount of Funds, Amount of Funds, Third Fund Amount
Account 3 Other Checkbox
Check this box if Account 3 is an account type not listed as Chequing, Saving, or Trust, and provide an explanation. Fill only if 'an account is affected by the transaction'.
Depends on: Amount of Funds, Amount of Funds, Third Fund Amount
Account 4 Details
Account 4 Number Text
Please enter the account number for Account 4. Fill only if 'an account is affected by the transaction'.
Max length: 38 characters
Depends on: Amount of Funds, Amount of Funds, Third Fund Amount
Account 4 Holder Name Text
Please provide the full name of the holder for Account 4. Fill only if 'an account is affected by the transaction'.
Max length: 31 characters
Depends on: Amount of Funds, Amount of Funds, Third Fund Amount
Account 4 Other Type Explanation Text
Please explain the type of account if 'Other' was selected for Account 4. Fill only if 'Other' is selected.
Max length: 61 characters
Depends on: Other
Chequing Checkbox
Check this box if Account 4 is a Chequing account. Fill only if 'an account is affected by the transaction'.
Depends on: Amount of Funds, Amount of Funds, Third Fund Amount
Saving Checkbox
Check this box if Account 4 is a Saving account. Fill only if 'an account is affected by the transaction'.
Depends on: Amount of Funds, Amount of Funds, Third Fund Amount
Trust Checkbox
Check this box if Account 4 is a Trust account. Fill only if 'an account is affected by the transaction'.
Depends on: Amount of Funds, Amount of Funds, Third Fund Amount
Other Checkbox
Check this box if Account 4 is an account type not listed (Chequing, Saving, or Trust) and provide a further explanation. Fill only if 'an account is affected by the transaction'.
Depends on: Amount of Funds, Amount of Funds, Third Fund Amount
Account 5 Details
Account 5 Number of Account Text
Enter the number of the fifth affected account. Fill only if 'an account is affected by the transaction'.
Max length: 38 characters
Depends on: Amount of Funds, Amount of Funds, Third Fund Amount
Account 5 Name of Account Holder Text
Provide the full name of the holder for the fifth affected account. Fill only if 'an account is affected by the transaction'.
Max length: 31 characters
Depends on: Amount of Funds, Amount of Funds, Third Fund Amount
Account 5 Other Account Type Explanation Text
If 'Other' is selected for the account type, provide a detailed explanation of the fifth affected account's type. Fill only if 'Other, explain' is selected.
Max length: 61 characters
Depends on: Other, explain
Chequing Checkbox
Check this box if Account 5 is a chequing account. Fill only if 'an account is affected by the transaction'.
Depends on: Amount of Funds, Amount of Funds, Third Fund Amount
Saving Checkbox
Check this box if Account 5 is a saving account. Fill only if 'an account is affected by the transaction'.
Depends on: Amount of Funds, Amount of Funds, Third Fund Amount
Trust Checkbox
Check this box if Account 5 is a trust account. Fill only if 'an account is affected by the transaction'.
Depends on: Amount of Funds, Amount of Funds, Third Fund Amount
Other, explain Checkbox
Check this box if Account 5 is a type of account not listed as Chequing, Saving, or Trust, and provide an explanation. Fill only if 'an account is affected by the transaction'.
Depends on: Amount of Funds, Amount of Funds, Third Fund Amount
Brokerage Reference Number
Brokerage Reference Number Text
Provide the reference number(s) of the brokerage that received the funds for this purchase/sale transaction and functions as an account for the funds. Fill only if 'an account is affected by the transaction'.
Max length: 56 characters
Depends on: Amount of Funds, Amount of Funds, Third Fund Amount
Corporation Details
Director Names Text
Enter the full name(s) of the corporation's directors.
Max length: 97 characters
Corporation Registration Number Text
Enter the registration number of the corporation.
Max length: 83 characters
Check this box when attached Checkbox
Check this box after attaching a copy of corporate records that show authority to bind the corporation regarding the transaction.
Credit File Method
Credit Bureau Name Text
Enter the name of the Canadian credit bureau that holds the credit file.
Max length: 62 characters
Credit File Reference Number Text
Enter the reference number associated with the credit file.
Max length: 84 characters
E. Other Persons or Entities
Person/Entity Name Text
Please provide the full name of the person or entity involved in providing the funds. Fill only if 'Amount of Funds (second instance)' is filled
Max length: 108 characters
Depends on: Amount of Funds
Address Text
Please enter the full mailing address of the person or entity. Fill only if 'Amount of Funds (second instance)' is filled
Max length: 106 characters
Depends on: Amount of Funds
Date of Birth Date
Please provide the date of birth for the person, if applicable. Fill only if 'Amount of Funds (second instance)' is filled
Max length: 79 characters
Depends on: Amount of Funds
Principal Business/Occupation Text
Please describe the principal business or occupation of the person or entity. Fill only if 'Amount of Funds (second instance)' is filled
Max length: 69 characters
Depends on: Amount of Funds
Financial Account Confirmation
Confirm Name and Financial Account Checkbox
Check this box if you are confirming the individual's name and a financial account to ascertain their identity using this method.
Name of Source (Financial Account) Text
Please provide the name of the source used to confirm the financial account. Fill only if 'Confirm Name and Financial Account' is 'Yes'.
Max length: 98 characters
Depends on: Confirm Name and Financial Account
Financial Account Type Text
Please specify the type of financial account being confirmed. Fill only if 'Confirm Name and Financial Account' is 'Yes'.
Max length: 92 characters
Depends on: Confirm Name and Financial Account
Account Number (Financial Account) Text
Please provide the account number for the financial account being confirmed. Fill only if 'Confirm Name and Financial Account' is 'Yes'.
Max length: 96 characters
Depends on: Confirm Name and Financial Account
First Fund Information
Amount of Funds Number
Enter the total monetary value of the funds received.
Max length: 42 characters
Currency of Funds Text
Specify the currency type in which the funds were received.
Max length: 30 characters
Date of Receipt Date
Provide the date on which the funds were received.
Max length: 89 characters
Purpose of Funds Text
Explain the specific purpose for which these funds were provided, such as a deposit for purchase.
Max length: 68 characters
Exchange Rate Number
Enter the exchange rate used if the funds are not in CAD. Fill only if 'Currency of Funds' is not 'CAD'.
Max length: 44 characters
Depends on: Currency of Funds
Source of Exchange Rate Text
Indicate the source from which the specified exchange rate was obtained. Fill only if 'Currency of Funds' is not 'CAD'.
Max length: 23 characters
Depends on: Currency of Funds
Other Method of Receipt Explanation Text
If 'Other' is selected as the method of receipt, provide a detailed explanation. Fill only if 'Other Method of Receipt' is 'Yes'.
Max length: 27 characters
Depends on: Other Method of Receipt
Other Type of Funds Explanation Text
If 'Other' is selected as the type of funds received, provide a detailed explanation. Fill only if 'Other Type of Funds' is 'Yes'.
Max length: 8 characters
Depends on: Other Type of Funds
Cheque Checkbox
Check this box if the funds were received via a standard cheque.
Certified Cheque Checkbox
Check this box if the funds were received via a certified cheque.
Cash Checkbox
Check this box if the funds were received in cash.
Bank Draft Checkbox
Check this box if the funds were received via a bank draft.
e-transfer Checkbox
Check this box if the funds were received via an electronic transfer.
Wire Transfer Checkbox
Check this box if the funds were received via a wire transfer.
Other Type of Funds Checkbox
Check this box if the type of funds received is not listed, and provide an explanation in the adjacent field.
Other Method of Receipt Checkbox
Check this box if the method of receipt is not listed, and provide an explanation in the adjacent field.
Electronically Checkbox
Check this box if the funds were received electronically, such as via e-transfer or wire transfer.
Mail Checkbox
Check this box if the funds were received through postal mail.
In Person Checkbox
Check this box if the funds were received directly from the payer in person.
Government-Issued Photo ID
Document Identifier Number Text
Provide the identifier number found on the government-issued photo identification document.
Max length: 23 characters
Other Identification Document Type Text
If 'Other' is selected for the type of identification document, explain what type of document it is. Fill only if 'Other' is 'Yes'.
Max length: 45 characters
Depends on: Other
Issuing Country Text
Provide the country that issued the government-issued photo identification document.
Max length: 35 characters
Document Expiry Date Date
Provide the expiry date of the government-issued photo identification document.
Max length: 94 characters
Issuing Jurisdiction Text
Provide the province, territory, or foreign jurisdiction that issued the government-issued photo identification document.
Max length: 51 characters
Passport Checkbox
Check this box if the government-issued photo ID used is a passport.
Driver license Checkbox
Check this box if the government-issued photo ID used is a driver's license.
Other Checkbox
Check this box if the government-issued photo ID used is another type of document not listed, and then provide an explanation.
Name and Address Confirmation
Confirm Name and Address Checkbox
Check this box if you are confirming the individual's name and address by referring to a document or source that contains this information.
Address Confirmation Source Name Text
Please enter the name of the document or source used to confirm the individual's name and address. Fill only if 'Confirm Name and Address' is 'Yes'.
Max length: 98 characters
Depends on: Confirm Name and Address
Address Confirmation Account Number Text
Please enter the account number associated with the source used to confirm the individual's name and address. Fill only if 'Confirm Name and Address' is 'Yes'.
Max length: 97 characters
Depends on: Confirm Name and Address
Name and Date of Birth Confirmation
Confirm Name and Date of Birth Checkbox
Check this box if you have confirmed the individual's name and date of birth by referring to a document or source that contains this information.
Source Name Text
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'.
Max length: 98 characters
Depends on: Confirm Name and Date of Birth
Account Number Text
Provide the account number associated with the source used for name and date of birth confirmation. The account must be valid, not expired, and recent if there is no expiry date. Fill only if 'Confirm Name and Date of Birth' is 'Yes'.
Max length: 97 characters
Depends on: Confirm Name and Date of Birth
Other Entity Registration Number
Other Entity Registration Number Text
Provide the registration number for the other entity.
Max length: 97 characters
Second Fund Information
Date of Receipt of Funds Date
Enter the date when the funds were received.
Max length: 89 characters
Amount of Funds Number
Enter the total amount of funds received.
Max length: 43 characters
Currency of Funds Text
Enter the currency in which the funds were received (e.g., CAD, USD).
Max length: 31 characters
Other Method of Receipt Explanation Text
If 'Other' was selected for the method of receipt, explain the method. Fill only if 'Other Method of Receipt' is 'Yes'.
Max length: 27 characters
Depends on: Other Method of Receipt
Purpose of Funds Text
Enter the purpose for which the funds were received (e.g., deposit for purchase).
Max length: 68 characters
Exchange Rate Number
Enter the exchange rate if the funds were not in CAD. Fill only if 'Currency of Funds' is not 'CAD'.
Max length: 44 characters
Depends on: Currency of Funds
Source of Exchange Rate Text
Enter the source of the exchange rate if the funds were not in CAD. Fill only if 'Currency of Funds' is not 'CAD'.
Max length: 23 characters
Depends on: Currency of Funds
Other Method of Receipt Checkbox
Check this box if the funds in the second fund information section were received by a method not listed above, and provide an explanation.
Wire Transfer Checkbox
Check this box if the funds in the second fund information section were received via a wire transfer.
E-transfer Checkbox
Check this box if the funds in the second fund information section were received via an electronic transfer.
Bank Draft Checkbox
Check this box if the funds in the second fund information section were received via a bank draft.
Cash Checkbox
Check this box if the funds in the second fund information section were received in cash.
Certified Cheque Checkbox
Check this box if the funds in the second fund information section were received via a certified cheque.
Cheque Checkbox
Check this box if the funds in the second fund information section were received via a standard cheque.
In Person Checkbox
Check this box if the funds in the second fund information section were received directly from the payer in person.
Mail Checkbox
Check this box if the funds in the second fund information section were received through postal mail.
Electronically Checkbox
Check this box if the funds in the second fund information section were received electronically (e.g., e-transfer/wire transfer).
Other Type of Funds Checkbox
Check this box if the funds in the second fund information section were received by a type not listed above, and provide an explanation.
Other Type of Funds Explanation Text
If 'Other' was selected for the type of funds received, explain the type of funds. Fill only if 'Other Type of Funds' is 'Yes'.
Max length: 8 characters
Depends on: Other Type of Funds
Third Fund Information
Third Fund Amount Number
Enter the total monetary amount of the third fund.
Max length: 41 characters
Third Fund Currency Text
Specify the currency type of the third fund (e.g., CAD, USD).
Max length: 31 characters
Third Fund Other Method Explanation Text
Provide a detailed explanation if the method of receipt for the third fund is not listed. Fill only if 'Other Method of Receipt' is 'Yes'.
Max length: 27 characters
Depends on: Other Method of Receipt
Third Fund Purpose Text
Describe the reason or purpose for which the third fund is being provided.
Max length: 67 characters
Third Fund Date of Receipt Date
Enter the date when the third fund was received.
Max length: 90 characters
Third Fund Exchange Rate Number
Provide the exchange rate used if the third fund is not in Canadian Dollars (CAD). Fill only if 'Third Fund Currency' is not 'CAD'.
Max length: 44 characters
Depends on: Third Fund Currency
Third Fund Exchange Rate Source Text
Indicate the source from which the exchange rate for the third fund was obtained. Fill only if 'Third Fund Currency' is not 'CAD'.
Max length: 23 characters
Depends on: Third Fund Currency
Third Fund Other Type Explanation Text
Provide a detailed explanation if the type of funds received for the third fund is not listed. Fill only if 'Other Type of Funds Received' is 'Yes'.
Max length: 8 characters
Depends on: Other Type of Funds Received
Cash Checkbox
Check this box if the funds were received in cash.
Bank Draft Checkbox
Check this box if the funds were received by bank draft.
Certified Cheque Checkbox
Check this box if the funds were received by certified cheque.
Cheque Checkbox
Check this box if the funds were received by cheque.
In Person Checkbox
Check this box if the funds were received in person.
Mail Checkbox
Check this box if the funds were received by mail.
Electronically (e-transfer/wire transfer) Checkbox
Check this box if the funds were received electronically, such as via e-transfer or wire transfer.
e-transfer Checkbox
Check this box if the funds were received via e-transfer.
Wire Transfer Checkbox
Check this box if the funds were received via wire transfer.
Other Type of Funds Received Checkbox
Check this box if the type of funds received is not listed, and provide a detailed explanation in the adjacent field.
Other Method of Receipt Checkbox
Check this box if the method of receipt is not listed, and provide a detailed explanation in the adjacent field.
Verification of Corporation/Entity
Name of Corporation or Entity Text
Enter the full legal name of the corporation or entity being verified.
Max length: 85 characters
Corporate/Entity Address Text
Enter the full street address of the corporation or entity.
Max length: 85 characters
Nature of Principal Business Text
Describe the primary business activity or industry of the corporation or entity.
Max length: 85 characters
Type of Verification Record Text
Specify the type of document or record used for verification of the corporation or entity.
Max length: 85 characters
Source of Verification Record Text
Provide the source from which the verification record was obtained.
Max length: 85 characters
Verification of Individual
Full Legal Name of Individual Text
Please enter the full legal name of the individual.
Max length: 89 characters
Address Text
Please enter the full residential address of the individual.
Max length: 108 characters
Date of Birth Date
Please enter the individual's date of birth.
Max length: 103 characters
Principal Business or Occupation Text
Please enter the individual's principal business or occupation.
Max length: 75 characters
Date Information Verified / Credit File Consulted Date
Please enter the date when the individual's information was verified or a credit file was consulted.
Max length: 72 characters