4502 - Customer Identification



CUSTOMER IDENTIFICATIONPrior to advancing mortgage funds, we require that you ascertain the identity of each customer in accordance with our Instructions to Solicitor. Each customer is required to be physically present at the time you ascertain his/her identity. Following, you must return the fully completed and signed form to Bridgewater Bank. To confirm identity, each customer must provide an acceptable form of photo identification, as listed in the table below. Photo identification must be authentic (issued by a federal, provincial or territorial government), valid (unaltered) and current (not expired). If the photo identification document is presented with different names, such as a maiden or married name, a certificate of marriage or certificate of name change must also be presented. DO NOT FORWARD COPIES OF IDENTIFICATION TO BRIDGEWATER BANKACCEPTABLE PHOTO ID DOCUMENTSPlace of IssuanceType of DocumentAlbertaDriver’s LicensePhoto Identification CardBritish ColumbiaDriver’s LicenseEnhanced IDServices CardCanadaPassportThe DND 404 Drivers LicensePermanent resident cardCitizenship Card issued prior to 2012Secure Certificate of Indian StatusPossession and Acquisition Licence (PAL)ForeignDriver’s LicensePassportPhoto Identification CardSecure Certificate of Indian StatusGlobal Entry CardNexus ManitobaDriver’s LicenseEnhanced Identification CardNew BrunswickDriver’s LicensePhoto ID CardNewfoundland and LabradorDriver’s LicensePhoto Identification CardNorthwest TerritoriesDriver’s LicenseGeneral Identification CardNova ScotiaDriver’s LicenseIdentification CardNunavutDriver’s LicenseGeneral Identification CardOntarioDriver’s LicensePhoto CardPrince Edward IslandDriver’s LicenseVoluntary IDQuebecDriver’s LicenseHealth Card (with photo)SaskatchewanDriver’s LicenseNon-driver photo IDYukonDriver’s LicenseGeneral Identification CardNote: ○Health cards from Manitoba, Nova Scotia, Ontario, PEI, and Yukon cannot be used for identification purposes, even if offered by the applicant.A Quebec driver’s license or provincial health card may be used for identification only if the applicant volunteers it as a form of identification; a financial institution cannot require a Quebec resident to provide their driver’s licence for identification purposes. THIRD PARTY DETERMINATIONMortgage Number: FORMTEXT ?????We require that you make reasonable inquiries or otherwise take reasonable measures to determine whether the person(s) applying for the mortgage is acting on behalf of a third party individual or entity.To do so, you may ask the customer directly if they are applying for this mortgage/account on behalf of a third party who is not disclosed on the application.If the customer says yes, or if you suspect the customer is acting on behalf of a third party individual or entity, complete the Third Party Declaration form (Form #7511 available at solicitordocs.ca in the Solicitor Documents section) and return the completed form to Bridgewater Bank. I have asked questions to determine whether the customer is acting on behalf of a third party not disclosed on the application, and a Third Party Declaration form is: FORMCHECKBOX Applicable and attached FORMCHECKBOX Not applicablePRIMARY CUSTOMERSECONDARY CUSTOMER (if applicable)Name FORMTEXT ?????Name FORMTEXT ?????ID Type FORMTEXT ????? ID Type FORMTEXT ?????Reference Number FORMTEXT ????? Reference Number FORMTEXT ?????Place of Issuance FORMTEXT ????? Place of Issuance FORMTEXT ?????Expiry Date FORMTEXT ????? Expiry Date FORMTEXT ?????Date ID was verified FORMTEXT ?????Date ID was verified FORMTEXT ?????In addition, please list any short forms of the customer’s name, including nicknames, or other aliases the customer frequently uses (e.g. Robert-Bob, Richard-Dick, middle name used rather than first name etc.). FORMTEXT ????? FORMTEXT ?????Dated at FORMTEXT ?????, this FORMTEXT ????? day of FORMTEXT ?????, 20 FORMTEXT ?????.I, hereby attest that I have met with, seen the forms of identification described herein and verified the identity of the Primary Customer and (if applicable, Secondary Customer) noted above. Solicitor Name________________________________________________ Solicitor Signature ................
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