TD Canada Trust Advisor's Acknowledgement (Note: If the Applicant is an Advisor, this form must be filled out and signed by another licensed advisor.) Advisor and Dealer Information: Dealer Code Advisor Code Company Name (the "Dealer") Advisor Name (such person and any person who replaces this person is the "Advisor") Fax No. Telephone No. Advisor's Acknowledgement. By signing below the Advisor acknowledges that the Advisor has acted as agent for the Bank for the purpose of ascertaining identity, and hereby certifies that the Applicant(s) were physically present before the Advisor and produced an original version (not a copy) of valid (i.e., not expired) Identification. "Identification" in this Application refers to: (i) one of the following: Canadian driver's license, Canadian passport, or Canadian Firearms License; OR (ii) two of the following: Canadian Government Issued Identification Card, Canadian Old Age Security Card, Canadian Birth Certificate, NEXUS Card, Social Insurance Number or Canadian Permanent Residency Card. The Advisor acknowledges that the Advisor is required to obtain Identification, documenting below the type, place of issuance, number and expiry date of the Identification. The Advisor agrees that he/she will, on the request of the Bank, send a copy of the Identification obtained to the Bank. The Advisor shall ensure that the Application accurately sets out the full legal name, date of birth, address, occupation, employer name and employer address of each Applicant. The Advisor shall: (i) forward the Application and Agreement to the Bank by courier or by any other method agreed to by the Bank from time to time; and (ii) provide the Applicant(s) with a copy of this Application and the Agreement. Signature of Advisor: X _________________________________ Particulars of Identification: Applicant Name: ________________________________ ______________________________ ________________________________ First Middle Last Type of Identification ____________________________________ Number _______________________________ Place of issue __________________________________________ Expiry ________________________________ Type of Identification ____________________________________ Number _______________________________ Place of issue __________________________________________ Expiry ________________________________ Applicant Name: ________________________________ ______________________________ ________________________________ First Middle Last Type of Identification ____________________________________ Number _______________________________ Place of issue __________________________________________ Expiry ________________________________ Type of Identification ____________________________________ Number _______________________________ Place of issue __________________________________________ Expiry ________________________________ 526568 (0614).