Designation Application Designated Financial Services Advisor (DFSA™)

PERSONAL INFORMATION

DFSA™ DECLARATION AND SIGNATURE OF APPLICANT

Continuing Education Requirements

You are not required to submit your CE documentation on an annual basis, however a percentage of DFSA holders will be audited for compliance annually.

Fit and Proper Requirement

Have you ever been accused of professional misconduct, disciplined or reprimanded by, or had a licence suspended or revoked by, an employer, professional association, regulatory authority (i.e. securities commission, CIRO, Insurance Regulator, or consumer protection legislation)?

Are you currently bankrupt or have you at any time in the past 5 years been adjudged bankrupt?

Have you ever been convicted of a criminal offence* in any jurisdiction for which a record suspension or a pardon has not been granted?

Have you ever been convicted of an offense under any financial services or consumer protection legislation in any jurisdiction (i.e., laws regulating the sale of securities, insurance, real estate, mortgages, etc.)?

If you have answered “Yes” to any of the questions above, please attach all relevant paperwork, including details of any punishment or disciplinary action taken. Any information you provide will be collected, stored and used in accordance with applicable law and our privacy policy and will be shared with the Designation Ethics Committee to determine your suitability for the designation.

Code of Ethics

Certification Mark License Agreement

Clear Signature