Marital Status Single Married Common law Widowed

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FINANCIAL PLANNING INFORMATION Date: IA Name: FPS Name: PERSONAL INFORMATION First name Last name Marital Status Single Married Common law Widowed Separated Divorced Date of birth Retirement age Date of Retirement Province Account Number Preferred Contact Method (e-mail or phone) DEPENDANTS Date of Birth Relationship 1 2 3 RISK TOLERANCE* Non-Registered Registered * Please choose a risk tolerance level from the following options: Conservative / Moderate /Moderate Growth / Moderate Aggressive / Aggressive Growth 1

LIFESTYLE NEEDS (AFTER-TAX) Joint Before retirement At Retirement EMPLOYMENT INCOME Income amount Employer Occupation GOVERNMENT BENEFITS CPP Benefits Starting age OAS Benefits NON-REGISTERED INVESTMENTS Joint ACB Cash & Equivalents Bonds Equities Annual Savings Total Investments outside of WG 2

RESP Dependant 1 Dependant 2 Dependant 3 Cash & Equivalents Bonds Equities Annual Savings Total Investments outside of WG TFSA Contribution Room Available Cash & Equivalents Bonds Equities Annual Savings Beneficiary Designation Total Investments outside of WG RRSP / RRIF INVESTMENTS Cash & Equivalents Bonds Equities Beneficiary Designation Total Investments outside of WG 3

RRSP CONTRIBUTIONS Contribution room (include this year) Annual contribution amount DEFINED BENEFIT PLAN Annual pension amount DEFINED CONTRIBUTION PLAN Employee contribution (% of income) Employer contribution (% of income) Beneficiary Designation LOCKED-IN PENSION (LIRA/LIF) Pension Jurisdiction Cash & Equivalents Bonds Equities Total Federal Provincial Federal Provincial PERSONAL USE REAL ESTATE Residence Recreational 1 Recreational 2 Current value Adjusted cost base (ACB) Mortgage amount Monthly payment Annual interest rate 4

LIFE INSURANCE Group Life Insurance Company Owner Type Death Benefit CSV Premium $ $ $ $ $ $ Total $ $ $ Notes: Personal Life Insurance Financial Institution Owner Type Death Benefit CSV Premium $ $ $ $ $ $ $ $ $ Total $ $ $ Notes: Disability Insurance Financial Institution Owner Benefit Amount Premium $ $ $ $ $ $ Total $ $ Notes: 5

Critical Illness Insurance Financial Institution Owner Benefit Amount Premium $ $ $ $ $ $ Total $ $ Notes: 6

GOALS: Goal Time Horizon Importance Priority All About You What is the most important financial issue in your life right now? What are your concerns? What keeps you up at night? What is it that you want that you haven t already achieved? Do you feel financially secure? If you had to spend a million dollars (not invest it or give it away) what would you buy? If you had to give away a million dollars, who or what would you give it to? 7

Our financial plans assume a life expectancy of age 90. Is there any reason to use a different assumption? Do you feel comfortable with your current Banker, Accountant, Lawyer? If not, would you like any recommendations? Have you structured your affairs to maximize family income-splitting opportunities? (Spousal loans, Spousal RRSP, Family Trusts, Splitting pension income) Do you enjoy your job? When would you like to retire? Would you like to continue working on a part-time or consulting basis throughout retirement? OTHER INFORMATION: 8

Do you have other sources of income? Are you expecting an inheritance in the future? What is your debt situation? How do you feel about the taxes you pay? Do you have an interest in charitable giving? Are you currently involved with any charitable organizations? Do you wish to include charitable giving in your financial or estate plan? Are you interested in leaving a legacy that includes a charity? 9

Do you have children or dependants? How old are they? Are your children in university? Do you want to help fund your child s post secondary education? Have you started saving for child s education through the creation of an RESP? If yes, is your child's RESP registered as a single or family plan? Is the account held with both parents listed as joint subscribers or in a single parent's name? Yes No Are your children married? How well do they get along with you and each other? Should we consider the possibility of future marriage breakdown in your plan? Have you ever gifted money to your children? Yes No How was it done? Do you intend to give your children money in the future? Is everyone in your family generally healthy? Are both of your parents/in laws living? Are they dependent on you? Financially? Physically? Emotionally? What are the most important values you learned growing up? What do you want your children or grandchildren to learn from you? How have you or will you convey your values to future generations? If parents aren t living, did you receive an inheritance? Where you involved in settling the estate? 10

LIFE AND INCOME PROTECTION How much insurance coverage do you carry? Is the risk of disability something you worry about? What is the financial consequence to your family should you were to die today? If you and your spouse were to pass away tomorrow, how would you like your assets to be distributed? Can you tell me if any of your assets have been allocated to support your long term care expenses? Have you made any provisions for your health care needs? Have you made a Will? When is the last time you reviewed your Wills and POAs? What specific bequests have you made in your Will? Do you have any assets of sentimental value that you want to ensure are preserved? What plan do you currently have in place to secure these assets? e.g., the creation of a testamentary trust How much money do you plan to leave in your estate? 11

1. If there are significant tax savings that can be achieved by implementing recommendations in this financial plan, where would the savings go in order of priority: Increase spending Increase savings/reduction in debt Help family during your lifetime Charitable gifts Retire earlier Reduce risk in your investments Enhance your legacy to your family Other (please specify) 2. Please order the following goals in order of importance: To ensure a lifetime of financial independence To minimize tax and probate fees for the estate To maximize inheritance for heirs To make charitable donations 3. Do you have any specific estate goals (indicate all that apply): Covering taxes triggered on your death without your estate selling assets Leaving a gift to a charity Providing for a special needs family member Ensuring a specific legacy for family members or friends Minimizing taxes and fees on death 4. Health and family longevity are important considerations in determining an appropriate time horizon and specific recommendations. Please indicate any of the following that apply: I would like my assets to last at least until age One or both of my parents have lived to age 90 One or both of my parents died before age 65 I have a medical history which includes diabetes, cancer, stroke or heart disease 5. Please describe in a single sentence what would best describe your expectations from this financial planning process as it relates to your estate. 6. General plan for Distribution of Estate To spouse To others Any special provisions To children Residue Executors 12

Do you plan to purchase any real estate outside of Canada? Do you wish for any properties to be transferred to the next generation? Do you plan to downsize/sell/renovate your principal residence or other properties? Have you ever considered renting any of your properties to provide additional cash flow in retirement? 13

HOLDCO Name: Other Ownership (%) Common Shares Preferred Shares (ACB) (ACB) Fair Market Value (ACB) (ACB) TAX BALANCES RDTOH Balance CDA Balance INVESTMENTS Fixed Income Equities Cash CDN Foreign CDN Foreign Total Market Value ACB Goodwill Value: Fixed Asset Value: Investor Profile: Additional Details: 14

OPCO Name: Other Ownership (%) Common Shares Preferred Shares (ACB) (ACB) Fair Market Value (ACB) (ACB) TAX BALANCES RDTOH Balance CDA Balance INVESTMENTS Fixed Income Equities Cash CDN Foreign CDN Foreign Total Market Value ACB Goodwill Value: Fixed Asset Value: Investor Profile: Additional Details: 15

CORPORATE REAL ESTATE Property 1 Property 2 Property 3 Market Value ACB Growth Rate Sale Date Net Rental Income From Year-to-Year Mortgage Balance As of Monthly Payment Interest Rate Life Insured If Holdco exists, there may be an opportunity to structure corporate-owned life insurance through the HOLDCO which will afford the potential for creditor protection. This is particularly useful for corporate IRPs. Assets in the HOLDCO may consist of shares and/or cash instruments. Knowing that may help in determining how much is available for the IRP. Additional Details: CIBC Wood Gundy is a division of CIBC World Markets Inc., a subsidiary of CIBC and a Member of the Canadian Investor Protection Fund and Investment Industry Regulatory Organization of Canada. s are advised to seek advice regarding their particular circumstances from their personal tax and legal advisors. If you are currently a CIBC Wood Gundy client, please contact your Investment Advisor. Transactions in insurance products, including segregated funds, are made on your behalf by CIBC Wood Gundy Financial services Inc., or in the case of Quebec residents, CIBC Wood Gundy Financial Services (Quebec) Inc. 16