Name of Employer and Location of Company?
Estimated annual employment income?
Estimated income from other sources?
Name of your financial advisor?
Value of RRSP savings?
Amount of your mortgage debt?
Your total debt including mortgage?
An estimate of your net worth (assets plus investments less all debt)?
Please provide a few details of this net worth total?
Current Life, Critical and Disability Insurance Policies
Total number of life insurance policies?
Total amount of personal life insurance coverage?
Name of life insurance advisor?
Total amount of critical illness insurance?
New Life Insurance Coverage
Desired amount of insurance coverage?
Reason(s) why you need new life insurance?
(Highlight one or more reasons)
Mortgage & Debt Insurance
Key Person Insurance
Coverage in the event of a critical illness or death of the shareholder or key employee.
Legato 3: Insurance, Investment, Legacy
Future Loan Collateral
Funding of Henson Trust (disabled dependent)
Required in Separation/Divorce
Income Replacement & Mortgage/Debt Coverage
Your banking institution?
--None--Bank of Montreal
Royal Bank of Canada (RBC)
Toronto Dominion (TD)
VanCity Credit Union
Owner name(s)on bank account from which premium deposits will be drawn (as shown on account statement)?
Title of your family holding company?