Tax Saving Consultation - Questionnaire Please fill out this form to help us design a tax saving strategy centered around what is most important to you and your specific objectives. This form takes around 2 - 3 min to fill. Thank you. GENERAL INFORMATION Your Email Your Phone Your Address Your Date of Birth Selected Event Date & Time Please provide some more information about your Business : Do you own a business ? * —Please choose an option—YesNo MY OPINIONS : Please check the one most appropriate to you: 1. Wills and Will planning is :Very importantImportantNot important 2. Appointing Power of Attorney is :Very importantImportantNot important 3. Insuring our key people is :Very importantImportantNot important 4. I consider a good life insurance program to be :Very importantImportantNot important 5. On my death, my family’s ability to maintain their standard of living is :Very importantImportantNot important 6. In the event of my death, paying off debt is :Very importantImportantNot important 7. Rewarding key people is :Very importantImportantNot important 8. Eventually passing my business to my child(ren) is :Very importantImportantNot important 9. If I cannot work due to sickness or disability, assuring an income is :Very importantImportantNot important 10. Retirement planning is :Very importantImportantNot important 11. Tax deferred investing is :Very importantImportantNot important 12. Buying out a shareholder on death is :Very importantImportantNot important 13. Estate planning to save tax is :Very importantImportantNot important IN THE NEAR FUTURE I plan to (OR) expect to : MarryBuy-out a partnerReceive inheritanceDivorceBring family into businessBorrow moneyRetireReorganize corporatelyBuy insuranceStart a businessChange firmsPay off a loanExpand a business Purchase propertyWrite a willSell a businessSell propertyOther BUSINESS 1. I have outlined my financial plans on paper : YesNoNot Sure 2. I know when I want to retire : YesNoNot Sure 3. I know what capital I need to enjoy my retirement years : YesNoNot Sure 4. I know how tax deferred savings can be used to my advantage : YesNoNot Sure 5. My life insurance program is consistent with my retirement plans : YesNoNot Sure 6. I carry personal disability or accident/sickness insurance : YesNoNot Sure 7. Our business has a written business succession plan : YesNoNot Sure 8. My life insurance is consistent with our business succession plan : YesNoNot Sure 9. I have developed a tax effective estate plan : YesNoNot Sure 10. I have a current, valid Will that is consistent with my estate plan : YesNoNot Sure 11. I understand the full impact of how taxes will be applied to my estate : YesNoNot Sure 12. My life insurance is consistent with my total estate plan : YesNoNot Sure 13. I understand how trusts are used in estate planning : YesNoNot Sure I AM INTERESTED IN DISCUSSING 1. A review of all my existing insurance : YesNoNot Sure 2. Ways to provide for my family in the event of death : YesNoNot Sure 3. Insurance to pay off debt : YesNoNot Sure 4. Creditor protection : YesNoNot Sure 5. Supplemental executive compensation plans for key employees : YesNoNot Sure 6. Supplemental executive compensation plans for business owners : YesNoNot Sure 7. Ways to minimize income taxes : YesNoNot Sure 8. Ways to reduce estate taxes : YesNoNot Sure 9. Tools for family business succession : YesNoNot Sure 10. Ways to pay me if I become critically ill : YesNoNot Sure 11. Tools to extract retained earnings : YesNoNot Sure 12. Tax efficient supplemental income for my retirement : YesNoNot Sure 13. Estate planning : YesNoNot Sure 14. Investments that are tax favored : YesNoNot Sure 15. Charitable giving : YesNoNot Sure 16. Buy-sell agreements for multiple shareholders : YesNoNot Sure 17. Other (specify) : MY OPINIONS : Please check the one most appropriate to you : 1. Saving and accumulating money on a regular basis is : Very importantImportantOf little value 2. Providing educational funds for children is : Very importantImportantOf little value 3. Having a professional advisor involved in my insurance, investment and retirement planning is : Very importantImportantOf little value 4. Developing and maintaining a strategic financial plan is : Very importantImportantOf little value 5. Having an up-to-date will and power of attorney is : Very importantImportantOf little value 6. In the event of my death or my spouse’s/partner’s premature death, maintaining our family’s lifestyle is : Very importantImportantOf little value 7. In the case of a disability or critical illness for me or my spouse/partner, paying off any outstanding mortgage or debt is : Very importantImportantOf little value 8. In the case of a disability or critical illness for me or my spouse/partner, providing for our children’s post-secondary education is : Very importantImportantOf little value 9. In the case of a disability or critical illness for me or my spouse/partner, being able to pay off the mortgage and other major bills is : Very importantImportantOf little value 10. In the case of a disability or critical illness for me or my spouse/partner, maintaining our standard of living and lifestyle is : Very importantImportantOf little value 11. In the case of a disability or critical illness for me or my spouse/partner, being able to pay for any additional medical expenses is : Very importantImportantOf little value 12. Minimizing the impact of inflation and taxes is : Very importantImportantOf little value 13. At retirement, having sufficient funds to retire on my own term is : Very importantImportantOf little value IN THE NEAR FUTURE I plan to (OR) expect to (check all that apply) : Occupationally Receive a raiseChange employmentStart a businessRetireOther Personally Get marriedStart a familyCare for a parentOther Financially Buy/Sell a home/propertyBorrow moneyPay off a loanBuy/Sell a businessOther FINANCIAL OVERVIEW 1. I have a professional advisor who guides me in my financial planning : YesNoNot Sure 2. I know what I am entitled to under my and/or my spouse’s/ partner’s group benefits and/or pension plan : YesNoNot Sure 3. I have a regular savings and accumulation program : YesNoNot Sure 4. I have plans in place to provide post-secondary education for my children : YesNoNot Sure 5. I know how much income I will receive if I become disabled : YesNoNot Sure 6. In the event of a critical illnes (e.g., heart attack, cancer) I have enough money to make the necessary lifestyle adjustments : YesNoNot Sure 7. I/We can afford the costs of long-term care should the need arise : YesNoNot Sure RETIREMENT OVERVIEW 1. I know what capital I need now to be on a permanent vacation during my retirement years : YesNoNot Sure 2. My pension plan/retirement fund is structured to maximize it’s benefits : YesNoNot Sure 3. I maximize my RRSP contributions each year : YesNoNot Sure 4. My current rate of savings and investments are sufficient to meet my retirement objectives : YesNoNot Sure 5. I understand what happens to my group benefits at retirement : YesNoNot Sure ESTATE OVERVIEW 1. I/We have made a list of all important documents and their location : YesNoNot Sure 2. I understand the full impact of how taxes will be applied to my estate and those ramifications : YesNoNot Sure 3. I have an up-to-date will and power of attorney : YesNoNot Sure 4. My/Our current life insurance coverage will sustain our family’s lifestyle after my death : YesNoNot Sure I AM INTERESTED IN DISCUSSING / REVIEWING 1. A review of my savings and investment programs : YesNo 2. Ways to maximize my pension and retirement income : YesNo 3. Ways to fund post secondary education for my children or grandchildren : YesNo 4. Ways to put an up-to-date financial plan in place : YesNo 5. Ways to maintain my family’s lifestyle in the event of my death or disability : YesNo 6. Ways to maximize charitable gifting : YesNo 7. Strategies to reduce taxes : YesNo 8. Insurance to pay off the mortgage : YesNo 9. Ways to offset the cost of a critical illness : YesNo 10. Ways to offset the substantial expense of long term care : YesNo 11. Ways to fund Capital Gains and other estate taxes : YesNo 12. Ways to ensure the value of my business goes to my family should I die, become disabled or critically ill : YesNo 13. Life insurance on (check accordingly) : MyselfMy spouse/partnerMy children/grandchildrenN/A 14. Income protection (Disability) (check accordingly) : MyselfMy spouse/partnerMy children/grandchildrenN/A 15. Critical Illness Insurance on (check accordingly) : MyselfMy spouse/partnerMy children/grandchildrenN/A 16. Long Term Care Insurance (check accordingly) : MyselfMy spouse/partnerMy children/grandchildrenN/A Δ