Investor application — Lendmax Capital

Your investment

Estimated investment amount *

An estimate is fine — you can change it later.

Investment vehicle / account type *

Investment type *

Preferred Share Class B Preferred Share Class R

Not sure which applies? Leave the default — your dealing representative will confirm the class

Registered account held with *

Choose Waiting to register if the plan has not been opened yet

Name of trustee *

Plan / account number

Leave blank if you do not have it to hand.

Preferred call time *

All times Eastern, Monday to Friday.

Personal information

Last name *

First name *

Initials

Street address *

City *

Province / territory *

Country *

Postal code *

Email address *

Telephone *

I consent to you sending me/us email and or text messages about my/our accounts.

I consent to you sending me/us email and or text messages about your products and services.

Optional — you can say no and still apply.

Identity and residency

Citizenship *

Tax residence (if not Canada)

Leave blank if you are resident in Canada for tax purposes.

Foreign tax identification number(s)

Social Insurance Number *

Required for registered plans and tax reporting. Sent encrypted; never stored in your browser.

Date of birth *

Driver's licence number *

Or another government photo ID — the dealer will ask for a copy.

Issuing jurisdiction *

Employment, family and account

Occupation *

Name of employer / business

If you are self-employed, what is your business name?

Civil status / family situation *

Number of dependents *

Is this a joint account? *

Yes No

Joint holder — last name *

Joint holder — first name *

Joint holder — initials

Right of survivorship? *

Yes No

Is a third party authorized to transact on your account? *

Yes No

Third party — last name *

Third party — first name *

Third party — initials

Third party — street address *

Third party — city *

Third party — province *

Third party — country *

Third party — postal code *

Does the third party have a financial interest in the account? *

Yes No

Other declarations

Are you, or a member of your family, a PEFP, PEDP or HIO? *

Yes No

Are you currently a director, officer or insider of a reporting issuer, or a reporting insider? *

Yes No

PEDP — name of the person *