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FPSC Level 1 Certification in Financial Planning:Reinstatement Application 2019/2020The following application must be completed in its entirety in order for FP Canada to review your request for reinstatement of yourFPSC Level 1 Certification in Financial Planning. This application will take approximately 5 – 10 minutes to complete. All documentsreferenced in this application are available at fpcanada.ca.If you are a former FPSC Level 1 certificant whose certification has lapsed due to non-renewal or suspension, you are permitted toseek reinstatement of your certification within five years of the date your certification expired, subject to the following reinstatementpolicies. You must: Have continued to adhere to the FP Canada Standards Council Standards of Professional Responsibility.Complete a reinstatement application;Provide documentation of CE requirements for each year not certified.Pay a pro-rated certification fee.Pay a separate non-refundable reinstatement fee.It is important that you complete the entire application and check the information provided for accuracy prior to submission. FPCanada cannot process incomplete applications. For personal assistance in completing the application, please feel free to contact FPCanada’s Stakeholder Support team at 416.593.8587, 1.800.305.9886 or info@fpcanada.ca.For additional information on maintaining your certification, please refer to the FP Canada Policies and Guidelines for Obtaining andMaintaining CFP Certification and FPSC Level 1 Certification in Financial Planning.FP Canada902-375 University Avenue, Toronto, ON M5G 2J5Phone 416.593.8587 Toll free 1.800.305.9886 fpcanada.caFPSC Level 1 Certification Reinstatement Application 2019/2020

PART A Personal Information (please print)FP Canada will use your preferred contact information to communicate with you. Please keep your contact information current, including email address, mailing address, telephone and fax numbers, by updating your FP Canada Portal or emailing info@fpcanada.capromptly. Alternatively, you may notify FP Canada in writing of changes to your contact details. It is your responsibility to ensure yourcontact information is accurate and up-to-date.NameFP Canada ID NumberCheck here if you do not have a business address.Business NameJob TitleSuiteBusiness Address (street number and name)CityProvincePostal CodePhone()Ext.FaxBusiness EmailSuiteToll FreeCountryExt.Residential Address (street number and name)CityProvincePostal CodePhone()CountryFaxHome / Personal EmailPreferred contact information:BusinessResidencePART B DeclarationsDefinitionsBankruptcyBankruptcy means having declared bankruptcy, or been petitioned into bankruptcy, made an assignment, proposal or plan (includingany Notice of Intention thereof) under any bankruptcy or insolvency legislation, been subject to or instituted any proceedings, arrangement or compromise with creditors, or had a receiver and/or receiver-manager appointed).Business“Business” means any business over which the Certificant has (or had at the time of the bankruptcy) a significant influence. Significantinfluence may include being: a partner, officer, director or shareholder holding at least 10% of the voting shares of the businessFPSC Level 1 Certification Reinstatement Application 2019/2020 2 / 9

PART B Declarations ContinuedOffence“Offence” includes, without limitation, an offence under:1. The Criminal Code (Canada);2. Any other Act of the Legislature of a province or territory of Canada or an Act of Parliament, which includes allegations (explicitly orimplicitly) of or relating to:a. Breach of trust;b. Corruption;c. Forgery;d. Fraud;e. Other activities involving deceit or dishonesty for personal gain or advantage;f. Perjury;g. The sale or trade of financial products and services; and/orh. Theft.1. AttestationsIn accordance with the FP Canada Standards Council Standards of Professional, please answer each of the following questions.a) Since signing your last application for certification, have you or any business with which you are/wereinvolved been charged with, pleaded or been found guilty of an offence?Yesb) Since signing your last application for certification, have you or any business with which you are/were involved been sanctioned, fined, held liable, pleaded or been found guilty by any tribunal, court,professional oversight body, licens- ing body and/or self-regulatory body for any reason whatsoever?Yesc) Since signing your last application for certification, has any judgment or garnishment been renderedagainst you or any business with which you are/were involved, or is any judgment or garnishmentcurrently outstanding?Yesd) Since signing your last application for certification, have you received notice of a pending or currentcomplaint, investigation, or proceeding against you or any business with which you are/were involvedbefore any professional oversight body, licensing body and/or self-regulatory body for any reasonwhatsoever?Yese) Since signing your last application for certification, have you received notice of a civil proceedingagainst you before a tribunal or court of a province or territory of Canada and/or have you commenceda civil proceeding before a tribunal or court of a province or territory of Canada?Yesf) Since signing your last application for certification, have you been found in breach of a Court Order?NoNoNoNoNoYesNog) Since signing your last application for certification, have you filed or declared bankruptcy, or enteredinto a consumer proposal?Yesh) Since signing your last application for certification, has any business with which you are/wereinvolved been declared bankrupt, been petitioned into bankruptcy, made an assignment, proposal orplan and/or had a receiver manager appointed?Yesi) Since signing your last application for certification, have you been found guilty of academicmisconduct?YesNoNoNoFPSC Level 1 Certification Reinstatement Application 2019/2020 3 / 9

PART B Declarations ContinuedIf you have answered “yes” to one or more of the above, please describe the principal facts, including dates, and the outcome, if any, on aseparate attached sheet and include copies of any relevant documentation with this application. Relevant documentation may include,for example: Proposals and/or discharges relating to bankruptcy; Pleadings (statements of claim, statements of defence, notices of application, etc.), court orders, endorsements and/or decisions; and Notices, letters, published settlement agreements, orders and decisions from licensing or regulatory bodies such as IIROC, MFDA, etc.2. Attestations for a Prior YearIf you answered “yes” in a prior year’s renewal to one or more of the declarations and the matter is still outstanding, indicate the renewalyear and specific attestation(s) in the boxes below:Renewal YearAttestations (See Attestations under 1. Attestations. Please circle all that apply.)a)b)c)d)e)f)g)h)i)3. Professional ObligationsI understand that, as an FPSC Level 1 certificant in Financial Planning, I have a professional obligation to providecomplete and accurate Declarations to FP Canada and to report any changes to the above Declarations in writingto FP Canada within 15 days of becoming aware of a change. I will send any such reports to FP Canada by mailor via email to info@fpcanada.ca. I will also report, within 15 days of notice, any outcome reached in respect ofany matters declared on this or prior application forms. I understand that this is an ongoing obligation and thatfailure to report this information within the required timeframe is a breach of the FP Canada Standards CouncilStandards of Professional Responsibility.INITIALI understand that, as an FPSC Level 1 certificant, if I am charged with an offence, I shall immediately notify FPCanada, in writing, and provide specifics in respect of the offence together with all relevant documentation.I understand that, as an FPSC Level 1 certificant, I must fulfill my professional and ethical obligations as outlinedin the Standards of Professional Responsibility, FP Canada Continuing Education Guidelines, and the FPSC Level 1Marks Usage Guide.4. Right to EnforceI understand that failure to comply with my professional and ethical obligations may result in remedial/disciplinary action by FP Canada including, without limitation, revocation, suspension or other restriction onmy ability to use the FPSC Level 1 marks. I further understand that any such disciplinary action may impactmy ability to maintain certification by FP Canada as an FPSC Level 1 certificant or obtain certification as aCFP professional in the future. I understand and acknowledge that FP Canada is not restricted in its abilityto investigate my conduct and take remedial/disciplinary action in response to concerns regarding activitiesthat occurred while I was certified by FP Canada or allegations of a breach of the Standards of ProfessionalResponsibility, even if I am no longer certified by FP Canada when a review of my conduct is initiated byFP Canada. Findings of professional misconduct by an FP Canada Standards Council Hearing Panel will bepublicized in accordance with the FP Canada Standards Council Policy on the Publication of Disciplinary Information.INITIAL5. PrivacyI consent to the manner in which FP Canada will collect, use, disclose and otherwise maintain my personalinformation as set out in FP Canada’s Privacy Policy (fpcanada.ca/privacy-legal).INITIALFPSC Level 1 Certification Reinstatement Application 2019/2020 4 / 9

PART C Continuing Education (CE) Requirements for Years LapsedIn order to maintain the integrity and reputation of FPSC Level 1 certification and to ensure that your knowledge and competence remaincurrent, FPSC Level 1 certificants are responsible for completing 12 qualifying CE credits each year in accordance with the FP CanadaContinuing Education Guidelines. Reinstatement of FPSC Level 1 certification requires that you provide documentation verifying completeof CE requirements for each year not certified. Please include your documentation with this application.For more information about CE requirements, please visit the Continuing Education page at fpcanada.ca/continuing-education.As part of our commitment to the integrity of FPSC Level 1 certification, each year FP Canada conducts random audits in which FPSC Level1 certificants are required to provide evidence of CE credits claimed. Please ensure that you have sufficient documentation to verify all CEcredits. Refer to the FP Canada Continuing Education Guidelines for further details.Mandatory Continuing Education RequirementsHave you completed your mandatory CE requirements for each calendar year that your certification waslapsed?YesNoAnswered Yes:If you indicated that you have completed the mandatory credits per calendar year, please proceed to Part D – Marketing Your Designation.Answered No:As you stated that you have NOT completed your mandatory CE requirements per calendar year, please indicate the reason:Maternity / Parental LeaveNot Yet RequiredOtherIf you have answered “No” to the question above, you are required to complete and submit to FP Canada a Continuing Education (CE)Exemption Request Form along with the required supporting documentation with this application. Failing to submit this completed requestform on time may result in a delay in the processing of your FPSC Level 1 Certification Reinstatement Application. Contact inform@fpcanada.ca to request the form.FPSC Level 1 Certification Reinstatement Application 2019/2020 5 / 9