PERSONAL FINANCIAL STATEMENT

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Personal Information


PERSONAL DATA ON YOUR SPOUSE
Under the laws of Canada or the provinces your spouse may have a legal interest in your assets
Note: If this section is completed, your spouse must sign in the space provided at the end.

FINANCIAL INFORMATION

Assets
Total Chequing Balances
Total Savings Balances
Life Insurance Cash Value
Automobiles
Make Model Year
Stocks & Bonds
Accounts / Notes Receivable
Real Estate Owned
Retirement Account (e.g. RRSP)
Other Assets (Household Goods, etc.)
TOTAL ASSETS
Liabilities
Bank Loans (Balance Owing)
Mortgages on Real Estate
Monthly Rent Payment
Credit Cards
Other Obligations
Total Monthly Payments
Total Liabilities
Net Worth
Income Sources
Income from alimony, child support or separate maintenance does not have to be stated unless you want it considered.
Description Amount ($)
Sundry Personal Obligations
Please provide details below if you answer Yes to the following question.

Schedule A - Stocks & Bonds
Quantity Description Where Quoted Market Value ($) Pledged as Collateral
Total
Schedule B - Real Estate Owned
PROPERTY ADDRESS
PROPERTY & RENTAL VALUES

MORTGAGE & EXPENSES

MORTGAGE HOLDER(S)

REGISTERED OWNER(S)

ACQUISITION
General Information
Please provide details if you answer Yes to any of the following questions.

Privacy Disclosure & Product Interest

Your Personal Information

What is Personal Information?

Personal Information is information that identifies you as an individual. It includes not only your name and address, age and gender, but also your personal

financial records, identification numbers including your social insurance number (SIN), personal references and employment records.

Why Does the Bank Ask You for Your Personal Information?

There are some purposes for using your personal information which are self-evident, such as asking for information concerning your credit history to help

determine your credit worthiness if you are applying for a loan or mortgage. Self-evident purposes should be clear, but if you have any questions, just ask us.

We also ask you for your personal information for the following purposes:

  • to verify your identity and protect against fraud,
  • to understand your financial service requirements,
  • to determine the suitability of products and services for you,
  • to determine your eligibility for certain of our products and services, or those of others, and offer them to you,
  • to set up and manage products and services you have requested, and
  • to comply with laws and securities regulations.

Sharing Your Personal Information

Your personal information is shared, to the extent permitted by law, within BMO® Financial Group (that is the Bank and its subsidiaries and affiliates) which

provides deposit, loan, investment, securities, brokerage, insurance, trust and other products and services. With this more comprehensive understanding, we

are better able to meet your needs as they grow and change.

Your Choices

If you would prefer not to receive our direct marketing service and/or not have your personal information shared with a member of BMO Financial Group, you

can have your name deleted from our direct marketing and/or shared information lists. All you have to do is ask us. Please note that you cannot opt out of

sharing your personal information where you have requested a product or service which is jointly offered by us and another member of BMO Financial Group.

Also, if you would prefer not to have us use your SIN for administrative purposes, just ask us. This option does not apply where we are required to use your

SIN for income tax reporting purposes.

For complete details on our commitment to respect and protect the privacy and confidentiality of personal information of individuals, please refer to

our Privacy code, which is available at any branch of the Bank of Montreal, by visiting our website at www.bmo.com/privacy/ or by calling

1-800-363-9992.

Please read and sign below:

In this agreement, “you” means each person who signs below.

You consent to Bank of Montreal (the “Bank”) obtaining credit information and other financially-related information

about you at any time from your employer(s), any credit bureau, any registry, any person who has or may have

financial dealings with you and any references that you have provided to the Bank. The Bank may disclose such

information about you to any credit bureau, and any person who has or may have financial dealings with you. If there is

more than one party to the loan(s) or guarantee which this agreement relates to, the Bank may choose whose information it will

disclose to the credit bureau. The Bank will not obtain such information after the loan(s) or guarantee which this agreement

relates to has been terminated, but may continue to disclose such information in order to maintain the integrity of the credit

bureau system and credit granting process.

You certify that all information you give to us in this agreement is true, correct and complete.

You confirm having read the terms and conditions above and agree to be bound by them

PERSONAL BANKING SERVICES

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