Clico Credit Union

Additional Forms for PEPs

PEP Status

A family member is considered to be:
(a) Their spouse or common-law partner; (b) Their child; (c) Their mother or father;
(d) The mother or father of their spouse or common-law partner e.a child of their mother or father (sibling)

A close associate is considered to be:
(a) Business partners with, or who beneficially owns or controls a business with, a PEP
(b) In a romantic relationship with a PEP, such as a boyfriend, girlfriend or mistress
(c) Involved in financial transactions with a PEP;(d) A prominent member of the same political party or union as a PEP (e) Serving as a member of the same board as a PEP; or (f) Closely carrying out charitable works with a PEP

Financial Information

Other Professional Information - Board/Committee Memberships

Source of Funds

Check all that apply
Pension/Gratuity/Severance
Personal Savings
Salary/Wages
Sale of Vehicle
Proceeds from Investment
Employment Bonus
Sale of Property/Real Estate
Sale of Shares/Dividend
Insurance Setllement
Proceeds from Self-owned Business
Gift/Inheritance
Other (state below)

Dependents

Spouse Information

Children Information

Child 1

Child 2

Child 3