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DirectorCandidateInformationGuide2018

DUCAFinancialServicesCreditUnionLtd.BoardofDirectors

2018ApplicationforNomination2018ELECTIONBoardofDirectorsDearProspectiveBoardCandidate:AtDUCAwevaluethededicationandcommitmentofourMemberswhochoosetoparticipate inournominationandelectionprocessasaBoardCandidate.Wethankyouforyourinterest inseekingnomination forourBoardofDirectors. Insidethispackageyouwillfindinformation thatwillclarifythequalification criteriaforCandidatesandexpectationsofBoardMembersintheirroleofgoverningthecreditunion.Youwillalsofindeverything thatyouneedtocompletethenominationprocess.ToassistthoseMemberswhoareinterested inconsideringcandidacy, theBoardappointsanElectionsCommitteeeachyear.TheCommittee’sprimaryroleistoensureMembersarefullyinformedofthenominationprocessandtheelectionprocess,aswellastoconsiderthequalificationsofCandidates inordertoensurethehighestqualityboardcomposition,andtomeetanygapsasidentifiedbytheBoardintheiranalysisoftheBoard’sskills,knowledgeandexperience.

ThisyeartheElectionsCommitteehasbeentaskedwithseekingtoselectnomineeswhonotonlyarethebestqualifiedandmeettherequiredcriteriabutwhoalsopossessspecificskillsandexperienceinthefollowingareas:

1. Financialliteracy(i.e.,CharteredProfessionalAccountant(CPA)and/orabletoreadandunderstand financialstatementsandfinancialreports,andassesstheimplicationsofthesedocuments);

2. Recentexperienceservingonboardsorcommitteesoforganizations thathavelargebudgetsandmakecomplexdecisions;

3. Demonstrated competence inoneormoreofthefollowingareas:a. Financialstatementanalysisb. Legalc. Strategicdirectionsettingd. Creditgranting/adjudicatione. Auditf. RiskManagementg. Governance

ADirector’sdesignation isadefiniteasset.Aswell,theCommittee ismotivatedtoachievegreatergenderbalanceontheBoard.FurtherdetailsontheprocessundertakenbytheElectionsCommitteeareoutlinedonPage2ofthisapplicationpackage.Ifyoudecidetoproceedwithsubmittinganapplication fornominationasaCandidate,pleasecompleteandsubmitthisapplicationpackagealongwithalltherequireddocuments,asoutlinedintheCandidate’sGuidesection.Ifyouhaveanyquestionsabouttheenclosedinformation,youmaycontacttheChairofElections,[email protected].

PleasenotethatapplicationsmustbereceivednoearlierthanMonday,November13,2017,andnolaterthanFriday,December15,2017.

Yourstruly,

CameronLoopstra,

ChairofElections

TableofContentsApplicationforNomination

Page 1 DUCA’sVisionandValues

2 DUCA’sElectionProcess-2018

3 Nomination&ElectionTiming-2018

4 Candidate’sGuide

5 Application forNomination totheBoardofDirectors

6 Candidate’sUndertaking

8 ScheduleA–DirectorEligibilityRequirements

9 ScheduleB–DirectorDisqualification

11 ScheduleC–Requirements tobemetbyNominators

12 ScheduleD–SelectionCriteria

14 ScheduleE–Expertise/Experience Assessment

16 ScheduleF–DeclarationofEconomic Interests

21 ScheduleG–Requirements toDisclose

22 ScheduleH–Background Information forCandidates

26 ScheduleI–ElectionCampaignPolicySShdjklsjdjl

28 ScheduleJ –SampleCreditInformationForm

SShdjklsjdjl

29 ScheduleK–SampleIndividualFidelityBondApplicationForm

SShdjklsjdjl

DUCA’s Vision & Values

OurVisionWeexisttohelppeopledomore,bemoreandachievemorewiththeirmoneyandtheirlives.OurValuesWeputpeoplebeforeprofits,arefinancialstewards,embracechange,areaccountable, thinkbig,aregenuine,fosterexcellence,nurturegrowth,arededicated,dowhat’srightforMembersandeachother,andgiveteammatesandMembersanauthenticvoice.

OurPropositionStatementWearethecreditunionforthosewhowanttodealwithafinancialpartnerthatconsistentlyexceedstheirexpectationswithinnovativeproductsandservices.WekeepourMembers’bestinterestatheart.WearecommittedtohelpingourMembersrealizetheirfinancialgoals,andgivethemtheconfidencethattheywillsucceedateveryturn.

DUCA’sElectionProcessApplicationforNomination

TheDUCABoard,asestablishedintheBy-Laws,consistsof9directorsandin2018threevacancies(threethree-yearterms)needtobefilled.AsdefinedinDUCA’sBy-Laws,andtheBoard’sGovernancepolicies,theElectionsCommitteeoftheBoardplaysanintegralroleintheprocessofreviewingnominatedCandidateswhomeettheeligibilityrequirements.ThisCommitteeisrequiredtointerviewallapplicantsandtoevaluatetheexperience,expertiseandqualificationsoftheCandidateinrelationtothespecificDirectorselectioncriteriaestablishedbytheBoardfromtimetotime.UponcompletionoftheCandidateinterviews,theElectionsCommitteewillmakeadeterminationastothebestqualifiedCandidatestofillthevacantpositions.

ThisdeterminationwillbebasedonboththeinformationcontainedintheCandidate’sapplicationaswellastheresultsoftheinterview.TheCommitteewillthenplacetheirrecommendationbehindthoseidentifiedCandidatesinanumberequaltothenumberofvacancies.

TheprocessusedforrecommendingCandidatesisbasedonachievingalignmentbetweenacandidateandtheBoard’sneedtoacquirerequiredskillsandfillidentifiedexperiencegapsbasedonaskillsmatrix.ThisprocessenablesanobjectiveevaluationandcreatesthestrongestpossibleteamattheBoardlevelinawaythatisopenandtransparenttoMembers.

TheElectionsCommitteewilladviseeachCandidatewhethertheyarereceivingtheCommittee’srecommendation,andanyCandidatenotbeingrecommendedwillhavethechoiceofstayingontheballotandparticipatingintheelection.TheCandidatebrochurewillindicatetocreditunionmembersthenamesofthoseCandidateswhohavereceivedtherecommendationoftheElectionsCommittee.DUCAelectionswillbeconductedviaelectronicvotingandinbranchpaperballoting,duringtheperiodofFebruary12,2018toMarch12,2018.Therewillnotbenominationsfromthefloor,norwillanyvotingforDirectorstakeplaceattheAnnualGeneralMeeting.TheresultsoftheelectionwillbeannouncedattheAnnualGeneralMeeting,onTuesday,April17,2018.

Nomination and Election Timing

Candidatesshouldensuretheyareavailableon:April17,2018and

adateTBDforInterviewwiththeElectionsCommittee

Date

1.CallfornominationssentoutbyemailandmailtoDUCAMembers November2017

2.Nominationperiodopens November13,2017

3.DeadlinetosubmittheOfficialNominationFormandotherrequiredmaterial

December15,2017at5pm

4.InterviewsofcandidatesbyElectionsCommittee November27,2017-December22,2017

5.ThefollowingispostedonDUCA’swebsiteandisavailableinthebranches:

• Each candidate’s digital photograph & printed

biography

• Blankballotswithself-addressedreturnenvelopes

• Electronicelectionpageonwebsite

February12,2018

6.Inbranchandelectronicvotebegins February12,2018

7.Inbranchandelectronicvoteends March12,2018

8.Resultsaretallied March13-16,2018

9.Candidatesareinformedoftheelectionresults ByMarch31,2018

10.AnnualGeneralMeeting

Theresultsoftheelectionarepublicallyannounced

April17,2018

11.TheElectionsCommitteecallseachunsuccessfulcandidateforadebriefing.

PriortotheAGM

Candidate’s GuideApplication for

1. IndividualswishingtobeCandidatesforDUCA’sBoardofDirectorsmustbeatleast18yearsofage,have

beenaMemberofDUCAforaminimumofsixmonthsasatthefirstdayoftheNominationperiod,November13,2017,andhold$1inMembershipShares.

2. AdditionaleligibilityrequirementsareoutlinedonScheduleA(Page8)ofthisApplication.3. IfafterreviewingtheaboveandtheBackgroundInformationforCandidates–ScheduleG(Page21),aCandidate

wishestomakeanapplication,heorshemust:

A. WithoutanyassistancefromemployeesofDUCA,seekthesignaturesofsixNominatorswhothemselvesmeettheNominatorEligibilityRequirementsoutlinedinScheduleC(Page11);

B. CompletethisApplicationinitsentirety;C. SubmititalongwiththethreedocumentsdetailedonPage6ofthisApplication.(Statementof

Interest,BallotStatement,Resume,completedScheduleE[ApplicantAssessment]andScheduleF[DeclarationofEconomicInterestsbyaRestrictedPartyofDUCA),andadigitalphotographalsodetailedonPage16;and

D.Completecreditcheck,criminalcheck,andbondingapplicationformsby5pmonDecember182017.Theseformswillbesentbyemailfromhr@duca.comoncetheApplicationisreceivedbytheElectionsCommittee.Theseformsmustbecompletedandsentdirectlytohr@duca.comby5pmonDecember18,2017.Thesecheckswillbeconductedonallcandidateswhochoosetostandforelection.Note:EligibilityforelectiontotheBoardofDirectorsisconditionaluponreceivingbondingapprovalfromDUCA’sinsurer.

4. ApplicationsforNominationmustbemarkedConfidentialandsubmitted:

A. To:ChairofElection,DUCAFinancialServicesCreditUnionLtd.,5290YongeStreet,Toronto,

OntarioM2N5P9.B. TobereceivedbytheChairofElectionbetweenMonday,November13,2017and

Friday,December15,2017at5:00p.m.

OncetheNominationperiodcloses:

• TheElectionsCommitteeoftheBoardwillvalidatetheCandidate’seligibility,andconductCandidateinterviewsduringtheperiod.

• TheelectionofDirectorsbyMemberswillbeconductedfromFebruary12,2018toMarch12,2018.

• ThesuccessfulCandidateswillbeannouncedatDUCAAnnualGeneralMeetingtobeheldonApril17,2018.

Application for NominationApplication for

EachBoardcandidacymustbesupportedbysixotherMembersusingthisform.AsmembersofDUCA,wearepleasedtonominatethefollowingpersonforelectiontotheBoardofDirectors.AsNominatorswemeetallofthequalificationsoutlinedinScheduleC(Page11).

PrintCandidate’sName

NominatorName SignatureofNominator Member#

1.

2.

3.

4.

5.

6. AcceptanceofNomination:IacceptthisnominationasacandidateforelectiontotheDUCABoard.

SignatureofCandidate1 MemberNumber Date

CandidateInformation:Emailaddress: Telephone(day): Telephone(evening):

1Bysigning this form, youdeclare that youmeet theDirector Eligibility Requirements outlined onSchedule A(page 8)ofthisdocument andagree tosubmit toacredit, criminalrecord,andcomprehensivepersonalbackgroundcheck. Youalsoagree torespect therequirements oftheElection Campaign Policyoutlined onSchedule I(page10).

Candidate’s UndertakingApplication for

TheundersignedherebyappliestobenominatedasaCandidateforelectiontotheBoardofDirectorsofDUCA.

Idosolemnlyundertaketo:

a. standforelectionand,ifelected,toserveasaDirector;b. observetheprovisionsoftheCreditUnionsandCaissesPopulairesAct(the“Act”),asapplicable,

includingtheprovisionsofdisqualified individualsasoutlinedinSection92(1)oftheAct.(TheActisaccessibleatwww.elaws.gov.on.ca/DBLaws/Statutes/English/94c11_e.htm);

c. complywiththeDirector’sCodeofConductandtheDutiesandObligationsofDirectors includingConflictofInterestGuidelinesadoptedbytheBoardfromtimetotime;

d. bearolemodelandadvocatefortheDUCAbrandtobothinternalandexternalstakeholderse. providefull,financialdisclosuretotheCreditUnion,asrequiredbytheBoardfromtimetotime;f. consenttothedisclosureofcreditand/orpersonalinformation to,orfromanycredit-reporting agency;g. observealltheCreditUnion’sBy-Laws,andtherulesrelatingtotheelectionsandtheconductthereof;

andh. resignfromtheBoardintheeventtheBoardhasdeterminedthatasaDirector, Ihaveceasedtomeet

theeligibilityrequirements,assetoutintheCreditUnion’sBy-LawsorSection91oftheActorifIhavemetthetestofanyofthedisqualifyingcriteriaassetoutinSection92(1)oftheAct,duringmytermofoffice

Ifurtherunderstand that inorder tobeeligible forconsideration forNomination, thisApplicationmustbecompleted asrequired; submitted asreferenced intheNotice ofNomination; andbeaccompanied bythefollowingdocuments,

1.AwrittenStatementofInterest,notexceeding150words,which:

i. providestheMembershipwithenoughinformationabouttheCandidatefromapersonaland

professionalperspective tohelpthemunderstandtheskillsandexpertisetheCandidatewouldbringtotheBoard;

ii. outlinestheCandidate’s reasonsforseekingelectiontotheBoardofDUCA;iii. explainswhyMembersshouldvoteforthisCandidate.

ThisStatementwillbepublishedbyDUCA,asreceived,andwillbeusedtoinformtheMembershipabouttheCandidate initselectionmaterials;2.Aresumethatincludesdisclosuresoutliningthefollowing:Experience,expertiseandqualificationsofthe

Candidate;

i. Candidate’sinvolvementincommunityactivities;ii. Candidate’spastandpresentserviceasaDirectorofaBoard;iii. AnyformalDirectoreducation/trainingaccreditations;iv. Candidate’sprofessional,communityorotheraffiliationsorMemberships;andv. Contactinformationfortwoprofessionalreferences(Recommendation:1Boardreferenceand1currentemployerreference.Ifnotcurrentlyemployed,1Boardreferenceand1formeremployerreferenceisrecommended.

Candidate’s Undertaking (continued)Application for

3.AcompletedApplicantExpertise/Experience AssessmentasfoundonScheduleE(Page14);and4.AcompletedScheduleF(Page#)(DeclarationofEconomic InterestsbyaRestrictedPartyand/orRelated

PartyofDUCA);5.Acurrenthigh-resolution colourdigitalphotographoftheCandidate.6.HavingsignedthisApplication forNomination theCandidateconsentstoDUCAreviewinganyofthe

Candidate’s financialinformationonfileattheCreditUnion,contactingreferees,andconductingacreditcheck,criminalcheck,andcomprehensivepersonalbackgroundchecksforthepurposeofdeterminingeligibility forelectiontotheBoard.

Inaddition,theCandidatemustbeavailablebetweenNovember27,2017andJanuary12,2018inordertoundergotheevaluationprocessbytheElectionsCommitteeassetoutintheCreditUnion’sBy-Laws.TheElectionsCommitteeusingtheDirectorSelectionCriteriasetoutinScheduleD(Page12)willbeconductingcandidate interviews.

Candidateswillberequiredtobeavailableduringthistimeperiod.Candidatesarerequestedtoindicatetheirfirstandsecondchoice,outofthedatesnotedabove.TheElectionsCommitteewillreasonably trytoaccommodate therequesteddate.

Candidate’spreferreddates:1stChoice:

1stChoice: Candidatesshouldbeawarethatcampaigning isnotpermitted.DatedAt ,Ontario,This DayOf , Candidate’sSignature:

Schedule AApplication for

DirectorEligibilityRequirements(asextractedfromDUCABy-Laws)

1.Onlyanaturalpersonwho:

(a) is amember of the Credit Union in full compliance with theminimumMembershipshare

requirements containedinsection2.03hereof;

(b) isatleasteighteenyearsofage;

(c) isaCanadian citizenoraperson lawfully admitted toCanada forpermanent residency andordinarilyresidentinCanada;

(d)hasthenservedasaDirectoroftheCreditUnionfornotmorethanfive(5)consecutive three-year (3-year)termssincetheCreditUnion’screationbyamalgamation;

(e) isnotdisqualifiedundertheAct;

(f) ifthatpersonisaformeremployeeoftheCreditUnionorofoneofthecreditunionswhichamalgamatedtoformtheCreditUnion,hasnotbeenemployedbytheCreditUnionorofoneofthecreditunions which amalgamatedto form the Credit Union in the twenty-four(24) month periodendingonthelastdayoftheNomination Periodfortheelection inwhichheorsheseeksnominationasacandidateforelectiontotheBoard;

(g) isnot asserting a legal claim against theCredit Union orofoneof the credit unionswhichamalgamatedto form the Credit Union which is not resolved as of the last day of the NominationPeriodfortheelectioninwhichheorsheseeksnominationasacandidateforelectiontotheBoard;

(h) isnotemployedinanycapacity,orisnotanemployee,officer,directororcommitteememberofanorganization, whichmaycompetewith theCreditUnion, including, without limiting thegenerality oftheforegoing,otherfinancialinstitutionsorentitiesprovidinginvestmentorcreditproductsorservices;and

(i) has disclosed to the Board, in a timely fashion before the election inwhich the natural person is a

candidate isheld,everything heorsheisrequiredbytheActtodiscloseasacandidate fordirectorofacreditunion,iseligibletobeadirectoroftheCreditUnion.

(j) hasbeenaMember oftheCreditUnion ingoodstanding foraminimumperiodof6monthspriorto

the1stdayoftheNominationPeriod,iseligibletobeadirectoroftheCreditUnion.

Schedule BApplication for

IndividualDirectorDisqualifications(asextractedfromtheAct–Section92)

Disqualified Individuals

92.(1)Thefollowing individualsaredisqualified frombeingdirectorsofacreditunion:

1. OnewhoseMembership inanycreditunionhasbeenterminated,otherthanvoluntarily.

2. Onewhoacourthasdecidedisofunsoundmind.

3. Onewhoisanundischargedbankruptorwhohasbeendischargedasabankruptinthefiveyearsprecedingthedateonwhichheorshemaybeelectedasdirector.

4. OnewhoisunabletoobtainabondofaninsurerlicensedundertheInsuranceActtowritesuretyand

fidelityinsurance.

5. Onewhoismorethan90daysinarrearsinthepaymentofadebtowedtothecreditunionunlessthecreditunionhasagreedtoextendthetimeforrepayment.

6. OnewhoisalistedpersonwithinthemeaningoftheUnitedNationsSuppressionofTerrorism

RegulationsundertheUnitedNationsAct(Canada).

7. Onewhohasbeenconvicted, inthefiveyearsprecedingthedateonwhichheorshemaybeelectedasadirector,ofanoffencedescribed insubsection(3)andwhohasnotreceivedapardonfortheoffence.

8. OnewhoseMembership inaprofessionalassociationhasbeenterminated, inthefiveyearspreceding

thedateonwhichheorshemaybeelectedasdirector, forprofessionalmisconduct.

9. AnemployeeofthecreditunionoraleagueinwhichthecreditunionisaMemberorhisorherspouse,parentorchild.

10. Aprofessionaladvisorwhoprovidesservicestothecreditunioninhisorherprofessionalcapacityor

whohasprovidedsuchservicesinthethreeyearsprecedingthedateonwhichheorshemaybeelectedasadirector.

11. AnemployeeoftheCorporation (DepositInsuranceCorporationofOntario).

12. ApublicservantemployedunderPartIIIofthePublicServiceofOntarioAct,2006whoseemployment

dutiesincluderegulatingcreditunions.

13. Onewhohasnotmetthetrainingrequirementsorqualifications fordirectorsestablishedbytheCreditUnion.

14. Onewhohasnotmetanyreasonableconditionorqualification setoutintheBy-lawsofthecredit

union.

Schedule B (Continued)Application for

Exception

(2)Anindividual isnotanemployeeforthepurposesofparagraph9ofsubsection(1)solelybecauseheorsheprovides,withoutremuneration, servicestothecreditunionorleaguethatareordinarilyprovidedbyanemployee.

Typeofoffence

(3)Anoffencereferredtoinparagraph7ofsubsection(1)isanoffencethat,

a. isrelatedtothequalifications, functionsordutiesofadirectorofabodycorporate;

b. involvestheftorfraud;

c. involvesacontravention orfailure tocomplywiththisAct,apredecessor ofthisActoranAct

governingasubsidiaryofthecreditunion;or

d. involvesacontravention orfailuretocomplywiththeSecuritiesAct.

Schedule CApplication for

RequirementstoBeMetByNominators

Criteria:

• Be18yearsofageorolder;• Beamemberingoodstanding;• Haveamembershipshareof$1

Schedule DApplication for

SelectionCriteriaTheselectioncriteriatobeusedbytheElectionsCommitteearethefollowing:

MandatoryIndividualDirectorCriteria

ADirectormusthavethefollowingskills/capabilities:

1.Understand theprinciplesbehindandsharethevisionoftheCreditUnionandhavetheabilitytoreflectthevaluesandcommitmentsoftheCreditUnionaswellasactingintheCreditUnion’sbestinterestatalltimes;

2.Demonstrate theabilitytobringaperspectiveofexternalbusiness,finance,andsocialissuestoBoarddeliberations;

3.Understandcorporategovernanceandthefiduciaryduties,rolesandresponsibilities oftheBoardasawholeandanindividualDirectorofaCreditUnion,includingwillingness toaskprobingquestionsandchallengeManagementwithinthegovernance framework;

4.CommittoregularattendanceatBoard/Committeemeetingsandtofullpreparednessandwillingness tocontributetomeetingcontent;

5.Understand theimportanceofcreditunionsintheircommunities;

6.Demonstrate theabilitytoprovideleadershipandbeaneffectivecommunicator;

7.Upholdthevaluesofteamworkdemonstrating theabilitytooperateas“ateam”atBoardleveland“speakwithonevoice”oncefulldiscussionhasbeenundertakenandadecisionmadebytheBoard;

8.Demonstratepersonalintegrity,discretion,discernment, financialstabilityandhighethicalstandards;

9.Haveneverdeclaredpersonalorbusinessbankruptcy;

10.Bewillingtocommittocontinuous learningandundertakeappropriatedirectortraininganddevelopmentinitiatives;

11.Havetheabilitytounderstandandassessimplicationsoffinancialstatementsandauditorsreports;

12.Agreetofulfillthetimecommitment, includingtraveltimeandworkloadassociatedwithbeingaDirectoroftheCreditUnion;

13.Havethecapability toaccesselectronic informationviatheInternet,andbeabletoprintassociatedmaterials.

Schedule D (Continued)Application for

Optional Individual DirectorCriteria

ItisdesirablethatDirectors:

1. HaveconsiderableexperienceasaDirectoronaBoard;

2. Haveademonstrated reputationofvaluablecommunityandprofessional involvementoutsideoftheir

activitiesattheCreditUnion;

3. Havecoreknowledgeoforexperience inthecooperative systemandanunderstanding ofthecooperativeprinciples.

4. Haveexperienceorfamiliaritywithaccountingandreportingstandards includingfinancial instruments

andInternational FinancialReportingStandards(IFRS).

5. Haveexperienceorfamiliaritywithenterpriseriskmanagement.

6. Haveexperienceorfamiliaritywithstrategicplanning;

7. Haveexperienceorfamiliaritywithcapitalmarketsfinancing instruments (e.g.securitizations, interestrates,onbalancesheetfinancingetc.),and

8. Haveexperience/expertise inthefieldofeconomics, finance,treasuryorinvestmentservices.

Schedule EApplication for

BoardofDirectorsApplicantExpertise/ExperienceAssessment

DUCAiscommittedtotheprincipleofahighqualityBoardofDirectors,andexpectsthateachDirectorbringstotheBoardacertainlevelofknowledgeandexperience,demonstratescertainkeyattributesandadherestocertainprinciples.Inaddition,DirectorsmustmeettheminimumrequirementsforDirector’scorecompetenciesataSTRONGCompetencyLevelasprescribedintheDICOGuidanceNote:CreditUnionsDirectorTrainingandQualifications.MoreinformationonDirector’scorecompetenciesrequirementscanbefoundatwww.dico.comunderthesectiontitled“HowOntarioCreditUnionsAreRegulated”.Thefollowingself-assessmentwillassisttheElectionsCommitteeindeterminingthedegreeofexpertisethatyoubringasaCandidate.

Pleaseindicateyourlevelofexpertise/experienceinthefollowingtablebyindicating:

E-ExpertS-StrongG-GoodB-BasicN/A–norelevantexperience

Toassistyouinansweringpleaserefertothefollowingdefinitions:

Expert: Youpossessadegree/certificate/diplomaintheskillareaand/orhavesignificantworkexperienceinthat

field.Strong: Youhavedirectexperience,orsignificantfamiliaritywiththefieldaspartofyouremploymentor

volunteeractivities.Good: Youunderstandthebasicfundamentalsandconceptsthatareencounteredinthisskillarea.Basic: YouhavesomeknowledgeofthecompetencyNA: Youhavenofamiliaritywiththetopicorarea

PleaseNote:IfyouareelectedtotheBoard,youwillbeexpectedtocompleteamorecomprehensiveself-assessmentofspecificcompetencieswithin12monthsofelection. Thisassessmentisusedtohelpdetermineyourtrainingandself-developmentneedsaswellasyourcompetencytocontinueservingtheremainderofyourterminordertofulfillthedirectortrainingandqualificationsrequirementsasestablishedbythecreditunion.

Schedule E (Continued)Application for

Competency/Area Rating

1. AuditandCompliance- performance andregulatory standards;examination&auditingprocedures

2. Board&CEOPerformance- settingandevaluating criteriaandstandardsofperformance ofthe

Board,directorsandtheCEO

3. CreditUnionOperations- Cooperative businessmodel;keycomponents ofoperations (people,physical

andtechnical infrastructure), operational risks

4. FinancialLiteracy/expertise- Readingandinterpreting financialstatements andfinancial

performanceindicators

5. Governance andEthics- Boardrolesandresponsibilities; structure;decisionmakingpowers;Board

policiesandprocess;Committees (mandates; structure;process)

6. Leadership- Leadership traits;skillsandeffectiveprofessional andpersonalattributes- Emotional andSocialIntelligence

7. Regulatoryenvironmentwithrespecttofinancialservices&creditunionsector- Governing legislationandguidance; regulatorybodies/organizations

8. RiskManagementOversight; EnterpriseRiskManagement- Financialandoperational risks;riskmanagement andmonitoring

9. StrategicPlanning- Strategicplanningconcepts;process; importanceofclearstrategicdirection;

monitoringofstrategicplanimplementation

10. Information Technology- Hardware; software;networking; bankingsystems;databases;web-

enabledservices

11.Partnering /MergersandAcquisitions- Mergerstrategies; issues,benefitsandchallenges

12.ExecutiveRecruiting&HumanResourceManagement- Recruitment; hiringcriteriaandpractices;performance evaluation

13.Othercompetencies; areasofexpertise

Schedule FApplication for

DeclarationOfEconomicInterestsByARestrictedPartyAnd/OrARelatedPartyOfDUCAFinancialServicesCreditUnionLtd.(“DUCA”)

Name: PositionwithDUCA:

DefinitionsRestrictedParty(RP):

A person or entity is “restricted” in relation to DUCA if they are or have beenwithin the last 12months:

A.adirectororofficerofDUCA;

B.aspouseofadirectororofficerofDUCA;

C.arelativeofapersondescribedin[A]or[B]above,iftherelativelivesinthehomeoftheaboveandisfinanciallydependentonthepersondescribedin[A]or[B];

D.acorporation/partnershipinwhichapersondescribedin[A]beneficiallyowns,directlyorindirectly,

morethan10%ofthevotingshares;or

E.acorporation/partnershipcontrolledbyapersondescribedin{[A][B][C]or[D]aboveRelative:Meansarelativebyblood,marriageoradoption.

ConnectedPersons(CP):

1. InrelationtoaMember,anotherpersonorentityisa“connectedperson”,ifheorsheoritisoneofthefollowing:A.acorporationinwhichtheMemberholdsorbeneficiallyowns,directlyorindirectly,atleast

35percentofthevotingsecurities,B. anaffiliate*ofacorporationdescribedin[A],

C. apersonorentitythathasa50percentinterestinapartnershipinwhichtheMemberalsohasa50percentinterest,

D.apartnershipinwhichtheMemberisapartner,

E. atrustorestateinwhichtheMemberhasasubstantialbeneficialinterest,

F. atrustorestateinrespectofwhichtheMemberservesasatrusteeorinasimilarcapacity,G.apersonor

entityonwhosefinancialresourcestheMemberdependstorepayaloantotheDUCA,

H.apersonorentitywhoprovidessecuritytoDUCAforaloantotheparty.

*“affiliate”meanswhenonebodycorporate isaffiliatedwithanotherbodycorporate ifoneofthemisthesubsidiaryoftheotherorbotharesubsidiariesofthesamebodycorporateoreachofthemiscontrolledbythesameperson.


2. InrelationtoaMemberwhoisanindividual,anotherindividualisaconnectedpersonof

theMemberifthatotherindividualisoneofthefollowing:

A. aspouseoftheMemberwhoisfinanciallydependentontheMember,

B. arelativeoftheMemberoroftheMember’sspousewholivesinthesamehomeastheMemberandwhoisfinanciallydependentontheMemberortheMember’sspouse.

ConflictofInterest:

ApplieswhenaDirectororOfficeris/has:

A. apartytoamaterialcontractorproposedmaterialcontractwithDUCA;

B. adirectororofficerofanentitythatisapartytoamaterialcontractorproposedcontractwithDUCA;

C. amaterialinterestinapersonwhoisapartytoamaterialcontactorproposedmaterial

contractwithDUCA;or

D. aspouse,parentorchildofanindividualwhoisapartytoamaterialcontractorproposedmaterialcontractwithDUCA.

RelatedParty(RLT.PTY):

ApersonorentityisrelatedtoDUCAinconnectionwiththepreparationofitsfinancialstatementsif:

A. thepersonoraclosememberofthatperson’sfamilyhascontrolorjointcontroloverDUCA;

B. thepersonoraclosememberofthatperson’sfamilyhassignificantinfluenceoverDUCA;

C. thepersonoraclosememberofthatperson’sfamilyisamemberofthekeymanagementpersonnelofDUCA(Executiveleadershipteam;BoardofDirectorsandOfficersofDUCA;or

D. theentity(acorporation/partnership)iscontrolledorjointlycontrolledbyapersonidentifiedin[A],[B],or[C].

Closemembersofthefamilyofapersondescribedin{A][B]or[C}abovearethosefamilymemberswhomaybeexpectedtoinfluence,orbeinfluencedby,thatpersonintheirdealingswithDUCAandinclude:

A. thatperson’schildrenandspouseordomesticpartner;

B. childrenofthatperson’sspouseordomesticpartner;and

C. dependentsofthatpersonorthatperson’sspouseordomesticpartner


Parentsandsiblingsarebyvirtueexpectedtohaveinfluenceorbeinfluencedbytheindividualunlessotherwiseproven.Familymembersoutsideoftheimmediatefamilyarenormallynotexpectedtoinfluenceorbeinfluencedbytheindividual.Possibleexamplesofwherenon-immediatefamilymemberswouldbeconsideredunderthedefinitionof“closemembersofthefamily”includesituationswheretheyaredependentsoftheindividual;liveinthesamehousehold;havestrongfinancialties.

ControlisthepowertogovernthefinancialandoperatingpoliciesofDUCAsoastoobtainbenefitsfromitsactivities.

Jointcontrolisthecontractuallyagreedsharingofcontroloveraneconomicactivity.

Keymanagementpersonnelarethosepersonshavingauthorityandresponsibilityforplanning,directingandcontrollingtheactivitiesofDUCA,directlyorindirectly,includinganydirectorofDUCA.

Significantinfluenceisthepowertoparticipateinthefinancialandoperatingpolicydecisionsofanentity,butisnotcontroloverthosepolicies.Significantinfluencemaybegainedbyshareownership,statuteoragreement.

DECLARATIONS:

NameofSpouse[RP&RLT.PTY]:

1. IsSpousefinanciallydependentonme?[CP]Yes No

2. NamesofChildrenandotherRelativesfinanciallydependentonmeormyspouseandwholiveinmyhome[RP&CP]: Other“closefamilymembers”whoareexpectedtoinfluenceorbeinfluencedbyme(whetherornottheyarefinanciallydependent)[RLT.PTY]:

A.Namesofchildrenofselforspouse/domesticpartner:

B.Namesofdependentsofselforspouse/domesticpartner:

C.Namesofotherindividualswholiveinthesamehouseholdasself:

D. Namesofotherindividualswhohavestrongfinancialtiestoselforspouse/domesticpartner:


3. NamesofcorporationswhetherornottheyareMembersofDUCAinwhichIbeneficiallyown,directlyor

indirectly,morethan10percentofthevotingshares,andtheaffiliates[CP]ofsaidcorporations:(statepercentage)[>10=RP;>35=CP]:

4. NamesofCorporations,PartnershipsorUnincorporatedAssociationswhetherornottheyareMembersof

DUCAinwhichIbeneficiallyown50percentorgreaterofthevotingsharesandtheirsubsidiaries:(statepercentage[50%=jointcontrol;>50%=control])[RLT.PTY]

5. NamesofcorporationswhetherornottheyareMembersofDUCAinwhichIoranyoneofmyspouse,

childrenandotherrelativesnamedaboveownshareswhichcarrymorethan50percentofthevotesfortheelectionofdirectors:[RP]

6. NamesofCorporations,PartnershipsorUnincorporatedAssociationswhetherornottheyareMembersof

DUCAinwhichanyoneofmyspouseorclosefamilymembers(identifiedabove)ownshareswhichcarry50percentorgreaterofthevotingsharesandtheirsubsidiaries:(statepercentage[50%=jointcontrol;>50=control])[RLT.PTY]

7. NamesofcorporationsorunincorporatedassociationswhetherornottheyareMembersofDUCAforwhichI

serveasaDirectororOfficer[CONFLICT]: 8. NamesofpartnershipswhetherornottheyareMembersofDUCAinwhichIamapartner:(statepercentage

interestandpercentageinterestofotherpartners)[CP]: 9. NamesoftrustsorestateswhichareMembersofDUCAandinwhichIhaveasubstantialbeneficial

interest[CP];[RLTPTY]:10.NamesoftrustswhichareMembersofDUCAandforwhichIactastrustee(includingaccountsonwhichIact

asattorneyforproperty)[CP]: 11. Namesofnon-relativeMembersforwhomIhaveprovidedfinancialassistance,includingaguarantee

orco-signatureforloansfromthecreditunion[CP]:


Acknowledgment:

Ihereby:

• acknowledgethatthisdeclarationisgivenforthepurposesofassistingDUCAincomplyingwithstatutoryandregulatoryrequirementsrelatingtotransactionswithRestrictedParties[RP];ConnectedPersons[CP],ConflictsofInterest[CONFLICT]andRelatedParties(RLTPTY].

• understandthatthequestionswillnotnecessarilyelicitanswersthatwilldiscloseallofmyrelatives

whomaybe“restrictedparties”unders.75oftheGeneralRegulationundertheCreditUnionsandCaissesPopulairesAct,norallofmyrelativeswhomayberelatedpartiesunderIFRS–IAS24–Relatedparties;andundertaketodisclosetotheBoardmyconnectiontoanyrelativewhohasamaterialcontractorloanwiththecreditunionassoonasIbecomeawareofit.Iwarrantthattheinformationprovidedhereiniscompleteandaccurateinallmaterialrespectsasofthedateitisgiven,and

• IundertaketobringtotheattentionoftheDUCAanysubsequentinformation,whichwouldnecessitatethecompletionofanewDeclaration.

AnydeclarationIhavemadeabovetotheeffectthatIamadirectororofficerofacorporation/partnership/unincorporatedassociation,orhaveamaterialinterestinaperson,shallberegardedasageneralnoticetotheBoardofDirectorsthatIaminterestedinanycontractmadewiththatentityorpersonbyDUCA.

DatedAt ,Ontario,This DayOf ,

SignatureofParty

Schedule GApplication for

RequirementstoDisclose

The Credit Unions and Caisses Populaires Act also requires Board candidates to disclose if they are a party to amaterial contract or proposed material contract with the credit union. You must include the disclosure in yoursubmissionifyou:

• Areapartytoamaterialcontractorproposedmaterialcontractwiththecreditunion;

• Areadirectororanofficerofanentitythatisapartytoamaterialcontractorproposedmaterial

contractwiththecreditunion;

• Haveamaterialinterestinapersonwhoisapartytoamaterialcontractorproposedmaterialcontractwiththecreditunion;or

• Areaspouse,parentorchildofanindividualwhoisapartytoamaterialcontractor

proposedmaterialcontractwiththecreditunion.Pleaseprovidedetailshereifanyoftheaboveapplies.

DatedAt Ontario,This DayOf , .

Signature NameWitnessSignature Name

Schedule HApplication for

BackgroundInformationforCandidates

Preamble:

DUCADirectorsareexpectedtoattendallscheduledBoardandCommitteemeetingsandbeactiveparticipantstherein.TheyarealsoencouragedtoattendotherDUCArelatedorganizationalandcommunityrelatedactivities,aswellasforDirectorsnewtothecreditunionsystem,bewillingtoattendcreditunionsystemconferences.DirectorsarealsorequiredtoparticipateinDirectoreducationasoutlinedbelow.

TheinformationfoundbelowidentifiesandbrieflydescribesDUCACommittees,DirectoreducationrequirementsandasummaryofmeetingsandestimatedcommitmentoftimewhichonemightexpectwhentheybecomeaDirectorofDUCA.WehopethattheinformationbelowwillassistyouinclarifyingyourobligationsshouldyoubecomeaDirector.However,ifyouhaveanyquestionsregardingtheinformation,orwishtolearnmoreaboutDUCAGovernancestructure/practices,pleasecontacttheChairofElectionsortheCEO.

Committees:

1 FullBoard

TheBoardofDirectorsconsistsof9Directors,eachelectedbytheMembershipforatermofthree years,subjecttoaterm-limitof15yearsinoffice.TheBoardisresponsibleforestablishingcorporateobjectives,policiesandperformancestandardsandmeasuringtheirachievementandhiringanddelegatingauthoritytotheCEO.

2 BoardCommittees

TheBoardhasestablishedsixstandingCommitteesthatareassignedresponsibilitiestoassisttheBoardtocarryoutitsmandate.

ThecurrentCommitteesandtheirmandatesareasfollows:

A. AuditCommittee:TheAuditCommitteeprovidestheBoardwithreportsonmattersrelatedtoaccountingandfinancialreportingpractices,riskmanagement,andinternalandexternalcontrolprocedures.TheAuditCommitteeischargedwithanumberofstatutoryresponsibilities,asrequiredundertheCreditUnionAct.ItalsoreviewsandrecommendstheannualfinancialstatementstotheBoard.Itisresponsibletoensureeffectivemanagementofoperationalriskaswell,thatcapital,liquiditymanagementandinternalcontrolsystemsareatacceptablelevels.ItisadditionallyresponsibleformonitoringcompliancewiththeCreditUnion’sRestrictedPartypolicy.

Schedule H (Continued)Application for

B. GovernanceCommittee:TheChairoftheBoardwillbetheChairoftheGovernanceCommittee.ThisCommitteehastheresponsibilitytoensureeffectivecorporategovernance,includingitsstructure,andtheestablishmentofCommitteemandatessothattheBoard’sresponsibilitytotheMembershipisfulfilled.ItisresponsibletoassesstheperformanceoftheBoardanditsCommittees.

C. CreditCommittee:TheCreditCommitteeisresponsibletoensurethatpolicyguidelinesand

systemsareinplacetoensurecredit,investmentandasset/liability(structural)risksareatacceptablelevels.ThisCommitteeisresponsibleforreviewingandapprovingrestrictedpartyloantransactionsasrequiredundertheAct,aswellasexceptionstocreditsundertheBoard’spolicylimits.TheCommitteereceivesregularreportingthatallowsthemtomonitorcompliancewithcreditriskmanagementpoliciesandtheDepositInsuranceCorporationofOntario’sstandards.TheCommitteemustensurethatitscreditandinvestmentriskmanagementstrategyisfair,soundandprudent.

D. ElectionsCommittee:TheElectionsCommitteeisresponsibletooverseethedirector

Nomination,Evaluation,SelectionandElectionprocessesforBoardCandidates,aswellastheoversightofactivitiesassociatedwiththeAnnualGeneralMeetingofMembers,includingthedevelopmentoftheAnnualReport.

E. HumanResourcesandCompensationCommittee:TheHumanResourcesand

CompensationCommitteeisresponsibletoprovideoversightinachievingDUCA’sBusinessEnterpriseRiskManagementvisionandmission.

F. RiskCommittee:TheRiskCommitteeisastandingcommitteeoftheBoardtowhich

theBoardhasdelegatedresponsibilityforoverseeingtheeffectiveoperationofallrisktakingoperationsandriskmanagementfunctionsoftheCreditUnionandensuringappropriateriskgovernanceprocessesareexecutedeffectively.


Meetings/TimeCommitment

Boardmeetingsareheldquarterly. Itisexpectedthat,inadditiontotheactualtimespentataBoardorCommitteemeeting,aDirectorwillfullyreviewallmaterials(e.g.,Boardmaterials,Committeeagendasandsupportingmaterial)providedpriortoattendingeachmeeting.MaterialsforallBoardandCommitteemeetingsaredistributedelectronically,generallyoneweekpriortothescheduledmeeting. ElectedDirectorsareexpectedtobeabletoreceive,printandcommunicateviaelectronicmeans.WhiletheamountoftimerequiredforthistaskwillvaryforeachindividualitisnotunusualforaDirectortospendapproximately2–5hourspreparingforaBoardorforsomeCommitteemeetings.

While travel time to and frommeetingswill varywith eachDirector, it is another factor to beconsidered.

AttendanceatallBoardandCommitteemeetingsistrackedandreportedtotheBoard.Whileoccasionalconferencecallsareheldtodealwithspecialissuesbetweenregularlyscheduledmeetings,forthemostpartDirectorsareexpectedtoattendmeetingsinperson.UnderexceptionalcircumstancestheChairmayallowparticipationinameetingviatelephoneconference.

ThefollowingmeetingsummaryshowstheapproximatetimecommitmentforeachDirectorduringthecourseofayear:

BOARDMEETINGS Themeetingsareheldinthecorporateboardroomat5290YongeSt,

Toronto,currentlyheldquarterly.

ORIENTATION PROGRAM FornewlyelectedDirectors;usuallyheldfollowingtheelectionandnolaterthantwomonthsafterhavingbeenelected.Allowminimumofoneday.

AUDITCOMMITTEE Meetsapproximately fivetimesayear(allow2-3hours/meeting).

GOVERNANCE COMMITTEE Meetsapproximately fivetimesayear(allow2-3hours/meeting).

ELECTIONSCOMMITTEE Meetsonasneededbasis.Aconcentrated periodusuallyoccursduringDecemberandJanuarywhenCandidate interviewsareconducted.

ANNUALGENERALMEETING UsuallyheldduringthefirstweekinAprilduringtheevening(3hours).

PLANNINGSESSIONS Generally involvesonefulldayonanannualbasis.

CREDITCOMMITTEE Meetsonadhocbasis(allow2-3hours/meeting).

HUMANRESOURCESANDCOMPENSATIONCOMMITTEE

Meetsapproximately 4timesperyear,quarterly(allow1-3hours/meeting).

RISKCOMMITTEE Meetsapproximatelyfivetimesayear(allow2-3hours/meeting).


EducationDUCAconsiderstraininganddevelopmentprogramsforourDirectorsextremelyimportanttoassisttheminunderstandingtherolesandresponsibilitiesofbeingaDirectorofaCreditUnion.In2012theDepositInsuranceCorporationofOntario(DICO)setoutminimumexpectationsforindividualDirectorCompetencies,whichwillrequirevariousprogramsbecompletedwithincertaintimeframes.RemunerationDirectorsreceiveamonthlyhonorariumplusadditionalcompensationforcommitteework. Thesepaymentsaretaxableaspersonalincome.Kilometersarereimbursedover20forreasonablebusinessexpenses.

Schedule IApplication for

ElectionCampaignPolicyTheBoardofDirectorsdeterminesthemethodandthemannerinwhichcandidatesarepermittedtocampaignforelection.Non-compliancewiththefollowingpolicymayresultinacandidate’sdisqualification,iftheElectionsCommitteesodetermines.

1.0 EffectiveDateofthePolicyThispolicytakeseffectasofthedatethatthecandidatesubmitshis/hernominationpapers.

2.0 CandidateInformation ProvidedToMembersTheElectionsCommitteeensuresthatthefollowinginformationabouteachcandidateismadeavailabletomembersthroughinbranchesandonitswebsite:

1.1 Picture–Nomineetoprovideadigital,highresolutionpicturewhichwillbepostedinthenewsletter,websiteandinallDUCAoffices.

1.2 Biography–Assubmittedbythecandidate,subjecttoeditingbytheChairofElectionsCommitteeaccordingtotherequirementsoutlinedintheBoardCandidateInformationKit.Maximumlengthtobe150words.

3.0 Campaigning RulesTheBoardofDirectorsbelievesthattheabovemeasuresprovidetheopportunityforcandidatestocampaigninafair,openandtransparentmanner. Campaigningactivitiesbeyondtheabovearestrictlyprohibited. Formoreclarity,theseincludebutarenotlimitedto:

No candidate shall interfere with the duties or seek assistance from anyemployeeofDUCAoranymemberoftheElectionsCommitteeinconnectionwiththeelection.

CandidatesshallnotcampaignonDUCApremisesorinterferewithnorimpedeanymembersofDUCA.

4.0 Non-AdherencetothePolicyNon-adherencetotheElectionCampaignPolicymayresultinacandidate’sdisqualification. Ifdisqualified,within24hours,theElectionsCommitteeshallgivewrittennoticeofsuchdisqualificationtothecandidateandthenoticeshallspecifythereason(s)forthedisqualification.

Schedule I (Continued)Application for

4.1 ImpactofCandidateDisqualification

Onceacandidatehasbeendisqualified,novotecastinfavourofthiscandidateshallbecountedinthetallyofballots,buttheballotsshallnototherwisebedeemedtobevoid.

4.2 Clarification

CandidateswhoareunsureoftheintentofanypartofthispolicyshallcontacttheChairoftheElectionsCommitteeforclarification.

4.3 Dispute

Anydisputeregardinginterpretation,applicationorallegedviolationofthispolicyshallbedealtwithbytheElectionsCommittee.ThedecisionoftheElectionsCommitteeshallbefinal,non-appealableandbinding.

5.0 RolesandResponsibilities

TheBoardofDirectorsofDUCAisresponsible,throughtheNominatingandGovernanceCommittees,toreviewthispolicyannually.

Schedule JSampleCreditInformationForm

DUCA Financial Services Credit Union Ltd. Credit Information Form, Sep. 2011

Credit Information Form

As part of the employment application process, I hereby authorize DUCA Financial Services Credit Union Ltd. to obtain credit information about me from any source. I understand that DUCA’s obtaining credit information about me will be part of the employment decision-making process and understand that, if deemed unsatisfactory by DUCA, this information may result in DUCA’s deciding to withdraw its offer of employment.

Name (please print): _______________________________________________________

Address: ________________________ Town/City: ____________________ Postal Code: _________

S.I.N.: ______ - ______ - ______

D.O.B.: _______________________

As a financial institution, we make any offers of employment conditionally upon our obtaining a satisfactory credit report for candidates from the credit bureau(s). To the best of your knowledge, would there be any problems with your credit rating?

Yes No

Signature: _____________________ Date: ___________________

_________________________________________________________________________________________

Important Notice: your personal credit information will be held in confidence by DUCA Financial Services Credit Union Ltd.

SAMPLE

ScheduleKSampleIndividualFidelityBondApplicationForm

(FBA –January 2015) Page 1 of 3

Employee Name: ________________________________________

Name of Employer: ______________________________________

Criminal record check completed? Yes No

Reason for Application: New Employee Promotion

Other

INDIVIDUAL FIDELITY BOND APPLICATION FOR EMPLOYEE

Fidelity bonding is a firmly established business practice. The fidelity bond you are applying for, within its agreements, conditions and limitations, guarantees that your employer will not sustain a loss by reason of your dishonesty. It also serves notice that you meet the high standards required by the issuer of your bond. Compliance with your employer’s rules and faithful and honest discharge of the duties of your position will assure your ability to obtain a bond in any future employment.

INSTRUCTIONS FOR APPLICANT

1. Complete this application only if you are currently employed by the entity requiring the bond or you have acceptedan offer of employment with the entity.

2. Complete all questions fully and accurately, as all answers are material to this application. PLEASE PRINT.3. Return the completed application to your employer.

INSTRUCTIONS FOR EMPLOYER To ensure that there are no delays in the processing of this application please ensure that:

• a full 10 years of employment / personal experience is listed (age 18+). Gaps in history will require clarification.• the applicant provides a detailed explanation for answering “Yes” to any questions #1-#11 on page 2• the applicant provides a detailed explanation for any unfavourable items on their credit report such as collection

items, R9, Beacon score under 600, judgements etc.TO ENSURE THAT ALL REQUIRED INFORMATION HAS BEEN INCLUDED, PLEASE REVIEW THE APPLICATION IN FULL PRIOR TO SUBMITTING.

THE APPLICANT:

___________________________ ________________________ ____________________________________ Male First Name Middle Name Last Name Female

Date of Birth ___________________________ Social Insurance No. ___________________________________ (Year/Month/Day)

Current Address _________________________________________________________________________________

Previous Address _______________________________________________________________________________ (if less than 3 years at current address)

How many persons are dependent upon you for support (as per most recent income tax return) ? ______________

POSITION: Title of your new position _________________________ Date of Initial Employment/Promotion _______________

Position Level: Clerical/Teller Supervisory position Management

The Credit Union Bonding Program

SAMPLE



OTHER EMPLOYMENT: Do you have employment, other than at the credit union Yes No If “yes” complete the following:

Name of Employer_____________________________________________ Position ________________________

Address______________________________________________________________________________________

PREVIOUS EMPLOYMENT: (For the past 10 years for ages 18+ only) Give full and complete names and addresses of previous employers, time engaged with each, position occupied, and reason for leaving. If there were periods when you were unemployed, please state what you did during that time. If you were not previously employed, provide general information regarding: school attendance, leave of absence, illness or travel. If more space is required, please continue on blank sheet and attach to this application.

*Please ensure that there are no gaps in the full 10 year history provided, otherwise please provide an explanation.*

Name and Address of Previous Employer Dates Employed Last Position Held Reason for Leaving 1. From:

To:

2. From:

To:

3. From:

To:

4. From:

To:

For the following questions, if you answer “Yes”, please provide us with a full explanation in a separate letter and attach it to this application. Yes No

1. Has any application for a bond been declined by a surety company?

2. Has any person or surety company been compelled to pay a loss on your account?

3. Have you ever failed in your own business?

4. Have you ever voluntarily declared or been petitioned into personal bankruptcy?

5. Has any part of your salary ever been garnished?

6. Have you been found guilty of an offence for which you have NOT received an unrevokedpardon under the Criminal Code, the Food and Drug Act, or the Narcotic Control Act?

7. Have you accepted responsibility for a criminal offence in an “Alternative Measures” orother similar “Restorative Justice Program”?

8. Are you presently the subject of any civil action, or have you had a civil judgementrendered against you?

9. Have you been discharged or asked to resign from any position of employment?

10. Has it been determined by a court of law, quasi-judicial tribunal, or Board of Arbitrationthat you have committed a dishonest or fraudulent act of any kind?

11. Are you related in any way to any individual currently employed by the credit unionwhich has hired you?

SAMPLE



IT IS IMPORTANT THAT THE APPLICANT READ AND FULLY UNDERSTAND THE CONTENTS OF THE AGREEMENT HEREUNDER BEFORE SIGNING

AGREEMENT OF APPLICANT

I hereby warrant that the foregoing statements are true and correct, and in consideration of CUMIS General Insurance Company, hereinafter called the Insurer becoming Insurer for me under this bond (the term “bond” shall include the bond herein applied for, every continuation or alteration thereof, and any new bond) in my present or any other position, I agree to unconditionally indemnify and save harmless the said insurer against all actions, proceedings, liabilities, damages, loss, cost and expense, including costs of realization and legal fees on a solicitor client basis, that it may sustain or become liable for by reason of dishonesty on my behalf.

I ALSO UNDERSTAND AND AGREE THAT:

(a) In the event I am bonded and it is later discovered by the Insurer that any of the answers given are untrue orinaccurate, the insurer may, at its option, cancel the bond.

(b) Should my circumstances change such that any of the answers given on this application (questions #1 to 11) by meare no longer accurate or true, then I shall immediately notify the Insurer of such change and any failure to do somay result in cancellation of the bond, at the option of the Insurer.

(c) In the event that I am bonded, I am bound by the terms and provisions of this Agreement.

(d) The bond is automatically deemed cancelled and terminated on the discovery of any dishonest act on my partwhether or not such dishonest act results in any monetary loss to the entity requiring the bond, the Insurer or anyother person or organization.

(e) The Insurer, its agent or the entity requiring the bond, may collect such additional information about me as maybe necessary to review and verify the information contained on this bond application. Information may beobtained from sources such as: financial institutions, police forces (federal, provincial, municipal and foreign),current and former employers, credit bureaus, insurance companies, business associates, provincial and federalgovernment departments and foreign governments. The information furnished on this form will be used by theInsurer to determine your eligibility for a bond.

(f) I may be requested by the Insurer to periodically complete and file an updated “Employee’s Application forFidelity Bond” in substantially the same form as the one filed herewith, with such modifications as may berequested by the Insurer.

I further represent and warrant that I have not concealed or failed to disclose any facts which, if known to the Insurer, would cause the Insurer to decline the bond or which would make the Insurer’s liability greater than would normally be expected and I understand and agree that if any such facts should become known to the Insurer, it may, at its option, cancel the bond.

______________________________________________ ____________________________________________ Signature of Applicant Date

NOTE: PLEASE ENSURE ALL QUESTIONS ARE ANSWERED BEFORE SUBMITTING. INCOMPLETE APPLICATIONS WILL NOT BE APPROVED

SAMPLE

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