Form - Representation Agreement

Representation Agreement Opening Form | KC Notary & Co.

Welcome to your Representation Agreement (RA) application. Here at KC Notary & Co. we are here to support you with all your legal documentation needs, ensuring quality, efficiency, and care every step of the way.

To get your RA application underway we require you complete the 3 pages below. Once we have your submission details we will begin working on your file. Once completed we will reach out to you with our next steps.

Thank you for trusting us with your RA.

Representation Agreement

Person(s) Giving

Person(s) Receiving

Terms and Disclaimer

Do you require mobile services?

Have you ever done a REPRESENTATION AGREEMENT before? (we will revoke all previous RAs) *

Yes

Do you want the Representative to be able to help make decisions or make decisions about where you might live if you cannot remain in your home? *

Yes

Special Circumstances: Rush Files - Leave Message Here

If you cannot meet 3 days before the Funding Date. We will contact you to set up an appointment. Rush Fees may apply.

Other Special Instructions:

RA is for: *

Single Individual

Couple

If Couple but require different Representation, please fill out two Single Individual forms.

1st Person (Couple)

Name of the Person Giving the Power (Must match IDs)

Title (Mr / Mrs / etc.)

First Name (include middle names) *

Last Name *

Address *

City *

Province/State/Region *

Postal Code *

Country *

Phone Number *

Email *

DIFFERENT Names of the Person Giving the Power (for identity clarification)

Please list all the names you have.

Upload Giver's IDs:

ID 1 (Front) *

Click, tap or use camera

Choose File

ID 1 (Back)

Click, tap or use camera

Choose File

ID 2 (Front) *

Click, tap or use camera

Choose File

ID 2 (Back)

Click, tap or use camera

Choose File

Your names MUST match your Government IDs or we will have to redo every document at your appointment. * Additional fees may apply when this occurs.

2nd Person (Couple)

Name of the Person Giving the Power (Must match IDs)

Title (Mr / Mrs / etc.)

First Name (include middle names) *

Last Name *

Address *

City *

Province/State/Region *

Postal Code *

Country *

Phone Number *

Email *

DIFFERENT Names of the Person Giving the Power (for identity clarification)

Please list all the names you have.

Upload Giver's IDs:

ID 1 (Front) *

Click, tap or use camera

Choose File

ID 1 (Back)

Click, tap or use camera

Choose File

ID 2 (Front) *

Click, tap or use camera

Choose File

ID 2 (Back)

Click, tap or use camera

Choose File

Your names MUST match your Government IDs or we will have to redo every document at your appointment. * Additional fees may apply when this occurs.

Back - Representation Agreement

What does a Monitor do?
(a) Ensures the Representative is acting properly.
(b) Can request information about decisions made.
(c) Can take steps if the Representative is not acting in the giver's best interests.

The Monitor is someone who will review the activities of the Representative and report any concerns to the Public Guardian and Trustee.

You have the option of appointing a Monitor. Would you like to appoint a Monitor in your agreement? *

Yes

Full Name *

Address *

City *

Province/State/Region *

Postal Code *

Country *

Phone Number *

Email *

Number of Person(s) Receiving RA Power *

RA Receiver 1

Name of the Person Receiving the Power (Must match IDs)

Title (Mr / Mrs / etc.)

First Name (include middle names) *

Last Name *

Address *

City *

Province/State/Region *

Postal Code *

Country *

Phone Number *

Email *

Upload Receiver's IDs:

ID 1 (Front) *

Click, tap or use camera

Choose File

ID 1 (Back)

Click, tap or use camera

Choose File

ID 2 (Front) *

Click, tap or use camera

Choose File

ID 2 (Back)

Click, tap or use camera

Choose File

Your names MUST match your Government IDs or we will have to redo every document at your appointment. * Additional fees may apply when this occurs.

RA Receiver 2

Name of the Person Receiving the Power (Must match IDs)

Title (Mr / Mrs / etc.)

First Name (include middle names) *

Last Name *

Address *

City *

Province/State/Region *

Postal Code *

Country *

Phone Number *

Email *

Upload Receiver's IDs:

ID 1 (Front) *

Click, tap or use camera

Choose File

ID 1 (Back)

Click, tap or use camera

Choose File

ID 2 (Front) *

Click, tap or use camera

Choose File

ID 2 (Back)

Click, tap or use camera

Choose File

Your names MUST match your Government IDs or we will have to redo every document at your appointment. * Additional fees may apply when this occurs.

RA Receiver 3

Name of the Person Receiving the Power (Must match IDs)

Title (Mr / Mrs / etc.)

First Name (include middle names) *

Last Name *

Address *

City *

Province/State/Region *

Postal Code *

Country *

Phone Number *

Email *

Upload Receiver's IDs:

ID 1 (Front) *

Click, tap or use camera

Choose File

ID 1 (Back)

Click, tap or use camera

Choose File

ID 2 (Front) *

Click, tap or use camera

Choose File

ID 2 (Back)

Click, tap or use camera

Choose File

Your names MUST match your Government IDs or we will have to redo every document at your appointment. * Additional fees may apply when this occurs.

Back - Person(s) Giving

SCOPE OF RETAINER ACKNOWLEDGEMENT AND AGREEMENT

I/We acknowledge that pursuant to previous correspondence with KC Notary & Company and at the direction that the scope of this retainer agreement with KC Notary & Company is strictly limited to the preparation of conveyance and mortgage documentation to complete the above noted transaction pursuant to the contract of purchase and sale received by KC Notary & Company. This may include mortgage life and/or critical illness insurance documents with your mortgage instructions or relevant materials for execution.

I/We have instructed KC Notary & Company not to conduct any work beyond the scope of this retainer unless I specifically instruct to do so in writing. I specifically acknowledge that KC Notary & Company has not been retained to represent me for any matters beyond the scope of this retainer and this includes, but is not limited to, the following:

Advice on tax implications of this transaction;
Advice on any Estate Planning matters or implications respecting this transaction;
Advice on Family Law matters or implications respecting this transaction;
Review of title and charges on title and I acknowledge that while this Law Office may, as a courtesy, provide copies of title and the charges on title, this Law Office has not been retained to provide an opinion on title, the charges on title or as to the nature of the property to be purchased;
Investigation into unregistered interests against title, review of zoning bylaws for the Property, investigation of environmental matters, investigation into heritage status, review of MLS listing information and review of strata bylaws and minutes;
Confirmation that the building and improvements are within the boundaries of the Property;
Advice on the contract of purchase and sale and whether or not to remove subjects to the contract;
Advice as to the type and scope of title insurance offered under title insurance policies;
Advice as to the type and scope of property insurance coverage offered under property insurance policies.

KC Notary & Company has strongly recommended and provided me/us with an opportunity to obtain competent legal, tax, and accounting advice from qualified advisors with respect to matters outside of the scope of this limited retainer prior to completing this transaction.

DISCLAIMER - TERMS AND CONDITIONS

If you provide incorrect information regarding your residency and properties, it is important to note that such actions may result in potential audits or investigations by the property tax department or relevant authorities. Our firm shall not be held responsible for any consequences arising from the client's submission of incorrect information.

Back - Person(s) Giving