PART A APPLICANT INFORMATION 1. PERSONAL INFORMATION 4. PROFESSIONAL MEMBERSHIP INFORMATION. First Name:



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PART A APPLICANT INFORMATION THE LAW SOCIETY OF UPPER CANADA APPLICATION FOR LICENSING FOLLOWING SURRENDER OF LICENCE AT PARALEGAL S REQUEST (sections 27 and 30 of the Law Society Act and By-law 4, Parts II and III) 1. PERSONAL INFORMATION 4. PROFESSIONAL MEMBERSHIP INFORMATION First Name: Middle Name(s): Last Name: Date of Birth: / / Day Month Year Place of Birth: (City/Country) I am or have been a member of the following Professional Regulary Body/ Law Society / Paralegal Organization, inside or outside Canada: Name of Professional Organization: Year of Licence/Membership: Member Number: Status: 2. HOME CONTACT INFORMATION Address: Telephone Number: Fax Number: Email Address: 3. BUSINESS CONTACT INFORMATION Address: Provide an original Certificate of Standing (dated within the last 30 days) from each Professional Regulary body / Law Society / Paralegal Organization of which you are or have been a member, inside or outside of Canada. NOTE: Your Certificate(s) of Standing must be replaced if it becomes more than 60 days old at the time your application is ready be approved. Telephone Number: Fax Number: Email Address: Page 1

5. LAW SOCIETY INFORMATION I was licensed on: / / Law Society Number Day Month Year I surrendered my licence on: / / Day Month Year Reason for surrender of licence: To confirm dates, contact our Resource Centre at: 416-947-3315 or 1-800-668-7380 Ext. 3315 or e-mail: records@lsuc.on.ca 6. PROOF OF LEGAL NAME Have you used another name or changed your name by court order, marriage, or other means? If Yes: Provide a certified copy of a: Canadian Name Change Certificate; OR Canadian Marriage Certificate; OR Court Order N/A *Documents must be certified within 60 days 7. Did you graduate from a legal services program in Ontario that is accredited by the Law Society? 8. The work that I plan perform upon being licensed is: Sole practitioner in a paralegal firm Partner in a paralegal firm Employee/associate in a paralegal firm Employed in education Employed in government Employed other (provide details) Providing legal services outside of Ontario Employed other outside of Ontario (provide details) Other (provide details) Page 2

9(a).Set out in full chronological order your work hisry from the date you were licensed by the Law Society of Upper Canada and the date you surrendered your licence. Dates (DD/MM/YY) Nature of Work Employer's Name and Address 9(b).Set out in full chronological order your business or employment activities from the date you surrendered your licence the present. Dates (DD/MM/YY) Nature of Work Employer's Name and Address Page 3

10. List all addresses where you have resided (inside and outside of Canada) since you surrendered your licence. Dates (DD/MM/YY) Address *A civil court search (or equivalent) is required from each Canadian jurisdiction named in Q10. *A foreign criminal search is required for each jurisdiction outside of Canada named in Q10. PART B GOOD CHARACTER If you answer Yes any of the questions in this part, provide full details on a separate sheet and attach any relevant documents including orders and/or judgments. 11. Are you currently the subject of criminal proceedings or proceedings for any other offence under any statute in Canada or elsewhere? Canadian Police Information Centre report (C.P.I.C.)is required 12. Have you ever been found guilty of, or convicted of, any offence under any statute in Canada or elsewhere? Exclude speeding and parking tickets. 13. Has judgment ever been entered against you in an action involving fraud? 14. Are there any outstanding civil judgments against you? 15. Have you ever disobeyed an order of any court requiring you do any act or abstain from doing any act? 16. While attending a post-secondary institution, have allegations of misconduct ever been made against you or have you ever been suspended, expelled or penalized by a post-secondary institution for misconduct? Page 4

17. Have you ever been refused admission in any professional /regulary/governing body? 18. Are you now or have you ever been suspended, disqualified, censured, the subject of a conduct, capacity or competence proceeding or otherwise the subject of discipline in any jurisdiction(s) where you are or were licensed provide legal services? 19. Are you now or have you ever been a member of a professional/regulary/governing body (other than a Canadian Law Society) in any jurisdiction? 20. Have you ever been denied a licence or permit, or had any licence or permit revoked for failure meet good character requirements? 21. Are you now the subject of a prosecution or have you ever been prosecuted, suspended, disqualified, censured, the subject of a conduct, capacity or competence proceeding or otherwise disciplined by any professional organization? 22. Are you aware of any complaint or charge pending against you in your professional capacity, which has not yet come the attention of your Law Society or professional/regulary/governing body? 23. Are you now or have you ever been the subject of an insurance claim under a policy for professional liability insurance? 24. Have you ever been discharged from any employment where the employer alleged there was cause? 25. Have you ever been disciplined by an employer, or been a respondent in proceedings alleging a violation of the Human Rights Code or similar legislation in any jurisdiction (e.g., sexual harassment, racial discrimination)? 26. Are you or any company or partnership of which you are or were a direcr, officer or employee currently subject a petition or assignment in bankruptcy or a proposal credirs under the Bankruptcy and Insolvency Act, or similar legislation in any jurisdiction and/or have you or any company or partnership of which you are or were a direcr, officer or employee ever been bankrupt or insolvent, under any statute? 27. Are there events, circumstances or conditions, other than those mentioned above, that are potentially relevant your ability provide legal services? Page 5

PART C REQUIRED ATTACHMENTS Required Attachment Application Fee I have included all of the following required attachments with my application (all necessary documentation must be enclosed unless not applicable where the N/A option exists): Non-refundable licensing application fee of $300 plus HST with the enclosed Fee Remittance form. Check all boxes Outstanding Law Society Fees Current Annual Law Society Fees Q4 Certificate(s) of Standing Q10 Civil Court Search Outstanding annual Law Society fees owing from the time of my surrender of licence in the amount of $, with the enclosed Fee Remittance form. OR I have contacted the Law Society's Resource Centre and confirmed that there are no outstanding annual fees owing from the time of my surrender of licence. *Contact information: 416-947-3315 or 1-800-668-7380 Ext. 3315 E-mail: records@lsuc.on.ca Note: Law Society annual fees for the year in which you apply be licensed will be payable upon approval for licensing. Contact the Law Society's Resource Centre for information on current fees payable. *Contact information: 416-947-3315 or 1-800-668-7380 Ext. 3315 E-mail: records@lsuc.on.ca Certificate(s) of Standing or equivalent from each Law Society (excluding the Law Society of Upper Canada) and/or other professional regulary body or Paralegal Organization of which I am or have been a member/licensee. Search result(s) from civil courts for each jurisdiction in which I have resided since my surrender of licence and, if applicable, copies of the related Statement(s) of Claim, Statement(s) of Defense, Court Order(s), or Judgment(s). *Searches can be obtained from each court office. *For jurisdictions that do not provide a civil court search, an equivalent will be accepted. *If the matter is ongoing, provide a copy of the Statement of Claim and if applicable, your Statement of Defense. *If the matter is completed, provide a copy of the Judgment, Order, or a copy of the Minutes of Settlement. N/A Page 6

Q11 / 12 CPIC Report Q12 Criminal Conviction Details Canadian Police Information Centre report (C.P.I.C.). Contact your local police station obtain this report. Criminal Conviction details from any jurisdiction in which I have resided since I surrendered my licence. * If you have been convicted or found guilty of a criminal offence, you must provide a certified copy of the information and/or indictment along with a transcript of the Guilty Plea and Sentencing Proceedings. In the event the matter proceeded by way of a trial, provide a transcript of the Judge s Reasons for Judgment and Sentencing. In the event the courts made an Order(s) of Restitution, provide evidence that the Order(s) has/have been satisfied. *Documents may not be older than 60 days N/A Q12 Pardon Details Q12 Foreign Criminal Search Q26 Bankruptcy Search Insurance Claims Hisry Pardon from Criminal Conviction. *If you obtained a Pardon from a criminal conviction, the Law Society will require adequate information by way of court records or transcripts in order make an appropriate assessment as whether the pardoned conviction adversely impacts the application for licensing. Criminal Record Search from foreign jurisdiction outside of Canada where I have resided since I surrendered my licence. *If you have resided outside of Canada, provide the results of a criminal record search from each applicable foreign jurisdiction. Results of a search with the Office of the Superintendent of Bankruptcy Canada and all other jurisdictions outside of Canada where I resided since I surrendered my licence. *If applicable provide supporting documentation. Original letter from my insurance provider with respect the status of my Errors & Omissions Claims Hisry, and confirmation that Premiums/Fees, Deductibles, and/or Levies have been paid and applicable filings have been submitted. *Complete and fax the enclosed Request and Consent for insurance information form N/A N/A N/A Page 7

PART D AUTHORIZATION AND DECLARATION I hereby authorize the Law Society of Upper Canada make inquiries of any person or government, any official or body, including, without limitation, any police or academic authority, with regard my background or character. On request by the Law Society of Upper Canada, I will furnish any additional specific authorization or any release that is required for the purpose of enabling the Law Society of Upper Canada obtain information related my background or character. I understand that if I am licensed in Ontario, I must comply with the Law Society Act, By-Laws, the Paralegal Rules of Conduct, and all other rules, regulations and requirements of the Law Society of Upper Canada. I understand that I have a continuing obligation notify the Law Society of Upper Canada immediately of any change the information that I have provided in this application. I,, solemnly declare that all information provided by me in this application or supplemental there, and in the documents furnished in connection with this application, is true, complete, and accurate. DECLARED BEFORE ME ) at, ) on the day of, 20 ) Signature of Applicant (Commissioner for Oaths or Notary Public) (office use only) Approved by: Approval date: Page 8

Obtaining your Insurance Claims Hisry Fax or mail this page directly your insurance company. Request that your insurance company mail the information directly you. Once received, forward the original letter and claims hisry along with your completed application package the Law Society. *Do not submit an e-mail response pertaining your Claims Hisry. An original letter that may not be older than 60 days is required. ATTENTION: FAX #: FROM: LAW SOCIETY #: APPLICANT'S MAILING ADDRESS: RE: REQUEST AND CONSENT FOR INSURANCE INFORMATION Using the mailing address provided above, I hereby direct Company provide me with a report on my claims hisry since I was licensed on / /, and information regarding any outstanding DD MM YY Errors & Omissions, Premiums/Fees, Deductibles and/or Levies. In addition I hereby authorize Law Society s staff review all of my open and closed claim files. This Consent is valid only for the purposes of the processing of my application for licensing the Law Society of Upper Canada. (Signature) Date Page 9

ADDITIONAL INFORMATION By-law 4, Part II In accordance with By-Law 4, Part II, paralegals will be required sign an Affidavit for Taking the Oath be licensed provide legal services in Ontario, which will be sent you by mail. Private Practice Re-entry Requirement On April 24, 2008, Convocation approved a new private practice re-entry requirement for licensees re-entering private practice. The Law Society requires licensees who are returning private practice as sole practitioners, or in a firm of five or fewer licensees, after an absence of 48 months over the past five years, undergo a practice management review within 12 months of establishing their practice. Licensees returning private practice will receive a package of materials designed assist them in establishing their practices. The package includes educational ols and guides based on the Practice Management Guidelines, self-assessment ols, and The Bookkeeping Guide. Mail : Accounts Receivable The Law Society of Upper Canada Osgoode Hall 130 Queen St W Toron ON M5H 2N6 Application Process Review and Approval: Administrative Compliance Questions? Tel: (416) 947-3315 and ask be transferred, or, Email: lsforms@lsuc.on.ca Page 10