SCHEDULE 2(Sections 10 and 11)Terrorist Group or Listed Person Property Report
PART A
Information on the Person or Entity Filing this Report
1*
Type of reporting person or entity
2*
Reporting person or entity’s identifier number (if applicable)
3*
Full name of reporting person or entity
4*
Full address of reporting person or entity
5*
Name and telephone number of contact person
PART B
Reason for Filing this Report
1*
Reason for filing the report
2
How the reporting person or entity came to know that the property in question is owned or controlled by or on behalf of a terrorist group or listed person
3
Full name of terrorist group or listed person that owns or controls the property or that the property is owned or controlled on behalf of
4
Full address of terrorist group or listed person referred to in item 3
5
Phone number of terrorist group or listed person referred to in item 3
6
Full name of person or entity that owns or controls the property on behalf of the terrorist group or listed person (if applicable)
7
Full address of person or entity referred to in item 6
8
Phone number of person or entity referred to in item 6
PART C
Information on the Property
1*
Type of property
2
Type of property identifier
3
Property identifier number
4*
Approximate or actual value of property
5
Description of property
PART D
Account Information (if applicable)
1*
Account number
2*
Branch or transit number
3*
Type of account (personal, business, trust or other)
4*
Type of currency of the account
5*
Full name of each account holder
6
Date account opened
7
Date account closed, if applicable
8*
Status of account (active, inactive or dormant)
PART E
Information on the Transaction or Proposed Transaction (if applicable)
1*
Date of transaction or night deposit indicator
2
Time of transaction
3
Posting date (if different from above)
4*
Purpose and details of the transaction, including type of funds or assets involved, amount of transaction, currency of transaction, and, if applicable, name and number of each other institution and name and account number of each other person or entity
5*
Disposition of funds, amount of disposition, currency of disposition, and, if applicable, name and number of each other institution and name, account number and policy number of each other person or entity
6*
Method by which the transaction is conducted or proposed to be conducted (in branch or office, ABM, armoured car, mail deposit, courier, telephone or other)
7
Identification number of person who first detected a transaction with respect to property owned or controlled by or on behalf of a terrorist group or listed person
PART F
Information on Person Conducting or Proposing To Conduct the Transaction (if applicable)
1
Person’s full name
2
Person’s alias, if any
3
Client number provided by reporting person or entity, if applicable
4
Person’s full address
5
Person’s country of residence
6
Person’s citizenship
7
Person’s personal telephone number
8
Person’s type of identifier (e.g., driver’s licence, birth certificate, provincial health insurance card — if such use of the card is not prohibited by the applicable provincial law —, passport, Record of Landing or permanent resident card) and identifier number
9
Place of issue of person’s identifier (province or state, country)
10
Person’s date of birth
11
Person’s occupation
12
Person’s business telephone number
13
Person’s employer
14
Employer’s full business address
15
Employer’s business phone number
PART G
Information on Entity on Whose Behalf the Transaction Is Conducted or Proposed To Be Conducted (if applicable)
1
Full name of entity
2
Full name of each person — up to three — who is authorized to bind the entity or act with respect to the account
3
Full address of entity
4
Telephone number of entity
5
Incorporation number and place of issue, if applicable
6
Entity’s type of business
PART H
Information on Person on Whose Behalf Transaction Is Conducted or Proposed To Be Conducted (if applicable)
1
Person’s full name
2
Person’s alias, if any
3
Person’s full address
4
Person’s personal telephone number
5
Person’s business telephone number
6
Person’s type of identifier (e.g., driver’s licence, birth certificate, provincial health insurance card — if such use of the card is not prohibited by the applicable provincial law —, passport, Record of Landing or permanent resident card) and identifier number
7
Place of issue of person’s identifier (province or state, country)
8
Person’s date of birth
9
Person’s country of residence
10
Person’s citizenship
11
Person’s occupation
12
Person’s employer
13
Employer’s full business address
14
Employer’s business telephone number
15
Relationship of person conducting or proposing to conduct the transaction to the person on whose behalf the transaction is conducted
