PART A APPLICANT INFORMATION AND STATUS. First Name:

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THE LAW SOCIETY OF UPPER CANADA APPLICATION FOR EXEMPTION FROM THE REQUIREMENT TO PAY ANNUAL FEE AND TO SUBMIT THE LAWYER ANNUAL REPORT (under By-Laws 5 & 8) Instructions: Complete all sections. Strike through the parts that are not applicable. Provide additional information on a separate sheet if required. Incomplete applications will delay processing. PART A APPLICANT INFORMATION AND STATUS PERSONAL INFORMATION First Name: Middle Name(s): Last Name: Date of Birth: / / I was called to the Ontario Bar on: / / Law Society Number: EMPLOYMENT INFORMATION Employer s Name: Employer s Address: CURRENT STATUS (choose one) A. Sole Practitioner in Ontario B. Partner in a Law Firm in Ontario C. Employee in a Law Firm in Ontario D. Associate in a Law Firm in Ontario E. Employed in Education in Ontario F. Employed in Government in Ontario G. Otherwise Employed in Ontario H. Not Working I. Not in Ontario HOME AND MAILING ADDRESSES Home Address: Mailing Address: (if different) Home Number: ( ) Facsimile Number: ( ) Business Number: ( ) Email Address: Facsimile Number: ( ) Email Address: Occupation: Page 1

PART B STATUS HISTORY Choose ALL that apply: I practised law in Ontario as a Sole Practitioner within the past three years and ceased to practise law in that capacity on: / / I practised law in Ontario as a Partner/Associate/Employee within the past three years and ceased to practise law in that capacity on: / / NOTE: Provide a letter from the firm s signing partner confirming that you no longer have signing authority over all estate/trust/mixed trust accounts I was never engaged in the private practise of law as an Ontario lawyer within the past three years. Reason for Exemption: (Choose ONE) I am over sixty-five years of age. I am incapacitated and as a result, I am unable to practise law as an Ontario lawyer. NOTE: Provide a letter from a qualified medical practitioner indicating that you are suffering from a permanent illness or disability and are unable to practise law in Ontario PART C TRUST MONIES AND PROPERTY Choose ONE response that is most appropriate with respect to your practice as an Ontario lawyer: I have paid over and distributed all money and property held in trust, including money and property held for estates to the person(s) entitled thereto for which I was responsible, or to another lawyer entitled to practise law. NOTE: Provide confirmation from your bank that all open estate/trust/mixed trust accounts have been closed I have not accounted for and/or paid over money and property held in trust for which I was responsible. Provide an explanation in Part G (page 4). I have not been responsible for any money or property held in trust. Page 2

PART D CLIENT FILES, DOCUMENTS AND PROPERTY Choose ONE response that is most appropriate with respect to your practice as an Ontario lawyer: I have disposed of/or arrangements have been made to the clients satisfaction to have their files, documents and property returned to them. I have turned over clients files, documents and property with the clients authorizations to another lawyer entitled to practise law. Provide details in Part H (page 5). I have not disposed of/or made arrangements to have clients files, documents and property returned to them to their satisfaction. Provide an explanation in Part G (page 4). I have not been responsible for any client matters, files, documents and property. PART E ESTATES AND POWERS OF ATTORNEY Answer ALL of the following questions. a) I am currently a sole estate trustee or a trustee of an inter vivos trust in Ontario. Yes No b) I am currently a Power of Attorney for property in Ontario. Yes No c) I act in these capacities for related persons* only. Yes No N/A NOTE: So long as you are a sole estate trustee and/or Power of Attorney for non-related persons you must: Continue to file the lawyer Annual Report File the appropriate exemption forms annually with LawPRO to confirm continuing status as exempt from payment of insurance premium levies Continue to be subject to the Spot Audit Program * Related persons as used in this application, has the same meaning given it for the purposes of the Income Tax Act Canada). Refer to section 251 of the Income Tax Act. Page 3

PART F GOOD CHARACTER Answer ALL of the following questions. If you answer yes to any question below provide an explanation in Part G (page 4). a) I am currently aware of a claim against me in either my professional capacity or with respect to my practice. b) I am the subject of an audit, investigation and/or search or seizure by the Law Society. Yes No Yes No c) I am party to a proceeding under Part II of the Law Society Act. Yes No d) I am party to a proceeding under section 33 of the Law Society Act. Yes No PART G SPECIFICS If the space provided for any answer is insufficient, complete your response on a separate sheet. Sign and date the sheet and submit it with this application. Page 4

PART H CLIENT PROPERTY AND FILE INFORMATION I have transferred and disposed of my clients files, documents and property as follows: Transferred to/ Location stored (Name, Address) Contact Information (Name, Telephone Number) Active Files Closed Files Wills Powers of Attorney Corporate Minute Books Corporate Seals Page 5

PART I DECLARATION I, solemnly declare that all information provided by me (Full Name of Applicant) in this application or supplemental thereto, and in the documents furnished in connection with this application, is true, accurate and complete. DECLARED BEFORE ME ) at, ) on the day of, 20 ) Signature of Applicant (A Commissioner for Taking Affidavits) Print Name (for office use only) Approved by: Approval date: Page 6

PART J UNDERTAKING TO THE LAW SOCIETY OF UPPER CANADA I,, of, hereby (Full Name of Applicant) (City/Town/etc.) Choose ONE response that is most appropriate with respect to your practice as an Ontario lawyer: I confirm that my law practice and any trust account(s) I have operated have been wound up. I further confirm that I have completed and filed the Lawyer Annual Report to the last filing due date required of me of the closure of both my law practice and all trust account(s); or I confirm that I was never engaged in the private practise of law as an Ontario lawyer and therefore have no trust accounts to wind up. I further confirm that I have completed and filed all outstanding Lawyer Annual Reports to the last filing due date before my exemption. In order to be exempted from further filing requirements, I hereby undertake to The Law Society of Upper Canada that should my circumstances change and I decide to return to legal practice and accept client monies or property in the future, I will immediately notify the Law Society of my intention. I will provide any required documentation to the Law Society to change my status. I understand that my obligation for Law Society annual fees and filing of the Lawyer Annual Report will then resume. Signature of Applicant Date Signature of Witness Date Print Name Page 7