1. Nidus Self-Help Course for Making and Registering a Representation Agreement with Section 7 Standard Powers Completing the Representation Agreement Form and Certificates © 2011 Nidus Personal Planning Resource Centre. All rights reserved.

2. Nidus is a non-profit, charitable organization. www.nidus.ca

3. Nidus is a non-profit, charitable organization. Nidus does not give legal advice. www.nidus.ca

4. Nidus is a non-profit, charitable organization. Nidus does not give legal advice. The Nidus Self-Help Course and this Module are based on: o The legal requirements set out in the Representation Agreement Act and Regulation, and o The best practices identified by Nidus from over 10 years experience helping people to learn about, make and use Representation Agreements. www.nidus.ca

5. Preparing for this Module We suggest you prepare for watching this video:

6. Preparing for this Module We suggest you prepare for watching this video: o Print off the forms Nidus sent you. Read the email for instructions.

7. Preparing for this Module We suggest you prepare for watching this video: o Print off the forms Nidus sent you. Read the email for instructions. o Plan to watch the video more than once.

8. Preparing for this Module We suggest you prepare for watching this video: o Print off the forms Nidus sent you. Read the email for instructions. o Plan to watch the video more than once. o Use a pencil to fill in your forms as you go along. Then you can go over the forms again in ink.

9. Completing the Forms The purpose of this Module is to help you complete the fill-in-the blank Representation Agreement form and Certificates.

10. Completing the Forms The purpose of this Module is to help you complete the fill-in-the blank Representation Agreement form and Certificates. Please remember that the Representation Agreement form is copyright. This means you do not have permission to use the form for anyone else. You also cannot copy the wording.

11. Completing the Forms The purpose of this Module is to help you complete the fill-in-the blank Representation Agreement form and Certificates. Please remember that the Representation Agreement form is copyright. This means you do not have permission to use the form for anyone else. You also cannot copy the wording. o In addition, this form is only for this one time. You cannot use this form again at a later time. Upcoming changes to the law will change wording. Existing Agreements are not affected but new ones will be.

12. Organizing the Forms Nidus suggests you organize the forms in this order for watching the video:

13. Organizing the Forms Nidus suggests you organize the forms in this order for watching the video: 1. The pages related to the Representation Agreement Form (RA Form).

14. Organizing the Forms Nidus suggests you organize the forms in this order for watching the video: 1. The pages related to the Representation Agreement Form (RA Form). 2. The Certificate of Representative/Alternate Representative – one for each representative and alternate named in the Agreement.

15. Organizing the Forms Nidus suggests you organize the forms in this order for watching the video: 1. The pages related to the Representation Agreement Form (RA Form). 2. The Certificate of Representative/Alternate Representative – one for each representative and alternate named in the Agreement. 3. The Certificate of Monitor (if a monitor is named).

16. Organizing the Forms Nidus suggests you organize the forms in this order for watching the video: 1. The pages related to the Representation Agreement Form (RA Form). 2. The Certificate of Representative/Alternate Representative – one for each representative and alternate named in the Agreement. 3. The Certificate of Monitor (if a monitor is named). 4. The Certificate of Witnesses.

17. Organizing the Forms Nidus suggests you organize the forms in this order for watching the video: 1. The pages related to the Representation Agreement Form (RA Form). 2. The Certificate of Representative/Alternate Representative – one for each representative and alternate named in the Agreement. 3. The Certificate of Monitor (if a monitor is named). 4. The Certificate of Witnesses. Consider keeping the originals in a plastic page protector – safe from spills and other damage.

18. Completing the Forms – Some Tips Print clearly. These are legal forms. Third parties such as health care providers and staff of financial institutions or government agencies need to be able to read the information.

19. Completing the Forms – Some Tips Print clearly. These are legal forms. Third parties such as health care providers and staff of financial institutions or government agencies need to be able to read the information. When you are filling in the blanks you will see wording below the line that tells you what information to fill in.

20. Completing the Forms – Some Tips Print clearly. These are legal forms. Third parties such as health care providers and staff of financial institutions or government agencies need to be able to read the information. When you are filling in the blanks you will see wording below the line that tells you what information to fill in. If you make a mistake when filling out the form, you can carefully draw a line through the mistake and then print the correction. You can put your initials beside it.

21. Completing the Forms – Some Tips Print clearly. These are legal forms. Third parties such as health care providers and staff of financial institutions or government agencies need to be able to read the information. When you are filling in the blanks you will see wording below the line that tells you what information to fill in. If you make a mistake when filling out the form, you can carefully draw a line through the mistake and then print the correction. You can put your initials beside it. Do NOT use white out on legal forms.

22. Completing the Forms – Getting Started There are two main steps to completing the forms:

23. Completing the Forms – Getting Started There are two main steps to completing the forms: 1. Print information on the fill-in-the blank Representation Agreement form and the Certificate forms.

24. Completing the Forms – Getting Started There are two main steps to completing the forms: 1. Print information on the fill-in-the blank Representation Agreement form and the Certificate forms. o NO signing and NO dating until information is filled in.

25. Completing the Forms – Getting Started There are two main steps to completing the forms: 1. Print information on the fill-in-the blank Representation Agreement form and the Certificate forms. o NO signing and NO dating until information is filled in. 2. Follow the steps for signing and witnessing as described in Module 2. These are reviewed at the end of this Module.

26. Completing RA Form – Start with Page 1 Start with the first page of the Representation Agreement Form.

27. Completing RA Form – Start with Page 1 Do not fill the date in yet. “No signing and no dating.” Later, you will fill in the date according to the date the adult and witnesses signed the Agreement.

28. Completing RA Form – Start with Page 1 Fill in all of this section with the adult’s information. ‘Current address’ means where the adult is living now. If the adult is in hospital for treatment and you do not know where he or she will be living, use the adult’s mailing address.

29. Completing the RA Form Complete the section for the representative’s information. Where it says ‘PRINT full name’ – use the name that appears on the representative’s identification. This way, if a third party asks to see the ID it will match the RA form.

30. Completing the RA Form If the Agreement names a monitor, complete the section for the monitor’s information.

31. Completing the RA Form If an alternate representative is named, complete the information for that section.

32. Completing the RA Form If the RA form is more than two pages, you will see this section at the bottom of page two. This helps indicate that all the pages are for the same person and the same Agreement.

33. Completing the RA Form In the section ‘Signing and witnessing’, ONLY print the adult’s name. The rest is filled in at the signing and witnessing step.

34. Completing the RA Form Next, look for a heading that indicates where the representative and alternate sign the RA form. This section will be on the same page below where the witnesses signed or on the next page.

35. Completing the RA Form Print the names on the line below where they will sign later.

36. Completing the Certificate of Representative Make sure you print a Certificate for each representative and each alternate.

37. Completing the Certificate of Representative At the top of each Certificate of Representative form, fill in the information for the representative or alternate.

38. Completing the Certificate of Representative In the middle section of each Certificate of Representative, fill in the adult’s name and address. You cannot fill in the date in this section until the adult and witnesses have signed.

39. Completing the Certificate of Representative See the bottom of the Certificate. No signing in advance. The representative(s) and alternate(s) sign their Certificate of Representative only after the adult and witnesses signed the Agreement. The date they sign the Certificate could be the same date the adult signed the Agreement or a later date.

40. Completing the Certificate of Monitor If a monitor is named in the Agreement, you will need to complete a Certificate of Monitor.

41. Completing the Certificate of Monitor At the top of the Certificate, fill in the monitor’s information.

42. Completing the Certificate of Monitor At the top of the Certificate, fill in the monitor’s information. Print the adult’s name.

43. Completing the Certificate of Monitor At the top of the Certificate, fill in the monitor’s information. Print the adult’s name. Later, you will fill in the date that the adult and witnesses signed. Leave blank for now.

44. Completing the Certificate of Monitor No signing in advance. The monitor will sign after the adult and witnesses signed the Agreement.

45. Completing the Certificate of Witnesses You will need one copy of the Certificate of Witnesses.

46. Completing the Certificate of Witnesses The witnesses will likely fill in their own information on the Certificate on the day they witness the adult’s signature.

47. Completing the Certificate of Witnesses In advance, you can print the adult’s name on the Certificate.

48. Completing the Certificate of Witnesses There are two places to print the adult’s name.

49. Completing the Certificate of Witnesses Check this box beside the adult’s name.

50. Signing the RA Form Once the forms are filled in, you are ready for the signing and witnessing.

51. Signing the RA Form Once the forms are filled in, you are ready for the signing and witnessing. Arrange for the adult and 2 witnesses to get together for signing. Find the RA form page where they need to sign.

52. Signing the RA Form The adult makes his or her mark with 2 witnesses watching. 

53. Signing the RA Form The witnesses sign below in front of the adult and each other. 

54. Signing the RA Form Fill in the date of signing. 

55. Signing the Certificate of Witnesses Make sure the two witnesses fill out the top part of the Certificate of Witnesses.

56. Signing the Certificate of Witnesses Each witness will sign.

57. Signing the Certificate of Witnesses The witnesses will put the date they signed the Certificate.

58. Signing the Certificate of Witnesses Fill in the date that the adult signed the RA form – there are two places.

59. Dating the Forms You will need to fill in the date the adult signed the Agreement on a number of other pages. Here is a checklist.

60. Dating the Forms You will need to fill in the date the adult signed the Agreement on a number of other pages. Here is a checklist. o RA form – top of page one.

61. Dating the Forms You will need to fill in the date the adult signed the Agreement on a number of other pages. Here is a checklist. o RA form – top of page one. o Each Certificate of Representative/Alternate – middle section.

62. Dating the Forms You will need to fill in the date the adult signed the Agreement on a number of other pages. Here is a checklist. o RA form – top of page one. o Each Certificate of Representative/Alternate – middle section. o Certificate of Monitor.

63. Dating the Forms You will need to fill in the date the adult signed the Agreement on a number of other pages. Here is a checklist. o RA form – top of page one. o Each Certificate of Representative/Alternate – middle section. o Certificate of Monitor. o Double check all forms.

64. Dating the Forms You will need to fill in the date the adult signed the Agreement on a number of other pages. Here is a checklist. o RA form – top of page one. o Each Certificate of Representative/Alternate – middle section. o Certificate of Monitor. o Double check all forms.  Depending on the number of pages for the RA form, you may need to add the date in the section above where each representative/alternate signs on the RA form.

65. Signing by Others No witnesses are required for representatives, alternates or the monitor.

66. Signing by Others No witnesses are required for representatives, alternates or the monitor. Representatives and alternates must:

67. Signing by Others No witnesses are required for representatives, alternates or the monitor. Representatives and alternates must: o sign the RA form.

68. Signing by Others No witnesses are required for representatives, alternates or the monitor. Representatives and alternates must: o sign the RA form. o sign and date the Certificate of Representative/Alternate.

69. Signing by Others No witnesses are required for representatives, alternates or the monitor. Representatives and alternates must: o sign the RA form. o sign and date the Certificate of Representative/Alternate. The monitor must sign and date the Certificate of Monitor.

70. Signing by Others No witnesses are required for representatives, alternates or the monitor. Representatives and alternates must: o sign the RA form. o sign and date the Certificate of Representative/Alternate. The monitor must sign and date the Certificate of Monitor. If any representatives, alternates or the monitor live out of town, please follow the steps outlined in the Nidus Booklet #1 – Completing the Representation Agreement.

71. Signing by Others No witnesses are required for representatives, alternates or the monitor. Representatives and alternates must: o sign the RA form. o sign and date the Certificate of Representative/Alternate. The monitor must sign and date the Certificate of Monitor. If any representatives, alternates or the monitor live out of town, please follow the steps outlined in the Nidus Booklet #1 – Completing the Representation Agreement. The law says the Agreement is not in effect until all the signing is complete.

72. Frequently Asked Questions What do we do after everything is signed?

73. Frequently Asked Questions What do we do after everything is signed? o Keep the original SAFE and ACCESSIBLE.

74. Frequently Asked Questions What do we do after everything is signed? o Keep the original SAFE and ACCESSIBLE. o Send a COPY to the Nidus Registry. See the Nidus Booklet #2 for registration forms and procedures. The registration fee is included in the Course fee.

75. Frequently Asked Questions What do we do after everything is signed? o Keep the original SAFE and ACCESSIBLE. o Send a COPY to the Nidus Registry. See the Nidus Booklet #2 for registration forms and procedures. The registration fee is included in the Course fee. o Make copies of the original to give to third parties. The bank will need to take in the original the first time. The bank can make a true copy. Read the Nidus Booklet #3 – Tips for Introducing and Using the Agreement.

76. Frequently Asked Questions What do we do if there is a change? o A change of address or phone number does not affect your Agreement. Let the Nidus Registry know and add a sticky note to your original.

77. Frequently Asked Questions What do we do if there is a change? o A change of address or phone number does not affect your Agreement. Let the Nidus Registry know and add a sticky note to your original. o If the adult wants to change a person named in the Agreement, he or she needs to make a new Agreement.

78. Frequently Asked Questions What do we do if there is a change? o A change of address or phone number does not affect your Agreement. Let the Nidus Registry know and add a sticky note to your original. o If the adult wants to change a person named in the Agreement, he or she needs to make a new Agreement. o Changes to the Representation Agreement Act and related legislation come into effect on September 1, 2011. Existing Agreements are not affected.

79. 411 Dunsmuir Street, Vancouver, BC V6B 1X4 Note: The information in this video is based on legislation in the province of British Columbia as of February 2011. www.nidus.ca tel toll free fax email 604.408.7414 1.877.267.5552 604.801.5506 info@nidus.ca

80. 411 Dunsmuir Street, Vancouver, BC V6B 1X4 Note: The information in this video is based on legislation in the province of British Columbia as of February 2011. Nidus is a Latin term for nest: A symbol of safety, support and self- development. www.nidus.ca tel toll free fax email 604.408.7414 1.877.267.5552 604.801.5506 info@nidus.ca