NLPNP – Declaration of Personal Net Worth – Revised: January 2017 Page 1 of 1
Newfoundland & Labrador Provincial Nominee Program
Declaration of Personal Net Worth
Important: You must provide us with documents to support all the information provided in this statement
A.
Exchange Rates – Please indicate all exchange rates used. Exchange rates are needed to convert your assets and
liabilities to Canadian Dollars from whatever currency they are in currently. In the example below, on September 4
th
,
2014, $1 Canadian was valued at 40.20 Philippine Pesos.
$1 Canadian Dollar Exchange rate Date
Example: $1 Canadian = 40.20 Philippine Pesos Sept. 4, 2014
$1 Canadian =
$1 Canadian =
B. Assets – List all the assets in Canadian Dollars, such as bank accounts, investment funds, real estate or property,
owned by the Principal Applicant and all accompanying dependants. Do not include items such as jewelry, vehicles, and
other personal valuables – these will be noted in a separate table below. Attach extra pages if necessary.
Description of Assets Value in Canadian $
$
$
$
$
Total Assets:
$
C. Liabilities – List all the liabilities (i.e. debts, loans, lines of credit, credit cards and other financial obligations) in
Canadian Dollars, including mortgages, bank loans, auto loans, fees owing to lawyers or consultants, alimony, and
child support payments, owed by the Principle Applicant and all accompanying dependant family members. Attach
extra pages if necessary.
Description of Liabilities Value in Canadian $
$
$
$
$
Total Liabilities:
$
D. Net Worth – Calculated by subtracting your total liabilities (Table C above) from your total assets (Table B above). In
other words,
Net Worth = Total Assets – Total Liabilities.
Net Worth:
$
E. Personal Valuables – Please indicate the value (in Canadian Dollars) of all personal assets brought, or to be brought to
Canada by the
Principle Applicant and all accompanying dependant family members. This would include items such as
jewelry, vehicles and artwork.
Total Value of Personal Valuables:
$
F. Certification – I certify that the information provided in this document (or attached) is complete, truthful and correct.
Name of Principal Applicant (please print) Principal Applicant’s date of birth
Signature of Principal Applicant Date of signature
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