Tax-Free Savings Account Application Tax-Free Savings Account Application

Transcription

1 Tax-Free Savings Account Application Tax-Free Savings Account Application Foresters Asset Management Inc.

2 Tax Free Savings Account Application 1. Account Holder Information Account Number Mr. Mrs. Dr. Last Name First Name Initial(s) Ms. Miss Street Address Apt/Suite City Province Postal Code Occupation Home Phone Work Phone Date of Birth ( ) ( ) Social Insurance Number 2. Contribution or Transfer Information Contribution Amount OR Transfer From Date 3. Successor Holder / Bene ciary Designations This section is Not Applicable for Annuitants Domiciled in Quebec The Successor Holder or Beneficiary Designation will not automatically change as a result of a future relationship or relationship breakdown and it may be necessary to complete a new designation for this purpose. In certain provinces and territories, a disposition of the account in the event of my death, a beneficiary designation, or any revocation thereof, can only be made by Will. If I am domiciled in Canada when I die, this Successor Holder and Beneficiary designation will be governed by the laws of the province or territory of my domicile at the time of my death. If I am NOT domiciled in Canada when I die, the laws of the province or territory where I was domiciled at the time of execution of this application, provided that was in Canada, will apply. Otherwise, the laws of Ontario will apply. 4. Investment Section for all transactions Where permitted by law, I hereby designate my spouse or common-law partner ("Spouse"), named below, to become the holder and acquire all of my rights as the holder of the Account in accordance with the terms of the Trust Agreement in the event of my death before termination of the Account, if he or she survives me. I reserve the right to change or revoke this designation, as permitted by law, in accordance with the terms of the Trust Agreement. Spousal Information: Mr. Mrs. Dr. Last Name First Name Initial(s) Ms. Miss Date of Birth Social Insurance Number Occupation Home Phone Language ( ) English French If I have not designated my Spouse as Successor Holder, or if I have but he or she has not survived me, and where permitted by law, I hereby designate each person named below as a beneficiary of the Account entitled to receive all or a portion of the amounts payable under the Account in accordance with the terms of the Trust Agreement in the event of my death, before termination of the Account, if he or she survives me. I reserve the right to change or revoke this designation, as permitted by law, in accordance with the terms of the Trust Agreement. It is the client's responsibility to ensure the designation is valid under the laws of Canada, its provinces or territories. Beneficiaries Allocation First Name Last Name Relationship (must add up to 100%) Add particulars of additional beneficiaries on a sheet marked schedule A. Check if schedule A is attached Initial Investments Sales Charge % (Initial Sales Fund Name Fund Code $ or % Charge only) Wire Order Number TOTAL INVESTMENT AMOUNT $ 5. Distribution Instructions Distributions will be reinvested in the same funds unless you choose one of the options below. Deposit directly to your bank account via EFT Receive cheque via mail Please attach personalized pre-printed VOID cheque 6. Dollar Cost Averaging Please attach personalized pre-printed VOID cheque I authorize Foresters AEGON Fund Asset Management to Inc. exchange to ( Foresters exchange funds Financial ) funds within within my to AEGON my exchange Foresters Fund funds Financial Management within Investment my Foresters account Management as Financial follows: account Company as of follows: Canada Inc. 6. Dollar Cost Averaging I account authorize as AEGON follows: Fund Management to exchange funds within my AEGON Fund Management account as follows: Amount From imaxxfund Name Fund Code Fixed $ OR # units To imaxxfund Name Fund Code *Please note for Dollar Cost Averaging you may only indicate one (1) from Fund. Start Date (1st to 28th of month): COPY 1 HEAD OFFICE COPY 2 ADVISOR COPY COPY 3 DEALER COPY COPY 4 CLIENT COPY Ç AFM975 11/17 2/12

3 7. Systematic Purchase (PAC) If the PAC date falls on a non-business day, the PAC will be drawn on the next valuation date following that t day. Minimum $50. $25. We need 5 business days to set up or change a PAC amount. Please attach a personalized pre-printed VOID cheque Start Date (1st to 28th of month): Frequency (select one): Weekly Bi-Weekly Monthly Quarterly Semi-Annually Annually Fund Name Fund Code $ PAC Amount Sales Charge % (Initial Sales Charge only) 8. Standing Instructions 9a. Agreement 9b. Consent to Collection and Use of Information 9c. Your Signature for all transactions TOTAL DOLLAR AMOUNT TERMS OF PAC AUTHORIZATION You hereby authorize Foresters Financial to draw on the account at the financial institution which is identified on the attached void cheque (PAC Account) in the amount and frequency indicated for the purpose of making deposits to the Account. For the purpose of this authorization, you agree that all pre-authorized debits will be treated as personal. By signing this form, you hereby waive any pre-notification requirement as specified by section 15(a) and (b) of the Canadian Payments Association ( CPS )Rule H1 with regards to pre-authorized debits. You warrant that all required signatures for the authorization of debits for the PAC Account are present in this Authorization. You consent to the disclosure of any personal information contained in this application to any third parties for the purpose of processing the PAC. You also understand and agree to all the terms and conditions. You certify that the information provided with respect to the PAC Account is accurate. You will provide Foresters Financial with a new void cheque if the PAC Account is changed. If this is for your own personal investment, your debit will be considered a Personal PAC by Canadian Payments Association definition. If this is for business purposes, it will be considered a Business PAC. Monies transferred between CPA members will be considered a Funds Transfer PAC. You acknowledge and agree that you are fully liable for any charges incurred if the debits cannot be made due to insufficient funds or any other reason for which you may be held accountable. Cancellation of PAC Authorization This Authorization is continuing, except that you may cancel this Authorization at any time by giving Foresters Financial at least 10 days, notice in writing. You may obtain a cancellation form by contacting your financial institution or at You agree to release the financial institution of all liability if the revocation is not respected, except in the case of gross negligence by the financial institution. Foresters Financial is authorized to accept changes to the PAC Authorization from my registered dealer or my financial advisor in accordance with the policies of Foresters Financial and in accordance with the disclosure and authorization requirements of the CPA. Cancellation of Right to Pay by PAC Foresters Financial may cancel your right to pay by PAC: (a) If deposits by PAC are returned unprocessed. You will be required to notify us in writing to re-establish Deposits to the Account by PAC. (b) On 10 days, written notice to you. You have certain recourse rights if any debit does not comply with this Authorization. For example, you have the right to receive reimbursement if a debit is not authorized or is not consistent with this PAC Authorization. To obtain more information on your recourse rights, contact your financial institution or visit You have requested this application form and all other documents relating hereto to be in English. J ai exigé que ce formulaire et tous les documents y afférant soient rédigés en anglais. To receive copies of the annual and/or semi-annual Management Report of Fund Performance (MRFP), the annual or semi-annual nancia statements, complete your option(s) below. If we have not received instructions then you are deemed to have requested to not receive these materials. Please provide your instructions below: Yes, I would like to receive copies of the annual MRFP, Yes, I would like to receive copies of annual nancia statements, Yes, I would like to receive copies of the semi-annual MRFP, Yes, I would like to receive copies of the semi-annual nancia statements. I am applying to open an Foresters Asset Management Inc. Tax-Free Savings Accounts ( the Account ), and request The Royal Trust Company ( Royal Trust ) to file an election with the Minister of National Revenue to register this qualifying arrangement as a Tax-Free Savings Account under section of the Income Tax Act (Canada). I will notify the Agent, in a form acceptable to the Agent and Royal Trust, should I no longer be resident in Canada. I understand that I may be liable for certain tax consequences arising in connection with a non-compliant qualifying arrangement. I acknowledge that I must and will notify the Agent should I wish to use my interest or right in the Account as security for a loan or other indebtedness. I acknowledge and agree to be bound by the terms and conditions of this Account as set out in the application, the Trust Agreement, and any relevant addendum to the Account. Upon receiving your application, Foresters Financial will establish and maintain a file containing your personal information, which will be accessible at Foresters Asset Management Inc. s Head Office. I hereby consent and agree to allow Foresters Asset Management Inc. and The Royal Trust Company (the Parties ) to collect personal information about me from me and from other sources (the Information ) and to use such Information to verify my identity; to administer the Account; to provide me with products and services I may request, or which are required to be provided to me by law or applicable regulatory policies; and as otherwise required or permitted by law. The Parties may use and disclose: (i) the Information to third parties as necessary to administer the Account or as required by law or by applicable regulatory policies; and (ii) my social insurance number as required by law, including for income tax reporting purposes. The Parties may make the Information available to their employees, agents and service providers, who are required to maintain the confidentiality of the Information. Your information may be securely used, stored or accessed in other countries and may be subject to the laws of those countries. For example, information may be disclosed in response to demands or requests from government authorities, courts, or law enforcement in these countries. The Parties may also use the Information to manage their risks and operations and those of their affiliates and to comply with valid requests for information about me from regulators, government agencies, public bodies or other entities who have a right to issue such requests. Subject to exceptions set out in applicable legislation, you may access your file and request corrections to your personal information by sending a written request to Foresters Asset Management Inc., Attn: Privacy Office, c/o RBC Investor and Treasury Services, Shareholder Services 155 Wellington Street West, 3rd Floor, Toronto, ON M5V 3L3. If I provide personal information about a third party (such as my spouse or beneficiary), I shall have first obtained appropriate consent from that third party to the collection, use and disclosure of their personal information by the Parties in the course of the administration of the Account, for the purposes for which I have provided it to any Party, including the purposes described herein. I acknowledge that I have received and reviewed a copy of the current Simplified Prospectus(es) of the imaxxfund(s) selected and understand that these transactions are made under the terms and conditions therein. I certify that the information provided by me on this application is complete and true in all respects. It is my wish that all documents relating to the Account have been and shall be drawn up in the English language only. Cíest mon désir que touts documents se rapportant au compte soient rédigès en anglais seulement. Mutual fund investments fiuctuate in value and are not insured by the Canada Deposit Insurance Corporation or the Rëgie de líassurance-déupùts du Quebec and are not guaranteed by Foresters Asset Management Inc. $ Signed on, 20, in the Province of. Account Holder Signature Accepted by Foresters Asset Management Inc. as Agent for The Royal Trust Company 10. Your Investment Professional Dealer Company s Name Dealer Code Rep. Code Investment Professional s Name Signature of Investment Professional Phone ( ) COPY 1 HEAD OFFICE COPY 2 ADVISOR COPY COPY 3 DEALER COPY COPY 4 CLIENT COPY

4 Foresters Asset Management Inc. Tax Free Savings Account Trust Agreement Agent means Foresters Asset Management Inc. and its successors and assigns;

5 January 2018

6 VISIT US ONLINE AT: imaxxwealth.com CALL US AT: US AT Foresters Asset Management Inc. c/o RBC Investor and Treasury Services Shareholder Services 3rd Floor Imaging Team 155 Wellington Street West Toronto, Ontario M5V 3L3 Foresters Financial and Foresters are trade names and trademarks of The Independent Order of Foresters and its subsidiaries. i maxx, imaxxfunds and imaxxwealth are trademarks of Foresters Asset Management Inc AFM975 11/17