Statement. en of Direction. ion. Financial ncial Instructions

Transcription

1 APRIL 2018 Statement en of Direction ion Contract t Changes Financial ncial Instructions t GUARANTEEDANTEED INVES VESTMENT T FUND UNDS Contracts Helios 2 Helios Millenia III New Era Millenia III Classic Millenia III F irst Editionion Imperial Gro wth Plan DFS Guar rant anteed ed Investment nt Funds ar e est stablished by Desjar jardins Financial ncial Security Life Assur urance Comp ompany. Desjar dins Insur urance refers ers to Desjardins Financial Security Life Assurance Comp any.

2 Statement of Direction 1 Complexe Desjardins P.O. Box 9000 Montreal, Quebec, H5B 1H5 Phone: Fax: gifclientservice@dfs.ca d Investment Funds (GIF) Dealer Code Branch Code Representative Code 1. Client Information Contract Number: Owner Surname First Name Initial Client Number Organization Name Co-Owner Surname First Name Initial Client/Co-Owner Number 2. Change Additional guarantee fees may be charged. Please refer to the Acknowledgement, Agreement and Direction section. Change is permitted a maximum of once per calendar year. 3. Helios Contract Optional Change 4. Reset of the Minimum Maturity Benefit (Available only with Helios2-100/100 i) Address Helios n Please change the Core on my/our Helios Contract to the following Core : n 75/75 n 75/100 i Helios2 n Please change the on my/our Helios2 Contract to the following : n 75/75 n 75/100 i n 100/100 i n 75/100 GLWB n Please add the GMWB Exercise Date to my/our d Minimum Withdrawal Benefit (GMWB). n Please delete the d Minimum Withdrawal Benefit (GMWB) from my/our Helios Contract. n Please delete the d Lifetime Withdrawal Benefit (GLWB or GLWB Version 2) from my/our Helios Contract. n I/We would like to reset the Minimum Maturity Benefit Amount of this Contract (up to twice per calendar year.) The reset: Automatically extends the Contract Maturity Date to 15 years after the date of the reset Has no effect on the Death Benefit Cannot be cancelled or modified 5. Helios2 75/100 GLWB Add or Change Lifetime Withdrawal Age I/We plan to make the first GLWB Eligible Withdrawal under Helios2 75/100 GLWB when the Annuitant is years of age. This age is for information purposes only to obtain a projection of your GLWB Maximum Amount. You will need to provide instructions if you wish to make any withdrawal. 6. Source of Funds (Deposits) n Personal Cheque $ n Transfer from a Desjardins Financial Security Life Assurance Company product Account # $ (please provide a copy of transfer documents) n Transfer from another financial institution $ (please provide a copy of transfer documents) Name of Institution Name of Institution $ Name of Institution $ 7. Investment Information Deposits and PAD Contract Number Identification Fund Number* To start or change a Pre-Authorized Debit (PAD) Agreement, complete the section Pre-Authorized Debit (PAD) Agreement Payor's PAD Authorization. Pre-Authorized Debit (PAD) Please complete the Single Deposit Pre-Authorized Debit (PAD) Agreement - Payor's PAD Authorization section The minimum PAD amount is $100 per month and $25 per fund. Sales Charge % Deposit Amount** $ Wire Order Number * A fund number denotes the Fund, Series, Fee Option and. ** Refer to the fund list page for minimum deposit requirements. *** PAD Interval: A-Annually SA-Semi Annually Q-Quarterly M-Monthly SM-Semi Monthly (1 st and 15 th of the month) BW-Bi-Weekly W-Weekly. If no interval is selected, default is monthly. Desjardins Insurance refers to Desjardins Financial Security Life Assurance Company. PAD Amount $ Start n Change n Cancel n Sales Charge % Interval*** Start Date (between 1 and 28) DD/MM/YYYY DD/MM/YYYY DD/MM/YYYY DD/MM/YYYY DD/MM/YYYY

3 8. Switch/Transfer For Helios2 Contracts, switches must be made within the same Fee Option, Series and guarantee. For transfers from RRSP/LIRA to RRIF/LIF, please complete Section 9 for payout instructions. Contract Number FROM: Fund Number Partial Total Net $ % Fund Number Annual Fee Waiver** Matured Units % n n % n n % n n % n n TO: Contract Number (if existing)* * If transferring to a new Contract, the appropriate Contract Application must be completed and attached. ** If you are applying the annual fee waiver to more than one fund, please indicate the specific amount for each fund. Wire Order Number 9. Systematic Withdrawal Program (SWP) and Fund Allocations for Helios Contract Optional s (GMWB or GLWB or GLWB Version 2) or Helios2 75/100 GLWB Maximum Amount n Start n Change n Cancel Contract Number Fund Number SWP (amount or %) Contract Number Fund Number SWP (amount or %) Payment Frequency: n Annually n Semi-Annually n Quarterly n Monthly n Semi-Monthly (1st and 15th of the month) n Bi-Weekly n Weekly Start Date (select a date between 1 and 28) Non-registered and TFSA Contracts I/We select: n $ per interval. Indicate if this amount is n Gross OR n Net (default if no selection is made) n Waiver of surrender charge amount n GLWB Maximum Amount n % of the GMWB Protected Value (maximum of 7% per year) RRIF/LIF I/We select: n Minimum Amount permitted under a RRIF or LIF n Maximum Amount permitted under a LIF (default payment date is December 15) n $ per year. Indicate if this amount is n Gross OR n Net (default if no selection is made) n Waiver of surrender charge amount n GLWB Maximum Amount n % of the GMWB Protected Value (maximum of 7% per year) n Temporary LIF income (Quebec only). Please provide the appropriate schedules. Payments will be deposited directly into the bank account that you specify. Please provide a personalized cheque marked VOID. Tax Withholding (RRIF/LIF) If you would like to use a different withholding tax rate, please indicate the rate as a percentage* Federal tax % Provincial tax (Quebec only) % and to which amount it should be applied** n On the full payment n On amounts in excess of the Minimum Amount * If you request a withholding rate lower than the prescribed rate, the prescribed rate will be applied. ** If you have not indicated how the rate should be applied, we will apply the rate to the full payment. 10. Surrender D D M M Y Y Y Y Contract Number Fund Number Total Partial Cheque Payable to Annual Fee Matured Waiver** Units Amount Net* Gross % Client Other * Default will be Net if no selection is made. ** If you are applying the annual fee waiver to more than one fund, please indicate the specific amount for each fund. n Direct Deposit (A personalized cheque marked VOID must be attached) Send Cheque to Branch n n n n n n n n n n n n n n n n n n n n n n n n n n n n n n n n Wire Order Number Mailing Address (if different than client's address) Account Holder (if applicable) City Province Postal Code 11. Client Information Change n Name Change: Attach supporting documentation, i.e., marriage certificate, proof of divorce Reference/Account Number (if applicable) n Address Change Surname First Name Initial Address Residence Telephone Number City Province Postal Code Business Telephone Number n Address Change

4 Owner Applicable to non registered Contracts only To be completed if the tax circumstances have changed and information in your Declaration of Tax Residence needs to be updated. Please complete all the options that apply to you. Are you a tax resident of any country other than Canada (including a U.S. citizen or U.S. tax resident)? n Yes n No If you answered Yes, please complete the following section. If you do not have a taxpayer identification number (TIN) for a specific jurisdiction, give the reason using one of these choices: Reason A: I will apply or have applied for a TIN but have not yet received it. Reason B: My jurisdiction of tax residence does not issue TINs to its residents. Reason C: Other reason. Name of the country of residence TIN If you do not have a TIN, indicate reason A, B or C (if reason C, please specify) Co-Owner Applicable to non registered Contracts only To be completed if the tax circumstances have changed and information in your Declaration of Tax Residence needs to be updated. Please complete all the options that apply to you. Are you a tax resident of any country other than Canada (including a U.S. citizen or U.S. tax resident)? n Yes n No If you answered Yes, please complete the following section. If you do not have a taxpayer identification number (TIN) for a specific jurisdiction, give the reason using one of these choices: Reason A: I will apply or have applied for a TIN but have not yet received it. Reason B: My jurisdiction of tax residence does not issue TINs to its residents. Reason C: Other reason. Name of the country of residence TIN If you do not have a TIN, indicate reason A, B or C (if reason C, please specify) 12. Beneficiary Designation Change The person(s) you name here will receive the Death Benefit on the death of the last surviving Annuitant. If a separate Beneficiary designation list is attached, it has to include Surname, First Name, % share and relationship. This list must be dated and signed by the Owner and the Co-Owner. n I/We hereby appoint the person(s) named below as Beneficiary(s) of Contract Number to receive any amounts which may be payable in the event of the death of the Annuitant (Life Assured). I/We reserve the right to change the Beneficiary(s) at any time. n I/We hereby appoint the person(s) named below as Beneficiary(s) of all contracts under Client Number to receive any amounts which may be payable in the event of the death of the Annuitant (Life Assured). I/We reserve the right to change the Beneficiary at any time. All Beneficiaries are revocable unless otherwise specified. If you designate a Beneficiary as irrevocable, all transactions and plan changes will require the Beneficiary s written authorization. In Quebec: Where your married or civil union spouse is appointed as the Beneficiary, indicate that the Beneficiary is REVOCABLE, failing which, the appointment as Beneficiary is irrevocable. Please check the following box if the Beneficiary is REVOCABLE n. n I/We want the Death Benefit to be payable to some or all of my/our Beneficiaries in the form of an annuity rather than a lump-sum payment. Please complete form _800E Beneficiary Designation Annuity Settlement Option (Endorsement) along with this Statement of Direction. Primary Beneficiary(s) Surname First Name Share % Relationship* Surname First Name Share % Relationship* Surname First Name Share % Relationship* In the event that my Primary Beneficiary(s) dies before the Annuitant, I appoint my Secondary Beneficiary to receive the Death Benefit. Surname First Name Share % Relationship* *to the Owner/Co-Owner (residents of Quebec) or to the Annuitant(s) (residents outside of Quebec). 13. Representative Information Dealer Name (Service Provider) Representative Name or Trainee (Trainee applies to Quebec only) By signing here, the Representative confirms that he is appropriately licensed, has disclosed any conflicts or interest and has thoroughly examined the Owner s/co-owner s needs for product suitability. The Representative also confirms that for Deposits into this Contract, he will receive compensation by Desjardins Financial Security Life Assurance Company and may receive additional compensation in the future in the form of bonuses, trailers and conferences. The Representative also confirms that he has completed and attached the Third Party Determination Form" (available at if he has reasonable grounds to suspect the Owner/Co-Owner is acting on behalf of a third party. Name of Training Supervisor (Quebec only) Signature of Training Supervisor (Quebec only) Signature of Representative or Trainee

5 14.Power of Attorney/ Authorized Signatory Information This section must be completed when a person is entitled to give instructions for a Desjardins Financial Security Life Assurance Company Contract held by another physical person, a corporation, a trust or other entity. Provide information on a separate sheet if needed. Mandatory: Attach the document giving the power to act (power of attorney, resolution, etc.) Authorized Signatory Verification of ldentity: The agent or representative certifies that he/she has verified the identity of the authorized signatory by examining one of the following forms of identification. Provide a document number. An expired document is not acceptable. Please specify if you are acting on behalf of the Owner or Co-Owner (check the appropriate box). n Owner n Co-Owner Authorized Signatory Surname Address First Name City Province/State Postal Code Important Country Occupation Please be specific, one word generic terms like manager, consultant or president are not sufficient. n Driver s Licence n Passport n Other photo card issued by a government n Provincial Health Card n Citizenship Card (prohibited in Ontario, Manitoba, Nova Scotia and P.E.I.) Important Important Place of Issue or Jurisdiction Document Number Expiration Date if applicable Authorized Cosignatory Surname First Name Address Authorized Cosignatory, if applicable Verification of ldentity: The agent or representative certifies that he/she has verified the identity of the authorized cosignatory by examining one of the following forms of identification. Provide a document number. An expired document is not acceptable. Signature(s) of the individual(s) acting on behalf of the Owner or Co-Owner. City Province/State Postal Code Important Country Occupation Please be specific, one word generic terms like manager, consultant or president are not sufficient. n Driver s Licence n Passport n Other photo card issued by a government n Provincial Health Card (prohibited in Ontario, Manitoba, n Citizenship Card Nova Scotia and P.E.I.) Important Important Place of Issue or Jurisdiction Document Number Expiration Date if applicable Authorized Signatory Name (block letters) Authorized Signatory Signature Date Authorized Cosignatory Name (block letters) Authorized Cosignatory Signature Date 15. Acknowledgement, Agreement and Direction I/We acknowledge that the above information is correct and request that the change(s) I/We have indicated be made. I/We have read the "Change of s" section of the Contract and Information Folder and have discussed the impacts of this transaction with my/our Representative. I/We fully understand the consequences that this may have and I am/we are aware of the changes to the fees that may result because of this modification. I/We have read and agree to the terms and conditions outlined in the Agreement and Direction section printed on the reverse. I/We acknowledge receipt of the current Contract and Information Folder describing the new Fund(s) to which Deposits are being made and their Fund Facts and agree to pay such fees as are therein described. I/We acknowledge having received a proper explanation of the consequences of my/our requested transaction including any tax consequences that may arise from a switch, transfer or redemption. I/We certify that the information provided in the "Declaration of Tax Residence" section of this form is correct and complete. I/We will provide a new form to Desjardins Financial Security Life Assurance Company (DFS) within 30 days of any change in circumstances that causes the information in this form to become incomplete or inaccurate. Signed at Date Owner's Signature (if applicable) Co-Owner s Signature (if applicable) Irrevocable Beneficiary Signature (Required if an irrevocable Beneficiary has been appointed.) 13140E (18-04)

6 1 Complexe Desjardins P.O. Box 9000 Montreal, Quebec, H5B 1H d Investment Funds (GIF) PRE-AUTHORIZED DEBIT (PAD) AGREEMENT PAYOR S PAD AUTHORIZATION 1. Account Holder Name Only complete this section if the Contract Owner is different from the bank account holder. Account Holder(s) Surname First Name Telephone Number Address City Province Postal Code 2. Authorization of I authorize Desjardins Financial Security Life Assurance Company (DFS) to make pre-authorized debits (PAD) Withdrawal from my account with the financial institution indicated below, at the following interval: n Start n Change n Cancel IMPORTANT: Please provide a personalized cheque marked VOID. Name of the Financial Institution where the Account is located Institution Number Transit Number Account Number (with check digit) n Weekly n Bi-Weekly n Semi-Monthly (1 st and 15 th of the month) n Monthly n Quarterly n Semi-Annually n Annually Start Date (select a date between 1 and 28) D D M M Y Y Y Y Each withdrawal will correspond to a fixed amount of $ (minimum $100 per month) to be deposited into my d Investment Fund Contract. Type of PAD Agreement n Personal/Individual n Business Waiver: I agree to waive any written notice before the first debit is made or when any change is made to the above debit. Change or cancellation: I shall inform DFS of any changes to this Agreement at least 10 business days prior to the next withdrawal. I may revoke my authorization at any time, with a notice of at least 10 business days. To obtain a copy of my cancellation form or for more information on my right to cancel a PAD Agreement, I may consult with my financial institution or visit the Payments Canada Web site at payments.ca. I 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. DFS can cancel the PAD agreement by providing a 30-day notice to the Contract Owner. The agreement can also be cancelled if the financial institution refuses the pre-authorized debits for any reasons. I confirm that all the people whose signatures are necessary for the operation of the account mentioned above have signed this authorization. 3. Reimbursement I have certain rights of recourse if a debit does not comply with the terms of this Agreement. For example, I have the right to receive reimbursement for any PAD that is not authorized or that is not compatible with the terms of this PAD Agreement. For more information on my rights of recourse, I may consult with my financial institution or visit payments.ca. I understand that these types of requests are to be made to my financial institution following the procedure it will provide me. 4. Consent for I agree that the information in my application for PAD authorization will be shared with the financial Disclosure of institution, insofar as the disclosure of this information is directly related to and necessary for the proper Information application of the rules applicable for PAD. 5. Signature of Account By signing below, you acknowledge that you have read and authorize the pre-authorized debits (PAD) as Holder(s) described above. Signature of Account Holder Date Signature of a Second Account Holder (Only if two signatures are required) Date Desjardins Insurance refers to Desjardins Financial Security Life Assurance Company.

7 AGREEMENT AND DIRECTION Deposits Under Existing Contracts I/We hereby apply for premium allocation to the Funds(s) indicated, on the terms and conditions contained in the Imperial Growth Plan (IGP), Millennia III, Helios or Helios2 Contracts and agree to pay such fees as are therein described. Surrenders I/We hereby irrevocably direct you to make the surrender cheque payable as indicated on the front of this form. Systematic Withdrawal Program If surrenders are in excess of net capital appreciation they may eventually result in the total surrender of your Contract.

8 Maximum Annuitant Age to make a Deposit (inclusively) Minimum Initial Deposit* or Minimum Pre-Authorized Debit (PAD) - per month** Additional Deposit Minimum Lump Sum or Minimum PAD - per month Deposit requirements for Series 6 Helios2-75/75 Helios2-75/100 i Helios2-100/100 i Helios2-75/100 GLWB 90 (Series 6A) 80 (Series 6B and 6C) $1,000 $1,000 $1,000 $10,000 n.a * Minimum Deposit per Fund is 0. Minimum Deposit for contracts registered as RRIF or containing locked-in money is $10,000. ** Minimum PAD amount per Fund is $25. Fund Names Series 6A No Load Series 6B Low Load Sales Charge Series 6C Deferred Sales Charge Helios2-75/75 Helios2-75/100 i Helios2-100/100 i Helios2-75/100 GLWB Helios2-75/75 Helios2-75/100 i Helios2-100/100 i Helios2-75/100 GLWB Helios2-75/75 Helios2-75/100 i Helios2-100/100 i Helios2-75/100 GLWB INVESTMENT SOLUTIONS DFS GIF Conservative S906A M906A T906A G906A S906B M906B T906B G906B S906C M906C T906C G906C DFS GIF Moderate S916A M916A T916A G916A S916B M916B T916B G916B S916C M916C T916C G916C DFS GIF Balanced S926A M926A T926A G926A S926B M926B T926B G926B S926C M926C T926C G926C DFS GIF Growth S936A M936A T936A G936A S936B M936B T936B G936B S936C M936C T936C G936C DFS GIF Maximum Growth S946A M946A T946A S946B M946B T946B S946C M946C T946C RESPONSIBLE INVESTMENT PORTFOLIOS DFS GIF Conservative Desjardins SocieTerra S986A M986A T986A G986A S986B M986B T986B G986B S986C M986C T986C G986C DFS GIF Balanced Desjardins SocieTerra S976A M976A T976A G976A S976B M976B T976B G976B S976C M976C T976C G976C DFS GIF Growth Desjardins SocieTerra S996A M996A T996A G996A S996B M996B T996B G996B S996C M996C T996C G996C DFS GIF Maximum Growth Desjardins SocieTerra S016A M016A T016A S016B M016B T016B S016C M016C T016C INDIVIDUAL FUNDS Income DFS GIF Money Market S556A M556A T556A G556A S556B M556B T556B G556B S556C M556C T556C G556C DFS GIF Income Fiera Capital S526A M526A T526A G526A S526B M526B T526B G526B S526C M526C T526C G526C DFS GIF Canadian Bond S956A M956A T956A G956A S956B M956B T956B G956B S956C M956C T956C G956C Balanced and Asset Allocation DFS GIF Diversified Income Franklin Quotential S356A M356A G356A S356B M356B G356B S356C M356C G356C DFS GIF Balanced Income Franklin Quotential S346A M346A G346A S346B M346B G346B S346C M346C G346C DFS GIF Canadian Balanced Fidelity S246A M246A S246B M246B S246C M246C DFS GIF U.S. Monthly Income Fidelity S966A M966A T966A S966B M966B T966B S966C M966C T966C DFS GIF Global Balanced Jarislowsky Fraser S206A M206A T206A G206A S206B M206B T206B G206B S206C M206C T206C G206C DFS GIF Canadian Balanced Fiera Capital S496A M496A T496A G496A S496B M496B T496B G496B S496C M496C T496C G496C DFS GIF Canadian Balanced Franklin Bissett S756A M756A T756A G756A S756B M756B T756B G756B S756C M756C T756C G756C DFS GIF Balanced Growth Franklin Quotential S366A M366A G366A S366B M366B G366B S366C M366C G366C DFS GIF Canadian Balanced CI Signature S266A M266A T266A G266A S266B M266B T266B G266B S266C M266C T266C G266C DFS GIF Income and Growth CI Signature S856A M856A T856A G856A S856B M856B T856B G856B S856C M856C T856C G856C DFS GIF Growth and Income NEI Northwest S586A M586A T586A G586A S586B M586B T586B G586B S586C M586C T586C G586C DFS GIF Global Growth NEI Select S536A M536A T536A G536A S536B M536B T536B G536B S536C M536C T536C G536C DFS GIF Canadian Asset Allocation CI Cambridge S866A M866A T866A S866B M866B T866B S866C M866C T866C DFS GIF Growth Franklin Quotential S336A M336A S336B M336B S336C M336C Canadian Equity DFS GIF Dividend Income Franklin Bissett S716A M716A T716A S716B M716B T716B S716C M716C T716C DFS GIF Canadian Dividend NEI Northwest S886A M886A T886A S886B M886B T886B S886C M886C T886C DFS GIF Canadian Equity Jarislowsky Fraser S236A M236A T236A S236B M236B T236B S236C M236C T236C DFS GIF Canadian Equity Fidelity True North S256A M256A T256A S256B M256B T256B S256C M256C T256C DFS GIF Canadian Equity Franklin Bissett S726A M726A T726A S726B M726B T726B S726C M726C T726C DFS GIF Specialty Equity NEI Northwest S596A M596A S596B M596B S596C M596C DFS GIF Small Cap Franklin Bissett S736A M736A S736B M736B S736C M736C Foreign Equity DFS GIF American Equity MFS S846A M846A T846A S846B M846B T846B S846C M846C T846C DFS GIF American Equity Value Desjardins S436A M436A T436A S436B M436B T436B S436C M436C T436C DFS GIF Global Dividend Desjardins S876A M876A T876A S876B M876B T876B S876C M876C T876C DFS GIF Global Equity MFS S776A M776A T776A S776B M776B T776B S776C M776C T776C DFS GIF International Equity MFS S406A M406A T406A S406B M406B T406B S406C M406C T406C DFS GIF International Equity Growth Desjardins S896A M896A T896A S896B M896B T896B S896C M896C T896C Fidelity True North is a registered trademark of FMR Corp.

9 Maximum Annuitant Age to make a Deposit (inclusively) Minimum Initial Deposit* or Minimum Pre-Authorized Debit (PAD) - per month** Additional Deposit Minimum Lump Sum or Minimum PAD - per month Minimum Total Market Value Market Value of the units attributed to all individual variable insurance contracts offered by the Company (Helios2 Contract and all the Contracts previously offered by the Company only)*** Fund Names Deposit requirements for Series 8 Helios2-75/75 Helios2-75/100 i Helios2-100/100 i Helios2-75/100 GLWB 90 (Series 8A) 80 (Series 8B and 8C) $1,000 $1,000 $1,000 $10, $250,000 $250,000 $250,000 $250,000 Series 8A No Load 0 Series 8B Low Load Sales Charge n.a. 0 * Minimum Deposit per Fund is 0. Minimum Deposit for contracts registered as RRIF or containing locked-in money is $10,000. ** Minimum PAD amount per Fund is $25. *** Valuation of the market value is performed periodically in accordance with our administrative rules. Series 8C Deferred Sales Charge Helios2-75/75 Helios2-75/100 i Helios2-100/100 i Helios2-75/100 GLWB Helios2-75/75 Helios2-75/100 i Helios2-100/100 i Helios2-75/100 GLWB Helios2-75/75 Helios2-75/100 i Helios2-100/100 i Helios2-75/100 GLWB INVESTMENT SOLUTIONS DFS GIF Conservative S908A M908A T908A G908A S908B M908B T908B G908B S908C M908C T908C G908C DFS GIF Moderate S918A M918A T918A G918A S918B M918B T918B G918B S918C M918C T918C G918C DFS GIF Balanced S928A M928A T928A G928A S928B M928B T928B G928B S928C M928C T928C G928C DFS GIF Growth S938A M938A T938A G938A S938B M938B T938B G938B S938C M938C T938C G938C DFS GIF Maximum Growth S948A M948A T948A S948B M948B T948B S948C M948C T948C RESPONSIBLE INVESTMENT PORTFOLIOS DFS GIF Conservative Desjardins SocieTerra S988A M988A T988A G988A S988B M988B T988B G988B S988C M988C T988C G988C DFS GIF Balanced Desjardins SocieTerra S978A M978A T978A G978A S978B M978B T978B G978B S978C M978C T978C G978C DFS GIF Growth Desjardins SocieTerra S998A M998A T998A G998A S998B M998B T998B G998B S998C M998C T998C G998C DFS GIF Maximum Growth Desjardins SocieTerra S018A M018A T018A S018B M018B T018B S018C M018C T018C INDIVIDUAL FUNDS Income DFS GIF Money Market S558A M558A T558A G558A S558B M558B T558B G558B S558C M558C T558C G558C DFS GIF Income Fiera Capital S528A M528A T528A G528A S528B M528B T528B G528B S528C M528C T528C G528C DFS GIF Canadian Bond S958A M958A T958A G958A S958B M958B T958B G958B S958C M958C T958C G958C Balanced and Asset Allocation DFS GIF Diversified Income Franklin Quotential S358A M358A G358A S358B M358B G358B S358C M358C G358C DFS GIF Balanced Income Franklin Quotential S348A M348A G348A S348B M348B G348B S348C M348C G348C DFS GIF Canadian Balanced Fidelity S248A M248A S248B M248B S248C M248C DFS GIF U.S. Monthly Income Fidelity S968A M968A T968A S968B M968B T968B S968C M968C T968C DFS GIF Global Balanced Jarislowsky Fraser S208A M208A T208A G208A S208B M208B T208B G208B S208C M208C T208C G208C DFS GIF Canadian Balanced Fiera Capital S498A M498A T498A G498A S498B M498B T498B G498B S498C M498C T498C G498C DFS GIF Canadian Balanced Franklin Bissett S758A M758A T758A G758A S758B M758B T758B G758B S758C M758C T758C G758C DFS GIF Balanced Growth Franklin Quotential S368A M368A G368A S368B M368B G368B S368C M368C G368C DFS GIF Canadian Balanced CI Signature S268A M268A T268A G268A S268B M268B T268B G268B S268C M268C T268C G268C DFS GIF Income and Growth CI Signature S858A M858A T858A G858A S858B M858B T858B G858B S858C M858C T858C G858C DFS GIF Growth and Income NEI Northwest S588A M588A T588A G588A S588B M588B T588B G588B S588C M588C T588C G588C DFS GIF Global Growth NEI Select S538A M538A T538A G538A S538B M538B T538B G538B S538C M538C T538C G538C DFS GIF Canadian Asset Allocation CI Cambridge S868A M868A T868A S868B M868B T868B S868C M868C T868C DFS GIF Growth Franklin Quotential S338A M338A S338B M338B S338C M338C Canadian Equity DFS GIF Dividend Income Franklin Bissett S718A M718A T718A S718B M718B T718B S718C M718C T718C DFS GIF Canadian Dividend NEI Northwest S888A M888A T888A S888B M888B T888B S888C M888C T888C DFS GIF Canadian Equity Jarislowsky Fraser S238A M238A T238A S238B M238B T238B S238C M238C T238C DFS GIF Canadian Equity Fidelity True North S258A M258A T258A S258B M258B T258B S258C M258C T258C DFS GIF Canadian Equity Franklin Bissett S728A M728A T728A S728B M728B T728B S728C M728C T728C DFS GIF Specialty Equity NEI Northwest S598A M598A S598B M598B S598C M598C DFS GIF Small Cap Franklin Bissett S738A M738A S738B M738B S738C M738C Foreign Equity DFS GIF American Equity MFS S848A M848A T848A S848B M848B T848B S848C M848C T848C DFS GIF American Equity Value Desjardins S438A M438A T438A S438B M438B T438B S438C M438C T438C DFS GIF Global Dividend Desjardins S878A M878A T878A S878B M878B T878B S878C M878C T878C DFS GIF Global Equity MFS S778A M778A T778A S778B M778B T778B S778C M778C T778C DFS GIF International Equity MFS S408A M408A T408A S408B M408B T408B S408C M408C T408C DFS GIF International Equity Growth Desjardins S898A M898A T898A S898B M898B T898B S898C M898C T898C Fidelity True North is a registered trademark of FMR Corp.

10 Deposit requirements for Series 7 Helios2 75/75 Helios2 75/100 i Helios2 75/100 GLWB Maximum Annuitant Age to make a Deposit Minimum Initial Deposit* or $250,000 $250,000 $250,000 Minimum Pre-Authorized Debit (PAD) per month** n/a n/a n/a Additional Deposit Minimum Lump Sum or Minimum PAD per month Fund Names Helios2 75/75 Helios2 75/100 i Series 7A No Load Helios2 100/100 i Helios2 75/100 GLWB INVESTMENT SOLUTIONS DFS GIF Conservative S907A M907A T907A G907A DFS GIF Moderate S917A M917A T917A G917A DFS GIF Balanced S927A M927A T927A G927A DFS GIF Growth S937A M937A T937A G937A DFS GIF Maximum Growth S947A M947A T947A RESPONSIBLE INVESTMENT PORTFOLIOS DFS GIF Conservative Desjardins SocieTerra S987A M987A T987A G987A DFS GIF Balanced Desjardins SocieTerra S977A M977A T977A G977A DFS GIF Growth Desjardins SocieTerra S997A M997A T997A G997A DFS GIF Maximum Growth Desjardins SocieTerra S017A M017A T017A INDIVIDUAL FUNDS Income DFS GIF Money Market S557A M557A T557A G557A DFS GIF Income Fiera Capital S527A M527A T527A G527A DFS GIF Canadian Bond S957A M957A T957A G957A Balanced and Asset Allocation DFS GIF Diversified Income Franklin Quotential S357A M357A G357A DFS GIF Balanced Income Franklin Quotential S347A M347A G347A DFS GIF Canadian Balanced Fidelity S247A M247A DFS GIF U.S. Monthly Income Fidelity S967A M967A T967A DFS GIF Global Balanced Jarislowsky Fraser S207A M207A T207A G207A DFS GIF Canadian Balanced Fiera Capital S497A M497A T497A G497A DFS GIF Canadian Balanced Franklin Bissett S757A M757A T757A G757A DFS GIF Balanced Growth Franklin Quotential S367A M367A G367A DFS GIF Canadian Balanced CI Signature S267A M267A T267A G267A DFS GIF Income and Growth CI Signature S857A M857A T857A G857A DFS GIF Growth and Income NEI Northwest S587A M587A T587A G587A DFS GIF Global Growth NEI Select S537A M537A T537A G537A DFS GIF Canadian Asset Allocation CI Cambridge S867A M867A T867A DFS GIF Growth Franklin Quotential S337A M337A Canadian Equity DFS GIF Dividend Income Franklin Bissett S717A M717A T717A DFS GIF Canadian Dividend NEI Northwest S887A M887A T887A DFS GIF Canadian Equity Jarislowsky Fraser S237A M237A T237A DFS GIF Canadian Equity Fidelity True North S257A M257A T257A DFS GIF Canadian Equity Franklin Bissett S727A M727A T727A DFS GIF Specialty Equity NEI Northwest S597A M597A DFS GIF Small Cap Franklin Bissett S737A M737A Foreign Equity DFS GIF American Equity MFS S847A M847A T847A DFS GIF American Equity Value Desjardins S437A M437A T437A DFS GIF Global Dividend Desjardins S877A M877A T877A DFS GIF Global Equity MFS S777A M777A T777A DFS GIF International Equity MFS S407A M407A T407A DFS GIF International Equity Growth Desjardins S897A M897A T897A Fidelity True North is a registered trademark of FMR Corp. * Minimum Deposit per Fund is 0. ** Minimum PAD amount per Fund is $25.

11 Fund Names Investment Solutions Helios Contract, GLWB Version 2; Helios Contract, GLWB and GMWB (available for 75/75 switches only) Fidelity True North is a registered trademark of FMR Corp. Series 5-C Back End Load 6 Year 75/100 i 100/100 r (available for switches only) 75/75 Helios Contract Series 5-B Low Load 3 Year 75/100 i 100/100 r (available for switches only) 75/75 Series 5-A Negotiable Fee Option 75/100 i 100/100 r (available for switches only) DFS GIF Conservative 4 S905 M905 L905 S900 M900 L900 S909 M909 L909 DFS GIF Moderate 4 S915 M915 L915 S910 M910 L910 S919 M919 L919 DFS GIF Balanced 4 S925 M925 L925 S920 M920 L920 S929 M929 L929 DFS GIF Growth 4 S935 M935 L935 S930 M930 L930 S939 M939 L939 DFS GIF Maximum Growth S945 M945 L945 S940 M940 L940 S949 M949 L949 Responsible Investment Portfolios DFS GIF Conservative Desjardins SocieTerra S985 M985 L985 S980 M980 L980 S989 M989 L989 DFS GIF Balanced Desjardins SocieTerra S975 M975 L975 S970 M970 L970 S979 M979 L979 DFS GIF Growth Desjardins SocieTerra S995 M995 L995 S990 M990 L990 S999 M999 L999 DFS GIF Maximum Growth Desjardins SocieTerra S015 M015 L015 S010 M010 L010 S019 M019 L019 Income DFS GIF Money Market 4 S555 M555 L555 S550 M550 L550 S559 M559 L559 DFS GIF Income Fiera Capital 4 S525 M525 L525 S520 M520 L520 S529 M529 L529 DFS GIF Canadian Bond 4 S955 M955 L955 S950 M950 L950 S959 M959 L959 Balanced and Asset Allocation DFS GIF Diversified Income Franklin Quotential 4 S355 M355 L355 S350 M350 L350 S359 M359 L359 DFS GIF Balanced Income Franklin Quotential 4 S345 M345 L345 S340 M340 L340 S349 M349 L349 DFS GIF Canadian Balanced Fidelity 4 S245 M245 L245 S240 M240 L240 S249 M249 L249 DFS GIF U.S. Monthly Income Fidelity S965 M965 L965 S960 M960 L960 S969 M969 L969 DFS GIF Canadian Balanced Fiera Capital 4 S495 M495 L495 S490 M490 L490 S499 M499 L499 DFS GIF Canadian Balanced Franklin Bissett 4 S755 M755 L755 S750 M750 L750 S759 M759 L759 DFS GIF Balanced Growth Franklin Quotential 4 S365 M365 L365 S360 M360 L360 S369 M369 L369 DFS GIF Canadian Balanced CI Signature 4 S265 M265 L265 S260 M260 L260 S269 M269 L269 DFS GIF Income and Growth CI Signature 4 S855 M855 L855 S850 M850 L850 S859 M859 L859 DFS GIF Growth and Income NEI Northwest 4 S585 M585 L585 S580 M580 L580 S589 M589 L589 DFS GIF Global Growth NEI Select 4 S535 M535 L535 S530 M530 L530 S539 M539 L539 DFS GIF Global Balanced Jarislowsky Fraser 4 S205 M205 L205 S200 M200 L200 S209 M209 L209 DFS GIF Canadian Asset Allocation CI Cambridge S865 M865 L865 S860 M860 L860 S869 M869 L869 DFS GIF Growth Franklin Quotential S335 M335 L335 S330 M330 L330 S339 M339 L339 Canadian Equity DFS GIF Dividend Income Franklin Bissett S715 M715 L715 S710 M710 L710 S719 M719 L719 DFS GIF Canadian Dividend NEI Northwest S885 M885 L885 S880 M880 L880 S889 M889 L889 DFS GIF Canadian Equity Fidelity True North S255 M255 L255 S250 M250 L250 S259 M259 L259 DFS GIF Canadian Equity Franklin Bissett S725 M725 L725 S720 M720 L720 S729 M729 L729 DFS GIF Canadian Equity Fiera Capital S465 M465 L465 S460 M460 L460 S469 M469 L469 DFS GIF Canadian Equity Jarislowsky Fraser S235 M235 L235 S230 M230 L230 S239 M239 L239 DFS GIF Specialty Equity NEI Northwest S595 M595 L595 S590 M590 L590 S599 M599 L599 DFS GIF Small Cap Franklin Bissett S735 M735 L735 S730 M730 L730 S739 M739 L739 Foreign Equity DFS GIF American Equity MFS S845 M845 L845 S840 M840 L840 S849 M849 L849 DFS GIF American Equity Value Desjardins S435 M435 L435 S430 M430 L430 S439 M439 L439 DFS GIF Global Dividend Desjardins S875 M875 L875 S870 M870 L870 S879 M879 L879 DFS GIF Global Equity MFS S775 M775 L775 S770 M770 L770 S779 M779 L779 DFS GIF International Equity MFS S405 M405 L405 S400 M400 L400 S409 M409 L409 DFS GIF International Equity Growth Desjardins S895 M895 L895 S890 M890 L890 S899 M899 L899

12 Fund Names 1 st Edition Classic New Era Series 3 Back End Load Deferred Sales Charge 7 Year Series 3-A Negotiable Fee Option Series 1 Back End Load Deferred Sales Charge 5 Year Series 1-A Negotiable Fee Option Series 3-C Back End Load 5 Year Series 1 Back End Load 5 Year Series 1-A Negotiable Fee Option Millennia III Contract Series 3-B Low Load 3 Year Series 3-A Negotiable Fee Option Income DFS GIF Money Market F C A N 559N DFS GIF Income Fiera Capital F C A N 529N Balanced and Asset Allocation DFS GIF Diversified Income Franklin Quotential N 359N DFS GIF Balanced Income Franklin Quotential N 349N DFS GIF Canadian Balanced Fidelity N 249N DFS GIF Canadian Balanced Fiera Capital F C A N 499N DFS GIF Canadian Balanced Franklin Bissett N 759N DFS GIF Balanced Growth Franklin Quotential N 369N DFS GIF Growth and Income NEI Northwest N 589N DFS GIF Global Growth NEI Select N 539N DFS GIF Global Balanced Jarislowsky Fraser C N 209N DFS GIF Growth Franklin Quotential N 339N Canadian Equity DFS GIF Dividend Income Franklin Bissett C N 719N DFS GIF Canadian Equity Fidelity True North N 259N DFS GIF Canadian Equity Franklin Bissett F C A N 729N DFS GIF Canadian Equity Jarislowsky Fraser N 239N DFS GIF Specialty Equity NEI Northwest N 599N DFS GIF Small Cap Franklin Bissett C N 739N Foreign Equity DFS GIF American Equity MFS C N 849N DFS GIF American Equity Value Desjardins F C A N 439N DFS GIF Global Equity MFS N 779N DFS GIF International Equity MFS F C A N 409N Fidelity True North is a registered trademark of FMR Corp. Fund Names DFS GIF Money Market DFS GIF Canadian Equity Franklin Bissett Imperial Growth Plan Series G (IGP) Front end Load IMP551GP IMP721GP

13 Choosing Desjardins... is choosing Desjardins Group, the largest cooperative financial group in Canada whose financial stability is recognized ed by the following credit ratings which are comparable, if not superior to those of the five largest Canadian banks and insurance companies: Standard and Poor s A+ Moody s Aa2 Dominion Bond Rating Service AA Fitch AA- desjardinslifeinsurance.com ance.com The Contract and Information Folder contains important information on the Desjardins Financial Security d Investment Funds Plan Helios2 and the DFS d Investment Funds. Please read it carefully before e investing. Helios2 is a trademark owned by Desjardins Financial Security Life Assurance Company. DFS d Investment Funds is a registered trademark owned by Desjardins Financial Security Life Assurance Company. DFS d Investment Funds are established by Desjardins Financial Security Life Assurance Company. DFS stands for Desjardins Financial Security. Desjardins Insurance refers to Desjardins Financial Security Life Assurance Company. This document is printed on Rolland Enviro paper. 100% 13140E ( )