Retirement income account

Transcription

1 APPLICATION FORM Retiremet icome accout Retiremet Icome Fud (RIF) Spousal Retiremet Icome Fud (SRIF) Life Icome Fud (LIF) Locked-I Retiremet Icome Fud (LRIF) Restricted Life Icome Fud (RLIF) Prescribed Retiremet Icome Fud (PRIF)

2 Applicatio for retiremet icome accout Your ivestmet professioal for all trasactios Dealer compay's ame Dealer code Rep. code Ivestmet professioal s ame Phoe ( ) Type of accout for all trasactios Note: All paymets out of the accout will be made to the registered ower(s) Trasfer iformatio attach all trasfer documetatio Persoal iformatio for all trasactios o New accout o Additioal ivestmet to existig accout Fidelity accout o. o Retiremet Icome Fud (RIF) o Spousal RIF o Life Icome Fud (LIF) o Locked-i Retiremet Icome Fud (LRIF) o Prescribed Retiremet Icome Fud (PRIF) o Restricted Life Icome Fud (RLIF) (attach locked-i agreemet ad idicate legislatio ) Fuds to be trasferred from FOR RIF OR SPOUSAL RIF FOR LIF FOR LRIF o a Registered Retiremet Savigs Pla (RRSP) o a Locked-i Retiremet Accout (LIRA) o a Locked-i Retiremet Accout (LIRA) o a Spousal RRSP o a Registered Pesio Pla (RPP) o a Registered Pesio Pla (RPP) o a Prescribed RIF o a LRIF o a LIF o aother RIF o a Restricted LIF o aother LRIF ofrom a existig Fidelity accout # o aother LIF o Mr. o Dr. Last ame First ame Iitial o Mrs. o Ms. o Miss Date of birth (dd/mm/yyyy) SIN (madatory) o Eglish Home phoe Work phoe o Frech ( ) ( ) address Street address Apt/Suite City Provice Postal code Spouse iformatio for Spousal RIF oly o Mr. o Dr. Last ame First ame Iitial o Mrs. o Ms. o Miss Date of birth (dd/mm/yyyy) SIN (madatory) Home phoe Work phoe ( ) ( ) address Ivestmet selectio for all trasactios ISC sales Allocatio Fud code Fud ame charge % o $ o % NOTE: U.S. currecy fuds are ot available for retiremet icome accouts. TOTAL INVESTMENT AMOUNT $ Paymet istructios for all trasactios Withdrawal amout (select oe) o I wat to withdraw the miimum amout. o I wat to withdraw the maximum amout (LIF, RLIF & LRIF oly). o I wat to withdraw the followig amouts: From fud code TOTAL WITHDRAWAL AMOUNT $ Amout RIF ONLY: Term of paymets based o o my age o my spouse s date of birth: (dd/mm/yyyy) Frequecy (select oe) o mothly o quarterly o semi-aually o aually Start date RIF ONLY: Paymets to be o gross o et o other Method of paymet o sed cheque to my address o deposit to o-registered Fidelity accout # o direct deposit (provide bakig details i ext sectio)

3 Applicatio for retiremet icome accout Bakig iformatio required if you chose direct deposit for method of paymet Attach persoalized void cheque here: attach persoalized void cheque here Systematic exchages optioal withi the same load optio o I authorize Fidelity to exchage fuds withi my Fidelity accout as follows: Amout From Fidelity fud o Fixed $ o # uits To Fidelity fud Start date (dd/mm/yyyy) Frequecy (select oe) o twice a moth which dates? o mothly o every 2 moths o quarterly o semi-aually o aually Your successor auitat ad beeficiary optioal NOTE: The beeficiary caot be the same as the successor auitat. You may wish to seek professioal advice regardig the effectiveess of this beeficiary desigatio uder the laws applicable i your provice. I certai provices, a beeficiary desigatio may be made oly by will, ad i some cases the rights of your spouse may override a beeficiary desigatio. Depedig o your situatio, you may also wish further iformatio o the impact of future marriages or divorces, the effect of a locked-i addedum attached to the Pla, or circum staces i which you may wish to chage your beeficiary. DESIGNATION OF SUCCESSOR ANNUITANT DESIGNATION OF BENEFICIARY I the evet of my death, I elect that paymets from my Pla will cotiue If I have desigated my spouse as successor auitat, the followig to my spouse amed below, if he/she survives me ad is my spouse o the beeficiary desigatio will be effective oly if my spouse predeceases me date of my death. or is ot my spouse o the date of my death. I desigate the perso amed below as the beeficiary uder the Pla, provided this perso is Name of spouse (First ad last ame, i full) livig at the date of my death; otherwise, paymet will be made to my estate. I reserve the right to revoke this desigatio. Date of birth (dd/mm/yyyy) SIN (madatory) Name of beeficiary (First ad last ame, i full) Relatioship Your sigature for all trasactios I ackowledge that I have received a copy of the curret Simplified Prospectus(es) ad curret fiacial statemets of the Fud(s) selected ad uderstad that these tras actios are made uder the terms ad coditios therei. I uderstad that mutual fuds are ot isured uder the Caada Deposit Isurace Corporatio Act or le Régie de l assurace-dépôts du Québec. I certify that the iformatio provided by me o this applicatio is complete ad true i all respects. I request that this applicatio ad all documetatio relatig to my accout or Pla, icludig ay LIRA Addedum, be provided to me i Eglish. Je vous prie de me faire parveir la présete demade aisi que toute la documetatio afférete à mo compte ou à mo Régime e aglais. TO: THE CANADA TRUST COMPANY (THE TRUSTEE ) I hereby request The Caada Trust Compay to act as Trustee of my retiremet icome pla (the Pla ) ad to apply for registratio of the Pla uder the Icome Tax Act (Caada) ad, if applicable, ay provicial icome tax legislatio. I ackowledge ad agree to be boud by the terms ad coditios set out i the Declaratio of Trust set forth o the reverse side hereof ad, if applicable, the LIF, RLIF, PRIF or LRIF Addedum which forms part of the Pla, as ameded from time to time. I uderstad that the paymets I receive from my Pla are taxable ad may be subject to withholdig tax. Date (dd/mm/yyyy) Your sigature/auitat s sigature (for registered accouts) X Accepted by Fidelity Ivestmets Caada ULC, as aget for The Caada Trust Compay, Trustee. Date (dd/mm/yyyy) Authorized sigature FIDELITY CONFIDENTIAL INFORMATION

4 Applicatio for retiremet icome accout Tips to help you complete this form Prit all iformatio clearly. Errors ca take up valuable time. Complete the Persoal iformatio sectio completely ad carefully. The applicatio caot be processed without it. Staple all required documets to Fidelity s copy, icludig cheques. Whe completig the Ivestmet selectio sectio, Copy the fud code carefully from the fud list we ve provided. Abbreviate the fud ame, elimiatig the words Fidelity ad Fud. For example, to choose the Fidelity Caadia Growth Compay Fud, simply prit Caadia Growth Compay or Cd Growth Co. We use this ame to verify the code you have writte. If there is a discrepacy betwee the fud code ad the fud ame idicated, we will assume the fud code is correct. Check oe box to show whether you are usig dollar amouts or percetages. Whe completig the Paymet istructios sectio, For all accouts Your first paymet must ot be later tha the ed of first complete caledar year after the date of this applicatio. If your first paymet is withi this caledar year, a withholdig tax will be applied. Your electio caot be chaged after the first paymet is made out of the Pla, eve if your spouse dies or you ad your spouse separate. For RIF ad Spousal RIF Each year, you must withdraw a miimum amout based o your age or your spouse s age. If you withdraw more tha the miimum, a withholdig tax will be applied. For LIF or RLIF You must withdraw a miimum amout each year. You ca withdraw more tha the miimum, but there is a limit to what you ca withdraw to be sure there is eough moey to provide a icome util you re 80. If your istructios exceed the maximum, you will receive oly the maximum. For LRIF You must withdraw a miimum amout each year. You ca withdraw more tha the miimum, but there is a limit to what you ca withdraw. If your istructios exceed the maximum, a withholdig tax will be applied. To have the paymets deposited directly ito your bak accout, complete the sectios called Paymet istructios ad Bakig iformatio. The applicat eeds to sig the form. The applicat s sigature i the sectio called Your sigature applies to all iformatio provided o the form. Sed the origial siged form with the iitial paymet to Fidelity at 483 Bay Street, Suite 300, Toroto ON M5G 2N7. or You may fax this form to Fidelity at Fidelity Ivestmets is a registered trademark of FMR LLC. Visit us olie at fidelity.ca or call Fidelity Cliet Services at or fax us at Fidelity Ivestmets Caada ULC 483 Bay Street, Suite 300 Toroto, Otario M5G 2N E OPR /11

5 FIDELITY INVESTMENTS RETIREMENT INCOME FUND DECLARATION OF TRUST The Caada Trust Compay (the Trustee ), a trust compay icorporated uder the laws of Caada, hereby declares that it agrees to act as trustee uder the Fidelity Ivestmets Retiremet Icome Fud ( your Pla ) for you, the applicat amed i the applicatio (the Applicatio ) o the reverse side of this declaratio o the followig terms ad coditios. 1. REGISTRATION The Trustee will apply for registratio of your Pla uder the provisios of the Icome Tax Act (Caada) (the Act ). If you reside i Quebec as idicated by your address i the Applicatio, the Trustee will also apply for registratio of your Pla uder the provisios of the Taxatio Act (Quebec). 2. COMPLIANCE At all times, your Pla will comply with all relevat provisios of the Act ad, if applicable, the Taxatio Act (Quebec) with respect to a registered retiremet icome fud ( RRIF ). You will be boud by the terms ad coditios imposed o your Pla by all applicable legislatio. 3. TRANSFERS TO YOUR PLAN You may from time to time trasfer cash or securities that are acceptable to the Trustee i its sole discretio from: (i) your registered retiremet savigs pla ( RRSP ) or RRIF; (ii) you to the extet that the trasfer is a amout described i paragraph 60(l)(v) of the Act; (iii) your spouse's or former spouse's RRSP or RRIF i circumstaces to which subparagraph 146.3(2)(f)(iv) of the Act applies; or (iv) ay other source permitted by the Act from time to time. The Trustee will hold assets trasferred to your Pla, ivestmets made with those assets ad ay icome or capital gais realized i respect of those ivestmets i trust for you i accordace with the terms ad coditios of this declaratio. 4. INVESTMENTS Property trasferred to your Pla will be ivested (ad reivested from time to time) i the ivestmets selected by you from time to time at the the curret offerig price ext determied followig the receipt of the trasferred property. I makig your ivestmet selectio, you may select securities of mutual fuds maaged by Fidelity Ivestmets Caada ULC or other ivestmets acceptable to the Trustee i its sole discretio. I makig ivestmets for your Pla, the Trustee will ot be limited to ivestmets authorized by legislatio goverig the ivestmet of property held i trust. Cash distributios received by the Trustee i respect of ivestmets held i your Pla will be ivested i additioal ivestmets of the same type. I the absece of satisfactory ivestmet istructios, the Trustee will ivest cash i uits of Fidelity Caadia Moey Market Fud. 5. PAYMENTS TO THE PLANHOLDER The assets of your Pla will be used to provide you with a icome that will begi o or before December 31 of the secod caledar year of your Pla. I each caledar year, the total paymets to you from your Pla will ot be less tha the miimum amout (the Miimum Amout ) required to be paid uder the Act. The amout of ay paymet from your Pla will ot exceed the value of the property of your Pla immediately before the time of the paymet. You may specify i writig i a form satisfactory to the Trustee, the amout ad frequecy of the paymets to be made durig ay year. You may chage the amout ad frequecy of the paymets or request additioal paymets by istructig the Trustee i writig i a form satisfactory to the Trustee. If you do ot specify the amout ad frequecy of paymets to be made i a year or if the amout that you specify is less tha the Miimum Amout for a year, the Trustee will make a paymet or paymets as it deems ecessary, i its sole discretio, to esure that the Miimum Amout for that year is paid to you. I the absece of satisfactory istructios, the Trustee may sell ivestmets of your Pla selected by it, i its sole discretio, for the purpose of makig paymets to you. Paymets from your Pla will be paid to you et of all proper charges icludig tax required to be withheld. The Trustee may impose ay other reasoable requiremets ad coditios i respect of the foregoig. A paymet to you will be deemed to have bee made whe: (i) a cheque payable to you is mailed i a postage pre-paid evelope addressed to you at the address idicated o the Applicatio or subsequetly provided by you to the Trustee i writig; or (ii) a amout is electroically trasferred to the credit of a bak accout desigated by you i writig. 6. CALCULATION OF THE MINIMUM AMOUNT The Miimum Amout will be zero i the first caledar year of your Pla ad for each subsequet year will be calculated i accordace with the provisios of the Act. You may elect to base the Miimum Amout o your age or your spouse's age. This electio is bidig ad caot be chaged, revoked or ameded uder ay circumstaces. 7. DATE OF BIRTH The statemet of your birth date i the Applicatio is deemed to be a certificatio of your age o which the Trustee may rely ad your udertakig to provide proof of your age if requested by the Trustee. 8. TRANSFERS Followig the receipt of your writte istructios i a form acceptable to the Trustee, the Trustee will trasfer all or part of the assets of your Pla (et of all proper charges ad ay amout that the Trustee is required by the Act to retai to esure the paymet of the Miimum Amout) to the issuer of a RRSP, a RRIF or a life auity that coforms with the Act, as istructed by you i the otice. The trasfer of assets will be made subject to ay restrictios uder the Act. 9. YOUR RESPONSIBILITY You aloe are resposible for esurig that: (i) the ivestmets held i your Pla are qualified ivestmets for your Pla uder Act; (ii) ivestmet i foreig property does ot exceed the permitted limits uder the Act; ad (iii) ay auity purchased with assets of your Pla complies with the Act. 10. FOREIGN PROPERTY AND NON-QUALIFIED INVESTMENTS If your Pla becomes liable for tax, iterest or pealties uder the Act or similar provicial legislatio, the Trustee will realize sufficiet ivestmets of your Pla to pay the liability ad the Trustee will ot be liable for ay resultig loss. 11. INCOME TAX RECEIPTS Before April of each year, the Trustee will provide you with ay applicable icome tax statemet pertaiig to your Pla ad required to be filed with your persoal icome tax retur for the previous year. 12. DESIGNATION OF BENEFICIARY If you are domiciled i a jurisdictio which by law permits you to validly desigate a beeficiary other tha by Will, you may desigate (i) your spouse as successor auitat of your Pla; or (ii) a beeficiary to receive the assets of your Pla i the evet of your death. You may make, chage or revoke your desigatio by writte otice siged by you i a form acceptable to ad received by the Trustee before your death. Ay desigatio, ameded desigatio or revoked desigatio will be valid o the day followig its receipt by the Trustee. 13. DEATH OF THE PLANHOLDER Upo receipt of satisfactory evidece of your death, the Trustee will cotiue paymets to your spouse provided he or she is the successor auitat of your Pla. If your spouse becomes the successor auitat of your Pla, he or she will be deemed to be the auitat of your Pla with the same rights as if he or she had bee the origial auitat. If your spouse is ot the successor auitat, the Trustee will hold the assets of your Pla for paymet i a lump sum to your desigated beeficiary. If you have ot desigated a beeficiary or if the desigated beeficiary predeceases you, the paymet will be made to your legal represetatives. The paymet will be made subject to the deductio of all proper charges, icludig icome tax required to be withheld, after the Trustee receives the releases ad other documets that it requires i its sole discretio. 14. YOUR ACCOUNT The Trustee will maitai a accout i your ame recordig all trasfers to your Pla, ivestmets held i your Pla, icome eared o ivestmets, paymets from your Pla, expeses icurred by your Pla ad the miimum ad maximum amout payable from your Pla. The Trustee will sed you a statemet of your accout at least oce a year. 15. PROHIBITION Except as geerally permitted uder the Act, o advatage that is coditioal i ay way o the existece of your Pla may be exteded to you or a perso with whom you do ot deal at arm s legth. Neither the assets of your Pla or paymets uder your Pla may be pledged, assiged to others, or otherwise ecumbered i whole or i part. The Trustee will ot make ay paymets from your Pla except those specifically permitted uder the terms ad coditios of this declaratio or the Act. 16. AMENDMENTS From time to time, the Trustee may amed this declaratio with the approval of Caada Customs ad Reveue Agecy provided that the amedmet does ot disqualify your Pla as a RRIF uder the Act. Ay amedmet to esure that your Pla cotiues to comply with the Act will be effective without otice provided that, i the Trustee s sole opiio, the amedmet does ot adversely affect your rights uder your Pla. Ay other amedmet will be effective ot less tha thirty (30) days after writte otice has bee provided to you.

6 17. NOTICE Ay otice give to you by or o behalf of the Trustee will be sufficietly give if mailed, postage prepaid, to you at your address as reflected i the Applicatio or ay subsequet address that you have provided to the Trustee i writig for that purpose. Notice will be deemed to have bee received by you o the day of mailig. 18. DELEGATION OF DUTIES Without detractig i ay way from the resposibility of the Trustee, the Trustee may appoit agets icludig, but ot limited to Fidelity Ivestmets Caada ULC, ad may delegate to its agets the performace of clerical, admiistrative ad other duties uder this declaratio. The Trustee may employ or egage accoutats, brokers, lawyers or others ad may rely o their advice ad services. The Trustee will ot be liable for the acts or omissios of ay of its advisors or agets. The Trustee may pay to ay advisor or aget all or part of the fees received by it uder the terms of this declaratio. Notwithstadig ay other provisio i this declaratio, the Trustee ackowledges that it is ultimately resposible for the admiistratio of your Pla. 19. FEES AND EXPENSES From time to time, the Trustee may charge you or your Pla fees for its services ad expeses. The Trustee is etitled to reimbursemet for all disbursemets ad expeses (icludig taxes, iterest ad pealties) reasoably icurred by the Trustee i coectio with your Pla. The Trustee will deduct its upaid fees ad expeses from the assets of your Pla ad for this purpose the Trustee will realize sufficiet assets of your Pla selected i its sole discretio for the paymet of the fees ad expeses ad the Trustee will ot be liable for ay resultig loss. 20. LIABILITY OF THE TRUSTEE Noe of the Trustee, its officers, employees or agets will be liable for ay loss suffered or for ay taxes, iterest or pealties imposed uder the Act as a result of holdig or dealig with the assets of your Pla i accordace with istructios which it believes i good faith to have bee give by you or dealig with the assets of your Pla i accordace with the provisios of this declaratio. You, your persoal represetatives ad each beeficiary uder your Pla will at all times idemify ad save harmless the Trustee ad its agets from all taxes, assessmets, expese, liability, claims ad demads arisig out of the purchase, sale or retetio of assets of your Pla or aythig doe i coectio with your Pla, other tha as the result of their gross egligece or willful miscoduct. 21. SUCCESSOR TRUSTEE The Trustee may resig ad be discharged from all duties ad liabilities uder this declaratio by givig you 30 days' writte otice. Fidelity Ivestmets Caada ULC is omiated to appoit a successor trustee. Upo acceptace of the office of trustee of your Pla, the successor trustee will be trustee of your Pla for all purposes as if it had bee the origial declarat of your Pla. 22. LOCKED-IN PLANS Where you have idicated i the Applicatio that assets trasferred to your Pla will be locked-i i accordace with applicable pesio beefits legislatio, a lockig-i addedum (the Addedum ) provided to you by the Trustee will form part of this declaratio. I the evet of ay icosistecy betwee the terms of the Addedum ad the terms of this declaratio, the terms of the Addedum will apply. 23. APPLICABLE LAWS This declaratio will be govered, costrued ad eforced i accordace with the laws of Otario ad Caada except that the word spouse as used i this declaratio meas a commo-law parter as defied i the Act or legally married persos. 24. DEFINITIONS I this cotract: (a) Act meas the Icome Tax Act (Caada); (b) RRIF meas a registered retiremet icome fud as defied i the Act ad, where applicable, the Taxatio Act (Quebec); (c) RRSP meas a registered retiremet savigs pla as defied i the Act ad, where applicable, the Taxatio Act (Quebec); ad (d) spouse meas a commo-law parter as defied i the Act or legally married persos. (e) Plaholder, Member ad Applicat meas Auitat as it applies to subsectio 146 (1) of the Icome Tax Act (Caada). 25. SPECIMEN PLAN This declaratio coforms with Specime Pla RIF 997. Revised March, 2001