26708 opr 23861 - general investment application form ... some cases the rights of your ... £ from...

APPLICATION FORM

Investment account

n Non-registered plansn Retirement Savings Plans (RSP)n Locked-In Retirement Account (LIRA)n Locked-In Retirement Savings Plan (LRSP)n Restricted Locked-In Savings Plan (RLSP)

YOUR INVESTMENT PROFESSIONALfor all transactions

TYPE OF ACCOUNTfor all transactions

Note: All payments out of the account will be made to the registered owner(s).

* Fidelity reserves the right to require all joint owners to sign.

Transfer-in informationfor registered plans only

PERSONAL INFORMATION/ ANNUITANT INFORMATIONfor all transactions

Personal Information for:■n Joint owner

■n Spousal

■n In Trust For

YOUR BENEFICIARY for registered accounts only

optional

for residents of Quebec beneficiary will be defaulted to Estate

INVESTMENT SELECTIONfor all transactions

■n minimum $500 total investment

■n Fund codes available at fidelity.ca/fundcodes

■n In the event of a discrepancy between the code and the name, we will treat the code as correct and process accordingly.

£ New account Fidelity account no.

Dealer Cross Reference no.

Initial investment Sales charge % Distributions*Fund code Fund name £ $ £ % (ISC only) Wire order number Reinvest Deposit Cheque £ £ £

£ £ £

£ £ £

£ £ £

£ £ £

TOTAL INVESTMENT AMOUNT $

* For RSP accounts, all distributions are reinvested. For non-registered accounts, you may choose to have distributions reinvested, directly deposited to your bank account or received by cheque. If you choose direct deposit, you will need to attach a personalized void

cheque to the application form. Please note that for T-SWP series and/or a series of a fund that pays monthly distributions at a fixed rate, the default distribution option will be cash/cheque unless otherwise indicated.

I revoke any previous designation of a beneficiary under my Plan, and designate the person named below as the beneficiary under the Plan, provided this person is living at the date of my death; otherwise, payment will be made to my estate. I reserve the right to revoke this designation. I understand that I must deliver any change to my beneficiary designation to Fidelity in writing, in a form acceptable to Fidelity. Note: You may wish

to seek professional advice regarding the effectiveness of this beneficiary designation in your province. In certain provinces, a beneficiary designation must be made by will. In some cases the rights of your spouse may override a beneficiary designation. You may also want information on the effects of future marriages or divorces, a locked-in addendum to the Plan, or changes to your beneficiary designation.

Name of beneficiary (Last and first name, in full) Relationship

£ Mr. £ Dr. Last name First name Initial£ Mrs. £ Ms. £ Miss

Date of birth (dd/mm/yyyy) SIN/BN/TIN (mandatory) £ English Home phone Work phone £ French

Email address Cell phone

Street address Apt/Suite City Province Postal code

£ Mr. £ Dr. Last name First name Initial£ Mrs. £ Ms. £ Miss

Date of birth (dd/mm/yyyy) SIN/TIN (mandatory) £ Use the ITF SIN Home phone Work phone for tax reporting

Address same as above £ Email address Cell phoneIf different, please complete:

Street address Apt/Suite City Province Postal code

Dealer company’s name Dealer code Rep. code

Investment professional’s name Phone

£ from another RSP (T2033 attached) £ from a RIF (T2030 attached) £ from a severance payment/retiring allowance (TD2 attached)

£ from an RPP or DPSP (T2151 attached) £ from an existing Fidelity account #

All non-registered accounts require the completion of the Declaration of Tax Residence for Part XVIII and Part XIX of the Income Tax Act. For individual, joint and in-trust for accounts, complete Form RC518 for each account holder. For corporate or formal trust accounts, complete Form RC519 for the entity and any controlling person(s), if applicable.

Application for investment account

NON-REGISTERED £ Single

£ Company (attach corporate resolution and provide business number BN)

£ Trust (attach trust agreement)

£ In Trust For (speak with your investment professional about this type of account)

JOINT£ Joint Owner with Rights of Survivorship

(Does not apply to Quebec residents)

£ Tenants in Common

To sign on account:£ AND (All joint owners must sign)

£ OR (One owner can sign) (Default is All must sign) (Affix signature guarantee stamp to all signatures in Your Signature section)

REGISTERED £ Retirement Savings Plan (RSP)

£ Spousal RSP

£ Locked-In Retirement Account (LIRA)/ Locked-in RSP (LRSP) (attach locked-in agreement and indicate legislation )

£ Restricted Locked-In Savings Plan (RLSP)

SYSTEMATIC EXCHANGESoptional

■n Fund code takes priority over fund name.

■n Only available between the same load option.

* The last run date is the actual last systematic exchange date.

SYSTEMATIC PURCHASES (PAC)optional

minimum $25, LIRA not eligible

NOTE:

■n 10 business days are required before the start date to set up or change a PAC plan.

■n If your PAC date does not fall on a business day, Fidelity will process the PAC on the next business day.


■n Attach personalized void cheque.

■n It may take up to 48 hours for funds to be withdrawn from your bank account from the date the PAC is scheduled to run.

* The last run date is the last date funds will be withdrawn from your bank account.

SYSTEMATIC WITHDRAWALS (SWP)Minimum $5,000 Account balance, Minimum $50, LIRA not eligible

NOTE:

■n 10 business days are required before the start date to set up or change a SWP plan.

■n If your SWP date does not fall on a business day, Fidelity will process the SWP on the preceding business day.


■n Attach personalized void cheque.

* The last run date is the last date funds will be deposited to your bank account.

BANKING INFORMATION

for PAC, SWP, TSWP distributions and redemptions (Attach personalized void cheque)

FIDELITY CONFIDENTIAL INFORMATION

£ I authorize Fidelity to exchange funds within my Fidelity account as follows:

FREQUENCY OPTIONS (choose one) Last run date*

£ Weekly £ Every 2 Weeks £ Monthly £ Twice a Month £ Every 2 Months £ Quarterly £ Semi-annually £ Annually


£ I authorize Fidelity to make regular withdrawals from my Fidelity account as shown below.


£ Weekly £ Every 2 Weeks £ Monthly £ Twice a Month £ Every 2 Months £ Quarterly £ Semi-annually £ Annually


£ Weekly £ Every 2 Weeks £ Monthly £ Twice a Month £ Every 2 Months £ Quarterly £ Semi-annually £ Annually £ One time

Start Date Second Run Date For twice a month (dd/mm/yyyy) only (dd/mm/yyyy) Fund Code Fund Name Amount ($) ISC Sales Charge %

TOTAL DOLLAR AMOUNT $

Start Date Second Run Date From Fidelity Fund Amount To Fidelity Fund For twice a month (dd/mm/yyyy) only (dd/mm/yyyy) Fund Code Fund Name $ Units Fund Code Fund Name

Start Date Second Run Date Amount ($) For twice a month (dd/mm/yyyy) only (dd/mm/yyyy) Fund Code Fund Name £ Gross £ Net Payment by

TOTAL DOLLAR AMOUNT $

£ Direct Deposit (attach void cheque)

£Cheque to You

■n For direct deposit it may take up to 48 hours to post on your bank account.

£ �I authorize Fidelity Investments to debit the bank account indicated on the attached void cheque for the amount(s) and in the frequencies indicated. If I transfer my account to a different branch of the same institution, this authorization will still be valid. Failure to make the payment will not give rise to any liability for Fidelity Investments. I may change these instructions or cancel this plan at any time, provided Fidelity Investments receives at least 10 business days notice by phone or by mail. I have certain recourse rights if a debit does not comply with this agreement. For example, I have the right to receive reimbursement for any debit that is not authorized or is not consistent with this preauthorized debit agreement (PAD).

(To obtain more information on recourse rights and/or a sample of a cancellation form, or more information on your right to cancel a PAD Agreement, contact your financial institution or visit www.cdnpay.ca.) By Canadian Payment Association definition, if this is for your own personal investment, your debit will be considered a Personal PAD. If this is for business purposes, it will be considered a Business PAD. By signing this form, I hereby waive any pre-notification requirements as specified by section 15(a) and (b) of the Canadian Payments Association Rule H1 with regards to pre-authorized debits. I confirm that all persons whose signatures are required to authorize transactions in the bank account, as per the attached void cheque, have signed this agreement below.

Bank Account Holder Signature Joint Bank Account Holder Signature Date

attach personalized void cheque here

eDELIVERYAn eDelivery notification will be sent to the email addresses provided in the “Personal information” section of the application form. You must provide Fidelity valid email addresses and notify Fidelity of any future changes to the email addresses.

YOUR SIGNATUREfor all transactions

Register my account(s) for eDeliveryConfirmation, Statements, Tax slips/receipts and Annual regulatory noticeIf you selected Online delivery of your account documents, please check the box below to accept the terms and conditions.Please read the eDelivery agreement below.


® Fidelity Investments is a registered trademark of Fidelity Investments Canada ULC.

63.101409E OPR-23861 01/18

Visit us online at fidelity.ca

or call Fidelity Client Services at 1 800 263-4077

or fax us at 1 800 387-8092

Fidelity Investments Canada ULC 483 Bay Street, Suite 300 Toronto, Ontario M5G 2N7

I acknowledge that I have received a copy of the current fund facts of the fund(s) selected and understand that these transactions are made under the terms and conditions therein. I understand that mutual funds are not insured under the Canada Deposit Insurance Corporation Act. I certify that the information provided by me on this application is complete and true in all respects. I request that this application and all documentation relating to my account or Plan be provided to me in English. Je vous prie de me faire parvenir la présente demande ainsi que toute la documentation afférente à mon compte ou à mon Régime en anglais.

FOR REGISTERED ACCOUNTSTO: Computershare Trust Company of Canada (The “Trustee”) – I request Computershare Trust Company of Canada to act as Trustee of my Fidelity Investments Retirement Savings Plan (the “Plan”) and to apply for registration of the Plan under the Income Tax Act (Canada) and, if applicable, any provincial income tax legislation. I acknowledge and agree to be bound by the terms and conditions set out in the Declaration of Trust set forth on the reverse side hereof and, if applicable, the LIRA Addendum which forms part of the Plan, as amended from time to time. I understand that I am solely responsible for determining the amount of contributions to the Plan that are deductible for income tax purposes.

Date (dd/mm/yyyy) Your signature/Annuitant’s signature (for registered accounts) Joint applicant’s signature (if applicable)

X X

Accepted by Fidelity Investments Canada ULC, as agent for Computershare Trust Company of Canada, Trustee.

Fidelity Investments Application form eDelivery Terms and ConditionsI/we acknowledge the following:■n By selecting “Online” delivery for my Confirmations,

Statements, Tax slips/receipts and Annual regulatory notice (“Account Documents”), I/we am/are consenting to receiving electronic notification when the Account Documents are available online through the Fidelity website (eDelivery). If enrolled in eDelivery, I/we understand it is my/our responsibility to access and view these documents when they become available at fidelity.ca/investorlogin;

■n I/we understand that once enrolled for eDelivery, I/we am/are consenting to have Account Documents for all accounts associated with my/our Fidelity user ID delivered according to the preferences I/we have selected;

■n I/we am/are responsible for providing Fidelity with a valid email address;

■n I/we understand that I/we will need to register for My Accounts at fidelity.ca/investorlogin in order to access and retrieve the Account Documents;

■n I/we am/are required to have internet access, an internet browser, and an appropriate version of Adobe Acrobat Reader in order to retrieve, view, save and monitor the availability of the Account Documents;

■n If the email address I/we provide is different from an existing email address on My Accounts, Fidelity will update My Accounts with the email address I/we have entered on this application form;

■n By consenting to this service I/we understand that I/we will not receive the Account Documents by mail;

■n “Statements” refers to any account statement, including but not limited to, enhanced account and performance reporting, where applicable;

■n I/we acknowledge that printed copies of the Account Documents will be sent to me/us by mail if delivery of the email notification fails; and

■n I/we can revoke my/our consent at any time by contacting Fidelity, and Fidelity will send the Account Documents by mail.

For more on how Fidelity uses your personal information, please read our privacy policy.

¨ I/we have read, understood and accept the eDelivery agreement

Authorized signature

PRIVACY PROTECTION NOTICE

I consent and agree to Fidelity collecting personal information, including my name, address, telephone number, social insurance number, date of birth and account holdings (the “Information”), from me or from other sources such as my Dealer or other financial institutions, and from third parties who represent that they have the right to disclose the Information, and using such Information to: administer my account; provide my Dealer and me with transaction confirmations, statements, tax receipts, or other information or services my Dealer or I request; process pre-authorized debit transactions; and as otherwise required or permitted by law.

Fidelity may disclose the Information to its employees, agents and third parties who are bound to maintain its confidentiality (including my Dealer, third party service providers, other financial institutions and any governmental authority) as necessary to administer my account or as required by law,

including to comply with requests for information from regulatory bodies and for income tax reporting purposes. If a service provider is located in a jurisdiction outside of Canada, it is bound by, and the Information may be disclosed in accordance with, the laws of that jurisdiction.

If I provide personal information about another individual (such as my spouse or beneficiary), I will have first obtained appropriate consent from that individual to the collection, use and disclosure of their personal information in the course of the administration of my account, including the purposes described above.

I may obtain access to the Information at any time from Fidelity and review its content and accuracy, and have it amended as appropriate; however, access may be restricted in accordance with applicable law.

For more information please see Fidelity’s Privacy Policy at fidelity.ca.

http://www.fidelity.ca/cs/Satellite/en/public/about_fidelity/legal/privacy_policy

Tips to help you complete this formPrint all information clearly. Errors can take up valuable time.

Complete the Personal information section completely and carefully. The application cannot be processed without it.

For Corporate accounts, a corporate resolution which specifies authorized signatories and a business number (BN) are required in order to properly set up an account.

For Formal Trust accounts, a trust agreement which indicates authorized trustees and a trust number (TN) are required in order to properly set up an account.

Attach all required documents to Fidelity’s copy, including cheques.

When completing the Investment selection section,■n Find the fund code at fidelity.ca

■n Abbreviate the fund name, eliminating the words “Fidelity” and “Fund.” For example, to choose the Fidelity Canadian Growth Company Fund, simply print “Canadian Growth Company” or “Cdn Growth Co.” We use this name to verify the code you have written. If there is a discrepancy between the Fund Code and the Fund Name indicated, we will assume the Fund Code is correct.

■n Check one box to show whether you are using dollar amounts or percentages.

■n Indicate how you would like your distributions. For RSP accounts, all distributions are reinvested. For non-registered accounts, you may choose to have distributions reinvested, directly deposited to your bank account or received by cheque. If you choose direct deposit, you will need to attach a personalized void cheque to the application form. Please note that for T-SWP series and/or a series of a fund that pays monthly distributions at a fixed rate, the default distribution option will be cash/cheque unless otherwise indicated.

■n To apply for a PAC plan, complete the sections called Systematic Purchases (PAC) and Banking information.

The investor needs to sign the form. The investor’s signature in the section called Your signature applies to all information provided on the form, including the PAC agreement in the section called Systematic Purchases (PAC).

Why is Fidelity asking you whether you are a U.S. citizen, U.S. tax resident, or tax resident of any other country outside of Canada?

The Income Tax Act (Canada) (the “ITA”), requires Canadian financial institutions like Fidelity to collect and report information

to the Canada Revenue Agency (CRA) about U.S. citizens (regardless of where they live) and tax residents of a country other than Canada who hold non-registered accounts. As a result, we must ask you these questions at the time of account opening, and ask you to inform your financial advisor and Fidelity if there is a change in your circumstances that causes you to become a U.S. citizen or a tax resident of a country other than Canada. We must also ask U.S. citizens and tax residents of a country other than Canada to provide their Taxpayer Identification Number (TIN) for all their tax residency jurisdictions.

If a reportable individual or entity fails to provide its TIN, the CRA could assess a penalty of up to $500 under the ITA. However, if the individual or entity makes an application for the assignment of a TIN within 90 days and provides the TIN to Fidelity within 15 days of receipt, or the foreign jurisdiction does not issue a TIN, the CRA will not assess penalties.

Individual Self-certification instructions

1. Only use Form RC518 for a non-registered account for one or more individuals.

2. Use Form RC519 for an account held by an entity such as a corporation, partnership, formal trust or any other organization.

3. For joint accounts, each owner must complete their own Form RC518.

4. For an informal trust account for a minor, Form RC518 may be completed for the minor by the parent or legal guardian, however, it is not mandatory for the minor’s tax status to be provided.

Entity Self-certification instructions

1. Only use Form RC519 for a non-registered account for an entity such as corporation, partnership, formal trust, or any other organization.

2. Please follow the questions to determine which sections are applicable to the entity and controlling person(s).

For additional information to assist you in completing this form, please visit the Canada Revenue Agency’s website at http://cra-arc.gc.ca/tx/nnrsdnts/nhncdrprtng/ntts-eng.html.

Send the original signed form with the initial payment to Fidelity at 483 Bay Street, Suite 300, Toronto ON M5G 2N7.

or

You may fax this form to Fidelity at 1 800 387-8092


® Fidelity Investments is a registered trademark of Fidelity Investments Canada ULC.

We, Computershare Trust Company of Canada, a trust company incorporated under the laws of Canada and having an office in the City of Toronto in the Province of Ontario, hereby declare that we accept the office of trustee for you, the planholder named on the application form accompanying this declaration (the “Application”) under the Fidelity Investments Retirement Savings Plan (the “Plan”) on the following terms and conditions. You acknowledge that we have retained Fidelity Investments Canada ULC (the “Agent”) as our agent to perform on our behalf certain of our duties and responsibilities under this declaration.

1. COMPLIANCE: The Plan will at all times comply with all relevant provisions of the Act and, if applicable, the Taxation Act (Quebec), with respect to RRSPs. You will be bound by the terms and conditions imposed on the Plan by all applicable legislation.

2. REGISTRATION: We will submit the Plan for registration in accordance with the Act.

3. DEALER: In this declaration, a “Dealer” means the person or entity acting (or representing that it acts) as or on behalf of your investment advisor, broker or dealer in connection with the Plan. You acknowledge that a Dealer is your agent and not our agent. We are entitled to accept and act on any notice, authorization or other communication that we believe in good faith to be given by you or Dealer on your behalf. Any reference in this declaration to your instructions or requests includes instructions or requests from your Dealer on your behalf. We are under no obligation to verify that a Dealer is properly authorized to act as your agent or is otherwise authorized to act on your behalf.

4. CONTRIBUTIONS: You or, where applicable, your spouse, and in limited circumstances your employer, may make contributions to your plan. At our sole discretion, we may accept or reject all or part of a contribution from any source permitted by the Act. You may not make contributions after December 31st of the year in which you reach the maximum age for maturity of the Plan set out in the Act.

5. INVESTMENTS: We will invest contributions to your Plan in the investments selected by you at the then current offering price next determined following the receipt of the contribution. In making your investment selection, you may select securities of mutual funds managed by the Agent or other investments acceptable to the Agent in its sole discretion. In making investments for your Plan, we will not be limited to investments authorized by legislation governing the investment of property held in trust. Cash distributions received by us in respect of investments held in your Plan will be re-invested in additional investments of the same type. In the absence of satisfactory investment instructions, we may invest cash in units of a money market fund managed by the Agent. We will hold the assets of the Plan in trust, and will custody such assets through the Agent or custodians appointed by the Agent.

6. PLANHOLDER’S RESPONSIBILITIES: You acknowledge and assume responsibility for the following:(a) assessing the appropriateness of any investment, selecting investments

for your Plan, obtaining appropriate advice, or authorizing a Dealer to do any of these things for you; and

(b) ensuring that your Plan’s contributions and investments comply with the rules under the Act or any other applicable legislation, including that any security held in your Plan is a qualified investment for the Plan under the Act and is not a “prohibited investment” under the Act.

We will not be responsible for any tax payable in respect of non-qualified investments, excess contributions or payments from your Plan, or for loss resulting from the sale or other disposition of assets of your Plan.

7. NON-QUALIFIED INVESTMENTS AND PROHIBITED INVESTMENTS: Subject to Section 24, if the Plan becomes liable for tax, interest, or penalties under the Act or similar provincial legislation, you authorize us to redeem sufficient assets of your Plan to pay the liability and we will not be liable for any resulting loss. We will exercise the care, diligence and skill of a reasonably prudent person to minimize the possibility that the Plan holds a non-qualified investment. Other than as set out in this declaration, we will not be liable for ascertaining whether any investment made on your direction is or remains a qualified investment for RRSPs under the Act.

We will not be liable for any tax payable in respect of any non-qualified investment or prohibited investment directed by you or made or held in the trust established hereunder. We will not otherwise be liable for the making, retention or sale of any investment or reinvestment as herein provided or for any loss or diminution of the assets comprising the Plan.

8. WITHDRAWALS: The assets of the Plan may not be withdrawn, transferred, assigned, or surrendered, in whole or in part, except where, after receiving satisfactory instructions from you or your Dealer on your behalf, assets of the Plan are paid or transferred:(a) to you pursuant to paragraph 9 of this declaration;(b) to a registered pension plan, RRSP, RRIF, or life annuity pursuant to

paragraph 10 or 11 of this declaration;(c) into court or to a third party pursuant to paragraph 13 of this

declaration;(d) upon your death pursuant to paragraph 15 of this declaration; or(e) as otherwise permitted by the Act.

Where required by the Act, we will withhold tax from payments made from the Plan. If the value of your Plan is less than $500, we may make a payment to you from your Plan equal to the value of your Plan. We may, in our sole discretion, sell any of the assetsin the Plan in order to make the foregoing payments and we will not be responsible for any resulting loss.

9. REFUND OF EXCESS CONTRIBUTIONS: Upon receipt of your satisfactory written request or, where applicable, your spouse’s satisfactory written request, we will make a payment from the Plan to you or your spouse, as applicable, to reduce the amount of tax otherwise payable under Part X.1 of the Act.

10. TRANSFERS: At any time and from time to time, you may direct us to transfer all or part of the assets of your Plan to the issuer of a registered pension plan, RRSP, RRIF, or a life annuity that provides for a retirement income in conformity with the Act. You must be the annuitant of the recipient plan. Upon receipt of your satisfactory written direction and subject to the conditions imposed by this declaration, the Act, and applicable provincial legislation, we will transfer the assets of the Plan requested to be transferred, together with all the necessary information for the continuance of the Plan, to the issuer of the recipient plan. You may instruct us to sell or transfer specific assets to effect the transfer. If you fail to provide us with satisfactory written instructions, we may sell or transfer the assets we deem appropriate, in our sole discretion, to effect the transfer. If we receive instructions from you to transfer some of the assets of your Plan, we may request instructions to transfer all of the assets of your Plan and we may delay the transfer until we have received the instructions.

11. MATURITY: On or before December 31 of the year in which you reach the maximum age for maturity of the Plan set out in the Act, the assets of the Plan must be transferred to a RRIF or used to purchase a life annuity that conforms with the Act. If you do not provide written instructions to us at least 90 days before that date, the assets of the Plan will be transferred on or before December 31 of that year to a RRIF selected by us in our sole discretion. You appoint us as your attorney to execute all documents and make elections necessary to establish the RRIF with the assets of the Plan. You will be deemed to have elected (i) to use your age to determine the minimum amount payable under the RRIF according to the Act; (ii) not to designate your spouse to become the successor annuitant of the RRIF on your death; and (iii) not to designate any beneficiary of the RRIF.

12. LIFE ANNUITY: A life annuity purchased with the assets of the Plan will be paid in equal annual or more frequent amounts to you until a full or partial commutation and, where the commutation is partial, equal annual or more frequent periodic amounts thereafter except for adjustments that are permitted by the Act. The aggregate of the periodic payments in a year after your death will not exceed the aggregate of the payments in a year before that death. If an amount becomes payable to a person other than your spouse, the life annuity will be commuted.

13. RELATIONSHIP BREAKDOWN AND PAYMENTS INTO COURT AND TO THIRD PARTIES: To the extent and in the manner permitted by applicable law, we will make a payment or payments out of your Plan to effect a division of property, provided such payment is made pursuant to

FIDELITY INVESTMENTS

RETIREMENT SAVINGS PLAN

DECLARATION OF TRUST

decree, order, or judgment of a competent tribunal or under a written separation agreement in the settlement of rights arising out of or on the breakdown of your marriage or other conjugal relationship.

If there is a dispute about:(a) the validity of enforceability of any legal demand or claim against the

assets of the Plan; or(b) the authority of a person or personal representative to apply for and

accept receipt of the proceeds payable under the Plan on your death,

we and the Agent are entitled to either apply to a court for directions or pay the disputed amounts into court and, in either case, fully recover any legal costs that either one incurs in this regard as expenses from the account. Where required by law, we and the Agent are entitled to make payments out of your Plan to third parties without your prior authorization.

14. BENEFICIARY DESIGNATION: You may designate one or more beneficiaries to receive the assets of the Plan on your death, provided that you are domiciled in a jurisdiction that by law permits you to validly designate a beneficiary other than by will. You must make, amend, or revoke the designation by way of written notice in a form acceptable to us and delivered to us. Any designation, amendment, or revocation will be valid only from the day following its receipt by us.

15. PAYMENTS UPON YOUR DEATH: Upon receipt of satisfactory evidence of your death, we will pay the assets of the Plan to your designated beneficiary(ies). If you have not designated a beneficiary or if the designated beneficiary predeceases you, the payment will be made to your legal representatives or as required by law. The payment will be made subject to the deduction of all proper charges, including tax required to be withheld, after we receive the releases and other documents that we require in our sole discretion.

16. PROHIBITION: No advantage that is conditional on the existence of the Plan may be extended to you or to a person not dealing at arm’s length with you, other than those advantages permitted under the Act and under any applicable provincial legislation. Retirement income under the Plan may not be assigned in whole or in part. We reserve the right to prohibit any transaction, investment, payment or transfer that is or may be prohibited or penalized under the Act.

17. PROOF OF AGE AND SOCIAL INSURANCE NUMBER: The statement of your age and social insurance number on the Application is deemed to be your certification thereof and an undertaking by you to provide evidence or proof thereof if requested by us.

18. YOUR ACCOUNT: We will maintain an account in your name which records, where applicable, with appropriate dates, contributions to the Plan, the number and cost of the assets in the Plan, earnings and expenses of the Plan for the preceding year, withdrawals and transfers from the Plan, and the balance of the Plan. We will send you a statement of your account at least once a year.

19. INCOME TAX RECEIPTS: If applicable, we will provide to you, or to your spouse where applicable, before March 31 of each year, any income tax statements pertaining to the Plan and required to be filed with your, or your spouse’s where applicable, personal income tax return for the previous taxation year.

20. AMENDMENTS: From time to time, we may in our sole discretion amend this declaration with the concurrence of the Canada Revenue Agency and, as required, provincial tax authorities, provided that an amendment to this declaration does not disqualify the Plan as an RRSP. Any amendment to this declaration that is necessary to ensure compliance with any legislation will be effective without further action or notice to you. In any other case, we will provide you with at least 30 days’ written notice of every amendment to this declaration.

21. NOTICE: We will provide notice by pre-paid regular mail, electronic mail or other form of electronic transmission addressed to you at the address indicated on the Application or such other address as you or your Dealer may provide to us from time to time. Notice we give you will be deemed to have been made on the day the notice is sent or transmitted. Any notice you give to us or the Agent must be in writing in a form satisfactory to us or the Agent, as applicable. We or the Agent may, in our sole discretion,

accept notice by means of electronic transmission. We may for any reason refuse to act on any notice, request or other communication from you or your Dealer and will not be liable for any resulting loss. Notice you or your Dealer gives to us will be deemed to have been made on the day of actual receipt of the notice.

22. OUR RESPONSIBILITY AND DELEGATION OF DUTIES: We are ultimately responsible for administering the Plan in accordance with the terms of this declaration and the provisions of the Act. We are entitled to exercise, in our sole discretion, the rights, powers, and privileges that otherwise could be exercised by a beneficial owner of the assets of the Plan. We may employ or engage accountants, brokers, lawyers, and others and may rely on their advice and services. Without detracting in any way from our responsibility, we may appoint one or more agents, including but not limited to the Agent, to perform any of our obligations under this declaration. We will not be liable for the acts or omissions of any of its advisors or agents. We will not be liable for the acts or omissions of a Dealer or any of your agents, advisors or service providers. Upon transferring assets from the Plan or making a payment from the Plan, we will be discharged from all further duties and liabilities under this declaration with respect to the assets transferred or paid out of the Plan.

23. FEES AND EXPENSES: Unless otherwise prohibited by the Act, we are entitled to charge your Plan fees for out-of-the-ordinary services requested by you or a Dealer in connection with your Plan and to reimbursement for all taxes, penalties and interest imposed on us and for all other costs and expenses incurred by us in connection with your Plan, or as described in the prospectus for the mutual fund(s) managed by the Agent held in your Plan. All amounts so payable will be charged against and deducted from the assets in your Plan, unless otherwise prohibited by the Act or you make other arrangements with us. We may, in our sole discretion, sell any of the assets in the Plan in order to pay same and we will not be responsible for any resulting loss.

24. TAXES IMPOSED ON YOU OR YOUR PLAN: We are not responsible for taxes, interest and penalties imposed on you or the Plan, except for taxes, interest and penalties, if any, imposed on us by the Act that are not reimbursable by the Plan under the Act. If your Plan becomes liable for tax, interest or penalties under the Act or provincial legislation, we may, in our sole discretion, sell any investment of your Plan to pay the liability. We will not be liable for any resulting loss.

25. INDEMNITY: None of the us, our officers, employees or agents will be liable for any loss suffered or for any taxes, interest or penalties imposed under the Act as a result of holding or dealing with the assets of your Plan in accordance with instructions that we believe in good faith to have been given by you or your Dealer or dealing with the assets of your Plan in accordance with the provisions of this declaration. You, your personal representatives and each beneficiary under your Plan will at all times indemnify and save harmless us and our agents from all taxes, assessments, expense, liability, claims and demands arising out of the purchase, sale or retention of assets of your Plan, payments on your death to any designated beneficiary, or anything done in connection with your Plan, other than as the result of our fraud, dishonesty, bad faith, willful misconduct, or gross negligence.

26. SUCCESSOR TRUSTEE: We may resign and be discharged from all duties and liabilities under this declaration by giving written notice to the Agent. The Agent is initially nominated to appoint a company as successor trustee (the “Successor Trustee”). If a Successor Trustee cannot be found within a reasonable period, the Trustee and/or the Agent may apply to a court of competent jurisdiction for the appointment of a Successor Trustee, acceptable to the Agent. Upon acceptance of the office of trustee of your Plan, the Successor Trustee will be trustee of your Plan as if it had been the original declarant of your Plan and your Plan continues in full force and effect with the Successor Trustee. Any trust company resulting from a merger, amalgamation or continuation to which we are party, or succeeding to substantially all of our RRSP and RRIF trusteeship business (whether by sale of such business or otherwise), will, if authorized, become the Successor Trustee of the Plan without further act or formality. At the time of the appointment or succession of a Successor Trustee, we will be relieved of all duties and liabilities under this declaration.




27. LIRA ADDENDUM: Where “locked-in” assets will be transferred, directly or indirectly, to the Plan in accordance with applicable pension benefits legislation, a locking-in addendum (the “LIRA Addendum”) that forms part of this declaration will be provided to you. In the event of any inconsistency between the LIRA Addendum and this declaration, the LIRA Addendum will apply.

28. DEFINITIONS: In this declaration:(a) Act means the Income Tax Act (Canada);(b) RRIF means a registered retirement income fund as defined in the Act

and, where applicable, the Taxation Act (Quebec);(c) RRSP means a registered retirement savings plan as defined in the Act

and, where applicable, the Taxation Act (Quebec); and(d) Spouse means a spouse or common-law partner as defined in the Act

or legally married persons.(e) You means “Annuitant” as defined in subsection 146(1) of the Act.

29. APPLICABLE LAWS: This declaration will be governed, construed and enforced in accordance with the laws of Ontario and Canada.

30. ELECTRONIC SIGNATURES: You hereby authorize and direct the Agent and us to rely on your electronic signature on the Application, this declaration and all ancillary documents and all such electronic signatures, however provided to the Agent and us, will be deemed to be reliable for the purpose of identifying you and will be deemed to be reliable for the purpose of the document signed.

31. HEIRS, EXECUTORS AND ASSIGNS: The terms of this declaration will be binding on your heirs, executors, administrators and assigns and on the Agent’s and our respective successors and assigns.

32. SPECIMEN PLAN: This declaration conforms with Specimen Plan RSP 574-678.

Effective April 1, 2018




Protected B when completed

Declaration of Tax Residence for Individuals – Part XVIII and Part XIX of the Income Tax Act

• If you are an individual and you are planning to open a financial account or if you already have a financial account with a Canadian financial institution, it may ask you to fill out this or a similar form. For more information, see How to fill out the form on page 2.

• Canadian financial institutions are required under Part XVIII and Part XIX of the Income Tax Act to collect the information you provide on this form to determine if they have to report your financial account to the Canada Revenue Agency (CRA). The CRA may share this information with the government of a foreign jurisdiction that you are resident of for tax purposes. In the case of the United States, the CRA may also share the information with that country’s government if you are a U.S. citizen. You can ask your financial institution if it reported your financial account to the CRA and what information it gave.

• Each account holder of a joint account has to fill out a declaration of tax residence form.

• Fill in all sections of this form that apply to you. If you do not have all the necessary information when you fill out the form, you may be given up to 90 days to give the missing information to your Canadian financial institution. If you do not give the missing information to your financial institution within the specified time frame, it may have to report your financial account to the CRA.

• If you need help with your tax residency information for this form, see Income Tax Folio, S5-F1-C1, Determining an Individual’s Residence Status, which you can find on the CRA website.

Section 1 – Identification of account holderLast name First name and initial(s)

Date of birth Year Month Day

Policy/account number assigned by the financial institution

Permanent residence address

Apartment number – street number and name City

Province, territory, state, or sub-entity Country or jurisdiction Postal or ZIP code

Mailing address (only if different from the permanent residence address)

Apartment number – street number and name City


Section 2 – Declaration of tax residence

Tick (✓ ) all of the options that apply to you.

I am a tax resident of Canada. If you ticked this box, give your social insurance number.

Social insurance number

I am a tax resident or a citizen of the United States. If you ticked this box, give your taxpayer identification number (TIN) from the United States.

TIN from the United States

If you do not have a TIN from the United States, have you applied for one? Yes No

I am a tax resident of a jurisdiction other than Canada or the United States. If you ticked this box, give your jurisdictions of tax residence and taxpayer identification numbers.

If you do not have a TIN for a specific jurisdiction, give the reason using one of these choices:

Reason 1: I will apply or have applied for a TIN but have not yet received it.

Reason 2: My jurisdiction of tax residence does not issue TINs to its residents.

Reason 3: Other reason.

For this form, "other reason" is enough. However, you still have to tell your financial institution the specific reason.

Jurisdiction of tax residence Taxpayer identification number If you do not have a TIN, choose reason 1, 2, or 3.

Section 3 – Certification

I certify that the information given on this form is correct and complete. I will give my financial institution a new form within 30 days of any change in circumstances that causes the information on this form to become incomplete or inaccurate.

Name (print) SignatureDate

Year Month Day

Personal information is collected under the Income Tax Act to administer tax, benefits, and related programs. It may also be used for any purpose related to the administration or enforcement of the Act such as audit, compliance and the payment of debts owed to the Crown. It may be shared or verified with other federal, provincial/territorial government institutions, and foreign governments to the extent authorized by law. Failure to provide this information may result in interest payable, penalties or other actions. Under the Privacy Act, individuals have the right to access their personal information and request correction if there are errors or omissions. Refer to Info Source at cra.gc.ca/gncy/tp/nfsrc/nfsrc-eng.html, Personal Information Bank CRA PPU 005.

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How to fill out the form

Section 1 – Identification of account holder

Use Section 1 to identify the account holder. Sometimes the account holder’s address may be different from the mailing address. If this is the case, give both addresses.

The account holder is the person listed or identified as the holder of the financial account by the financial institution that maintains the account. But, when a person other than a financial institution holds a financial account for the benefit of or for another person as an agent, custodian, nominee, signatory, investment advisor, or intermediary, they are not considered the account holder. In such cases, the account holder is the person for whom the account is held.

If a trust or an estate is listed as the holder of a financial account, the trust or the estate is the account holder, not the trustee or the liquidator. Similarly, if a partnership is listed as the holder of a financial account, the partnership is the account holder, not the partners in the partnership. In such cases, fill out Form RC519, Declaration of Tax Residence for Entities – Part XVIII and Part XIX of the Income Tax Act.

An account holder also includes any person who can access the cash value or designate a beneficiary under a cash value insurance contract or an annuity contract.

The policy/account number is the number your financial institution assigned to you. For example, enter the number assigned to you (such as a bank account number or insurance policy number) in this box. When you fill out this form as a controlling person of an entity, enter the policy or account number assigned to the entity, not your personal number. If you do not have such a number, leave this box blank.


Use Section 2 to identify the account holder’s tax residence and taxpayer identification number. If the account holder does not have such a number, give the reason.

Generally, an individual will be a tax resident of a jurisdiction if, under the laws of that jurisdiction, they pay or should be paying tax there because of their domicile, residence, or a similar criterion.

Individuals who are tax residents in more than one jurisdiction can rely on the tie–breaker rules in tax conventions (when they apply) to resolve cases of dual tax residence.

For more information on tax residency, talk to your tax adviser or go to oecd.org/tax/automatic-exchange/crs-implementation-and-assistance/tax-residency/#d.en.347760.

A taxpayer identification number, often referred to by its abbreviation TIN, is a unique identifier made of letters or numbers that the jurisdiction assigns to an individual. The jurisdiction uses the TIN in administering its tax laws to identify the individual. Enter the TIN in its official format. For more details about acceptable TINs, go to oecd.org/tax/automatic-exchange/crs-implementation-and-assistance/tax-identification-numbers/#d.en.347759.

If you do not have a TIN from the United States, you have 90 days to apply for one and 15 days after you receive it to give it to your financial institution.

Reasons that fall under “Reason 3: Other reason” for not having a TIN include not being eligible to receive one. However, if you are eligible to receive a TIN but you do not have one, you have 90 days to apply for one through your jurisdiction of residence. You have 15 days after you receive it to give it to your financial institution.


Make sure you fill in and sign Section 3 before you give this form to your Canadian financial institution.

Type of controlling person

Fill in this section only if you are filling out this form as a controlling person of an entity.

Controlling persons of an entity are the natural persons who exercise direct or indirect control over the entity. Generally, whether any person exercises control over an entity is determined in a way similar to how beneficial owners are identified for Canada’s Proceeds of Crime (Money Laundering) and Terrorist Financing Act.

For example, a person is generally considered a controlling person of a corporation if they directly or indirectly own or control 25% or more of the corporation. When no natural person is identified as exercising control of the corporation, a director or senior official of the corporation is considered the controlling person.

In the case of a trust, controlling persons include its settlors, trustees, protectors (if any), beneficiaries (or class of beneficiaries), and any other natural persons exercising ultimate effective control over the trust.

A settlor, trustee, protector, or beneficiary of a trust may be an entity. If so, to determine the trust’s controlling persons you have to look through the entity’s chain of control or ownership to identify the natural persons exercising ultimate effective control over the entity. You then have to report those you find as controlling persons of the trust. Financial institutions may apply this requirement in a way similar to how beneficial owners are identified for Canada’s Proceeds of Crime (Money Laundering) and Terrorist Financing Act.

In the case of a legal arrangement other than a trust, controlling persons are persons in equivalent or similar positions.

Type of controlling person*

* Enter the description that best describes the type of controlling person:1) Direct owner of a corporation or other legal person 2) Indirect owner of a corporation or other legal person (through an intermediary)3) Director or senior official of a corporation or other legal person4) Settlor of a trust5) Trustee of a trust6) Protector of a trust7) Beneficiary of a trust8) Other controlling person of a trust 9) Equivalent to a settlor of a legal arrangement other than a trust (e.g. partnership)

10) Equivalent to a trustee of a legal arrangement other than a trust (e.g. partnership) 11) Equivalent to a protector of a legal arrangement other than a trust (e.g. partnership) 12) Equivalent to a beneficiary of a legal arrangement other than a trust (e.g. partnership) 13) Other controlling person of a legal arrangement other than a trust (e.g. partnership)

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Declaration of Tax Residence for Entities – Part XVIII and Part XIX of the Income Tax Act

• If you are an entity and you are planning to open a financial account or if you already have a financial account with a Canadian financial institution, it may ask you to fill out this or a similar form. For more information on how to fill out this form, see the General information section at the end of the form. You will also find in that section the definitions of terms we use on the form.

• Canadian financial institutions are required under Part XVIII and Part XIX of the Income Tax Act to collect the information you provide on this form to determine if they have to report your financial account to the Canada Revenue Agency (CRA). The CRA may share that information with the government of a foreign jurisdiction that a person identified on this form is a resident of for tax purposes. In the case of the United States, the CRA may also share the information with that country’s government if the person is a U.S. citizen. You can ask your financial institution if it reported your financial account to the CRA and what information it gave.

• For this form, an entity includes a corporation, a partnership, a trust, an association, a fund, a joint venture, an organization, a syndicate, or a foundation. If you are a sole proprietorship, fill out Form RC518, Declaration of Tax Residence for Individuals – Part XVIII and Part XIX of the Income Tax Act.

• Each account holder of a joint account has to fill out a declaration of tax residence form.

• Fill in all sections of this form that apply to you and the Annex if required. If you do not have all the necessary information when you fill out the form, you may be given up to 90 days to give the missing information to your Canadian financial institution. If you do not give the missing information to your financial institution within the specified time frame, it may have to report your financial account to the CRA.

• If you need help with your tax residency information for this form, see Residency of a corporation at cra.gc.ca/tx/nnrsdnts/bsnss/bs-rs-eng.html or Income Tax Folio, S6-F1-C1, Residence of a Trust or Estate, which you can find on the CRA website.

Section 1 – Identification of account holderLegal name of the entity Jurisdiction of incorporation or organization

Policy/account number assigned by the financial institution

Permanent residence address

Suite number – street number and name City


Mailing address (only if different from permanent residence address)

Suite number – street number and name City



Tick (✓ ) all of the options that apply to the entity.

The entity is a tax resident of Canada. If the entity is a trust, give its trust account number. Otherwise, give its business number.

Business number Trust account number

T-

The entity is a tax resident of the United States.

The entity is a tax resident of a jurisdiction other than Canada or the United States. If you ticked this box, give the entity’s jurisdictions of tax residence and taxpayer identification numbers (TIN).

If the entity does not have a TIN for a specific jurisdiction, give the reason using one of these choices:

Reason 1: The entity will apply or has applied for a TIN but has not yet received it.

Reason 2: The entity’s jurisdiction of tax residence does not issue TINs to its residents.

Reason 3: Other reason.

For this form, "other reason" is enough. However, you still have to tell your financial institution the specific reason.

Jurisdiction of tax residence Taxpayer identification number If the entity does not have a TIN, choose reason 1, 2, or 3.

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Section 3 – Entity classification

Tick (✓ ) all of the appropriate boxes.

Section 3.1 – Is the entity a financial institution?

No. Go to Section 3.3.

Yes. Give the entity’s global intermediary identification number (GIIN) and go to Section 3.2.

. . .

If the entity does not have a GIIN, give the reason why.

Section 3.2 – Does the financial institution meet all of these criteria?

• It is a resident of a non-participating jurisdiction (see cra.gc.ca/tx/bsnss/tpcs/slps/fnncl/crs/jrsdctns-eng.html for the List of participating jurisdictions).

• At least 50% of its gross income is from investing or trading in financial assets.

• It is managed by another financial institution.

No. Go to Section 4.

Yes. List the controlling persons of the entity in the Annex and then go to Section 4.

Section 3.3 – Is the entity a specified United States person?

No. Go to Section 3.4.

Yes. Give the TIN from the United States and go to Section 3.4.TIN from the United States

If you do not have a TIN from the United States, have you applied for one? Yes No

Section 3.4 – Tick ( ✓ ) the option that best describes the entity:

The entity is a corporation with shares that regularly trade on an established securities market. It can also be a corporation related to that corporation. If this is the case, go to Section 4.

The entity is engaged in an active trade or business—less than 50% of its gross income is passive income and less than 50% of its assets produce passive income. If this is the case, go to Section 4.

The entity is a government, a central bank or an international organization (or an agency of one). If this is the case, go to Section 4.

The entity is an active non-financial entity other than one described in the three previous options (see paragraphs d) to i) of the definition of active non-financial entity). If this is the case, go to Section 4.

The entity is a passive non-financial entity. If this is the case, list the controlling persons of the entity in the Annex and then go to Section 4.


I am an authorized signing officer of this entity and I certify that the information given on this form and Annex is correct and complete. I will give the entity’s financial institution a new form within 30 days of any change in circumstances that causes the information on this form to become inaccurate or incomplete.

Authorized person’s name (print) Authorized person’s signature Office or positionDate

Year Month Day

Personal information is collected under the Income Tax Act to administer tax and related programs. It may also be used for any purpose related to the administration or enforcement of the Act such as audit, compliance and the payment of debts owed to the Crown. It may be shared or verified with other federal, provincial/territorial government institutions, and foreign governments to the extent authorized by law. Failure to provide this information may result in interest payable, penalties or other actions. Under the Privacy Act, individuals have the right to access their personal information and request correction if there are errors or omissions. Refer to Info Source at cra.gc.ca/gncy/tp/nfsrc/nfsrc-eng.html, Personal Information Bank CRA PPU 047.

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Annex – Controlling persons Identify the entity’s controlling persons. Attach a separate list if you need to enter the information of more than two controlling persons. Or you can include a separate Form RC518, Declaration of Tax Residence for Individuals – Part XVIII and Part XIX of the Income Tax Act, for each controlling person. Make sure to give the type of controlling person for each controlling person on your list or forms.

Controlling person 1

Last name First name and initial(s)Date of birth

Year Month Day


Permanent residence addressApartment number – street number and name City


Mailing address (only if different from the permanent residence address)Apartment number – street number and name City


Declaration of tax residence


The controlling person is a tax resident of Canada. If you ticked this box, give the controlling person’s social insurance number.

Social insurance number (SIN)

The controlling person is a tax resident or a citizen of the United States. If you ticked this box, give the controlling person’s taxpayer identification number (TIN) from the United States.


If the controlling person does not have a TIN from the United States, has that person applied for one? Yes No

The controlling person is a tax resident of a jurisdiction other than Canada or the United States. If you ticked this box, give the controlling person’s jurisdictions of tax residence and TINs. If the controlling person does not have a TIN, choose reason 1, 2, or 3, as described in Section 2.

Jurisdiction of tax residence Taxpayer identification number If the person does not have a TIN, choose reason 1, 2, or 3.

Controlling person 2

Last name First name and initial(s)Date of birth

Year Month Day


Permanent residence addressApartment number – street number and name City


Mailing address (only if different from the permanent residence address)Apartment number – street number and name City


Declaration of tax residence


The controlling person is a tax resident of Canada. If you ticked this box, give the controlling person’s social insurance number.

Social insurance number (SIN)

The controlling person is a tax resident or a citizen of the United States. If you ticked this box, give the controlling person’s taxpayer identification number (TIN) from the United States.


If the controlling person does not have a TIN from the United States, has that person applied for one? Yes No

The controlling person is a tax resident of a jurisdiction other than Canada or the United States. If you ticked this box, give the controlling person’s jurisdictions of tax residence and TINs. If the controlling person does not have a TIN, choose reason 1, 2, or 3, as described in Section 2.

Jurisdiction of tax residence Taxpayer identification number If the person does not have a TIN, choose reason 1, 2, or 3.

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General information

How to fill out the form

Section 1 – Identification of account holderUse Section 1 to identify the account holder. Sometimes the address of an account holder may be different from its mailing address. If this is the case, give both addresses.

The account holder is the person listed or identified as the holder of the financial account by the financial institution that maintains the account. But, when a person other than a financial institution holds a financial account for the benefit of or for another person as an agent, custodian, nominee, signatory, investment advisor, or intermediary, they are not considered the account holder. In such cases, the account holder is the person for whom the account is held.

If a trust or an estate is listed as the holder of a financial account, the trust or the estate is the account holder, not the trustee or the liquidator. Similarly, if a partnership is listed as the holder of a financial account, the partnership is the account holder, not the partners in the partnership.

An account holder also includes any person who can access the cash value or designate a beneficiary under a cash value insurance contract or an annuity contract.

The policy/account number is the number your financial institution assigned to the entity. For example, enter the number assigned to the entity (such as a bank account number or an insurance policy number) in this box. If you do not have such a number, leave this box blank.

Section 2 – Declaration of tax residenceUse Section 2 to identify the entity’s tax residence and taxpayer identification number. If the entity does not have such a number, give the reason.

Generally, an entity will be a tax resident of a jurisdiction if, under the laws of that jurisdiction, it pays or should be paying tax there because of its domicile, residence, place of management or incorporation, or a similar criterion. For this form:

a) a partnership, a limited partnership, or a similar legal arrangement is considered to reside in the jurisdiction where its place of management is located;

b) a trust is considered to reside in the jurisdiction where its place of management and control is located; and

c) an entity that is a "United States person" is a tax resident of the United States.

Entities that are tax residents in more than one jurisdiction can rely on the tie-breaker rules in tax conventions (when they apply) to resolve cases of dual tax residence. For more information on tax residency, talk to your tax adviser or go to oecd.org/tax/automatic-exchange/crs-implementation-and-assistance/tax-residency/#d.en.347760.

A taxpayer identification number, often referred to by its abbreviation TIN, is a unique combination of letters or numbers that a jurisdiction assigns to an individual or entity. The jurisdiction uses the TIN in administering its tax laws to identify the individual or entity. Enter the TIN in its official format. For more details about acceptable TINs, go to oecd.org/tax/automatic-exchange/crs-implementation-and-assistance/tax-identification-numbers/#d.en.347759.

Reasons that fall under “Reason 3: Other reason” for not having a TIN include not being eligible to receive one. However, if you are eligible to receive a TIN but you do not have one, you have 90 days to apply for one through your jurisdiction of residence. You have 15 days after you receive it to give it to your financial institution.

Section 3 – Entity classificationUse Section 3 to identify what type of entity the account holder is.

In Section 3.1, identify if the entity is a financial institution and whether it has a global intermediary identification number (GIIN). A GIIN is a unique identifier the Internal Revenue Service of the United States issues to financial institutions. Reasons for not having a GIIN include being a deemed compliant foreign financial institution or a non-participating foreign financial institution.

A financial institution is a custodial institution, a depository institution, an investment entity, or a specified insurance company. An entity that is a tax resident of Canada can classify itself as a financial institution only if it is a Canadian financial institution. However, an entity that is a prescribed non-reporting financial institution in Canada can classify itself as a financial institution even if it is not a Canadian financial institution.

Use Section 3.2 to determine whether the financial institution is a type of investment entity that needs to identity its controlling persons in the Annex. An entity has to fill out the Annex if it resides in a non-participating jurisdiction and is an entity described in paragraph b) of the definition of investment entity.Use Sections 3.3 and 3.4 to determine if an entity, other than a financial institution, has to identify its controlling persons in the Annex.

Section 4 – CertificationMake sure you complete the Annex where applicable, and fill in and sign Section 4 before you give this form to your Canadian financial institution.

Annex – Controlling personsUse the Annex to identify the controlling persons of the entity.

Controlling persons of an entity are the natural persons who exercise direct or indirect control over the entity. Generally, whether a person exercises control over an entity is determined in a way similar to how beneficial owners are identified for Canada’s Proceeds of Crime (Money Laundering) and Terrorist Financing Act.For example, a person is generally considered to control a corporation if they directly or indirectly own or control at least 25% of the corporation. If no individual is named as controlling the corporation, the director or senior official of the corporation is considered the corporation’s controlling person.

In the case of a trust, controlling persons include its settlors, trustees, protectors (if any), beneficiaries (or class of beneficiaries), and any other natural persons exercising ultimate effective control over the trust.

A settlor, trustee, protector, or beneficiary of a trust may be an entity. If so, to determine the trust’s controlling persons you have to look through the entity’s chain of control or ownership to identify the natural persons exercising ultimate effective control over the entity. You then have to report those you find as controlling persons of the trust. Financial institutions may apply this requirement in a way similar to how beneficial owners are identified for Canada’s Proceeds of Crime (Money Laundering) and Terrorist Financial Act.

In the case of a legal arrangement other than a trust, controlling persons are persons in equivalent or similar positions.

Enter the description that best describes the type of controlling person:1) Direct owner of a corporation or other legal person 2) Indirect owner of a corporation or other legal person (through an intermediary)3) Director or senior official of a corporation or other legal person4) Settlor of a trust5) Trustee of a trust6) Protector of a trust7) Beneficiary of a trust8) Other controlling person of a trust 9) Equivalent to a settlor of a legal arrangement other than a trust (e.g. partnership) 10) Equivalent to a trustee of a legal arrangement other than a trust (e.g. partnership) 11) Equivalent to a protector of a legal arrangement other than a trust (e.g. partnership) 12) Equivalent to a beneficiary of a legal arrangement other than a trust (e.g. partnership) 13) Other controlling person of a legal arrangement other than a trust (e.g. partnership)

Definitions

Active non-financial entityAn active non-financial entity is an entity other than a financial institution that meets at least one of the following criteria:

a) Less than 50% of the entity’s gross income for the preceding fiscal year is passive income and less than 50% of the assets the entity held during the preceding fiscal year are assets that produce or are held to produce passive income.

b) The stock of the entity is regularly traded on an established securities market or the entity is related to an entity whose stock is regularly traded on an established securities market.

c) The entity is a governmental entity, an international organization, a central bank, or an entity wholly owned by one or more of the above.

d) Substantially all of the activities of the entity are made up of holding (in whole or in part) the outstanding stock of, or providing financing and services to, one or more subsidiaries that engage in trades or businesses other than the business of a financial institution. But, an entity does not qualify for this status if the entity functions (or presents itself) as an investment fund. Examples of an investment fund include a private equity fund, a venture capital fund, a leveraged buyout fund, and any investment vehicle whose purpose is to acquire or fund companies and then hold interests in those companies as capital assets for investment purposes.

e) The entity is a start-up and is not yet operating a business and has no operating history, but it is investing capital into assets with the intention of operating a business other than the business of a financial institution. This is as long as the entity does not qualify for this exception later than 24 months after the date it was first organized.

f) The entity is in liquidation and was not a financial institution in the past five years. And, it is in the process of liquidating its assets or is reorganizing with the intention of continuing or restarting operations in a business other than the business of a financial institution.

g) The entity mainly engages in financing and hedging transactions with, or for, related entities that are not financial institutions. It does not provide financing or hedging services to an entity that is not a related entity. This is as long as the group of any such related entities is mainly engaged in a business other than the business of a financial institution.

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Active non-financial entity (continued)

h) The entity is a non-profit entity that meets all of the following requirements:

i) It is established and operated in its jurisdiction of residence exclusively for religious, charitable, scientific, artistic, cultural, athletic, or educational purposes. Or, it is established and operated in its jurisdiction of residence and is a professional organization, business league, chamber of commerce, labour organization, agricultural or horticultural organization, civic league, or an organization operated exclusively to promote social welfare.

ii) It does not have to pay income tax in its jurisdiction of residence.

iii) It has no shareholders or members who have a proprietary or beneficial interest in its income or assets.

iv) The laws of the entity’s jurisdiction of residence that apply or the entity’s formation documents do not allow any of the entity’s income or assets to be distributed to, or applied for the benefit of, a private person or non-charitable entity other than in line with the entity’s charitable activities, as payment of reasonable compensation for services rendered, or as payment representing the fair market value of property the entity bought.

v) The laws of the entity’s jurisdiction of residence that apply or the entity’s formation documents require that, as soon as the entity is liquidated or dissolved, all of its assets will be distributed to a governmental entity or other non-profit entity. Or, they will be handed over to the government of the entity’s jurisdiction of residence or one of its political subdivisions.

i) The entity is organized in a United States territory and all of the owners of the payee are tax residents of that United States territory.

Canadian financial institutionA Canadian financial institution is an entity that resides in Canada or a foreign entity that has a branch in Canada. The entity can be any of these:

a) an authorized foreign bank within the meaning of section 2 of the Bank Act in respect of its business in Canada, or a bank that act applies to

b) a cooperative credit society, a savings and credit union, or a caisse populaire regulated by a provincial act

c) an association regulated by the Cooperative Credit Associations Act

d) a central cooperative credit society, as defined in section 2 of the Cooperative Credit Associations Act, or a credit union central or a federation of credit unions or caisses populaires that is regulated by a provincial act other than one enacted by the Government of Quebec

e) a financial services cooperative regulated by An Act respecting financial services cooperatives, R.S.Q., c. C-67.3 or by An Act respecting the Mouvement Desjardins, S.Q. 2000, c. 77

f) a life company or a foreign life company that the Insurance Companies Act applies to, or a life insurance company regulated by a provincial act

g) a company the Trust and Loan Companies Act applies to

h) a trust company regulated by a provincial act

i) a loan company regulated by a provincial act

j) an entity authorized under provincial law to deal in securities or any other financial instruments or to provide portfolio management, investment advice, fund administration, or fund management services

k) an entity that is presented or promoted to the public as a collective investment vehicle, mutual fund, exchange traded fund, private equity fund, hedge fund, venture capital fund, leveraged buyout fund, or similar investment vehicle that is established to invest or trade in financial assets and is managed by an entity referred to in j) above

l) an entity that is a clearing house or clearing agency

m) a department or an agent of the Crown or of a province that accepts deposit liabilities

Investment entityThere are two types of entities that can be considered an investment entity:

a) an entity that mainly carries on the business of one or more of the following activities or operations for a customer:

i) trading in money market instruments (such as cheques, bills, certificates of deposit, and derivatives); foreign exchange; exchange, interest rate and index instruments; transferable securities; or commodity futures trading;

ii) individual and collective portfolio management; or

iii) investing in, administering, or managing financial assets or money for other persons.

b) An entity the gross income of which is mainly from investing, reinvesting, or trading in financial assets. The entity is managed by another entity that is a depository institution, a custodial institution, a specified insurance company, or the first type of investment entity described in a) above.

Passive non-financial entityA passive non-financial entity is an entity that is:

a) not a financial institution or an active non-financial entity;

b) an investment entity described in paragraph b) of the definition of investment entity; or

c) not a withholding foreign partnership nor a withholding foreign trust under United States Treasury Regulations.

Related entity An entity is considered to be related if one entity controls the other or if the two entities are under common control (the "related entity group"). Control means direct or indirect ownership of:

a) in the case of a corporation, more than 50% of the votes and value;

b) in the case of a trust, an interest as a beneficiary in the trust with a fair market value that is greater than 50% of the fair market value of all interests as a beneficiary in the trust.

c) in the case of a partnership, interest as a member in the partnership that entitles the member to more than 50% of the income or loss of the partnership, or of the assets (after deducting any liabilities) if the partnership were to stop existing; and

In the case of two entities that are investment entities described in paragraph b) of the definition of investment entity, the two entities are considered related entities if they are under common management and such management has to meet the due diligence obligations of the investment entities.

Specified United States personA specified United States (U.S.) person is a U.S. person, other than any of the following:

a) a corporation the stock of which is regularly traded on one or more established securities markets

b) a corporation that is a member of the same expanded affiliated group, as defined in section 1471(e)(2) of the U.S. Internal Revenue Code as a corporation described in a) above

c) the United States or any wholly owned agency or instrumentality of the United States

d) a state of the United States, a U.S. territory, a political subdivision of any of the foregoing, or a wholly owned agency or instrumentality of any one or more of these

e) an organization that does not have to pay tax under section 501(a) of the U.S. Internal Revenue Code or an individual retirement plan as defined in section 7701(a)(37) of the U.S. Internal Revenue Code

f) a bank as defined in section 581 of the U.S. Internal Revenue Code

g) a real estate investment trust as defined in section 856 of the U.S. Internal Revenue Code

h) a regulated investment company as defined in section 851 of the U.S. Internal Revenue Code or an entity registered with the U.S. Securities and Exchange Commission under the U.S. Investment Company Act of 1940

i) a common trust fund as defined in section 584(a) of the U.S. Internal Revenue Code

j) a trust that does not have to pay tax under section 664(c) of the U.S. Internal Revenue Code or that is described in section 4947(a)(1) of the U.S. Internal Revenue Code

k) a dealer in securities, commodities, or derivative financial instruments (including notional principal contracts, futures, forwards, and options) that is registered as such under the laws of the United States or one of its states

l) a broker as defined in section 6045(c) of the U.S. Internal Revenue Code

m) a tax-exempt trust under a plan that is described in section 403(b) or section 457(b) of the U.S. Internal Revenue Code

United States personA United States (U.S.) person is any of the following:

a) a U.S. citizen or an individual who resides in the United States

b) a partnership or corporation organized in the United States or under the laws of the United States or any State thereof

c) a trust, if

i) a court in the United States would have the authority under applicable law to deliver orders or judgments about substantially all issues regarding the administration of the trust, and

ii) one or more U.S. persons have the authority to control all the trust’s major decisions

d) the estate of a person that is a citizen or resident of the United States

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