H o w t o C... Yo u r R S P ...

How to Complete
Yo u r R S P A p p l i c a t i o n
How to complete your
Phillips, Hager & North RSP Plan & Account Application
Applicant
Information
RSP
Retirement Sav ings Plan
Please complete all applicable sections of this application.
If sections are left blank, Phillips, Hager & North will not be able to process your application.
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YOUR INFORMATION AS APPLICANT
If you already have an
account with us, please
indicate the account number.
If your company retirement
plan is with us, please
indicate the company name.
Account number
Company name
2
Full name (first, middle, last)
Mr
Mrs
Ms
Date of bir th (yyyy/mm/dd)
Dr
Social Insurance Number
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Mailing address (number, street, apar tment or suite number)
City or town
Province
Postal code
Work telephone number
Home telephone number
Email address
(
(
B
3
)
Plan Information
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Please select the type of Retirement Savings Plan you would like to open. If you would like to open more than one account, please
complete a separate application for each new account. Applications may be found at www.phn.com.
Beneficiary*
Locked-in Account
Name of contributing spouse* or common-law partner* (first, middle initial, last)
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PH&N USE ONLY Jurisdiction: Please specify the jurisdiction
that governs the pension plan from which the funds originated.
Date of Birth (yyyy/mm/dd)
Mr
Mrs
Ms
Dr
Relationship to you
Social Insurance Number
Province
Postal code
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Mailing address if dif ferent than yours (number, street, apar tment or suite number)
City or town
Work telephone number
Home telephone number
(
(
)
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Date of bir th (yyyy/mm/dd)
or
)
Your estate
RETIREMENT SAVINGS PLAN ACCOUNT APPLICATION
Securities regulators require us to obtain the following information before opening this account.
These questions will help us develop a sense of your financial situation. Please indicate only one
choice for each question.
Your investment objective for
Your investment experience
Your investment knowledge
Your estimated investment
this account (see Investment
time horizon for money in
Stocks
Excellent
Objective on page 4)
this account
Bonds
Good
Growth
Mutual Funds
Fair
Under 3 years
Balanced
None
Limited
3 – 10 years
Income
More than 10 years
Account Objectives and Investor Profile
Your risk tolerance for this
account (see Risk Tolerance
on page 4)
High
Medium
Low
Your approximate annual income
$0 – $24,999
$25,000 – $49,999
$50,000 – $74,999
$75,000 – $99,999
$100,000+
2. Enter your
information, as
applicant. Your
Social Insurance
Number (SIN) is
required for a
registered plan.
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Designation of a Beneficiary may not be permitted by law in some provinces. This designation cancels any previous Beneficiary designations.
If you wish to name multiple Beneficiaries or Contingent Beneficiaries, please complete the appropriate Beneficiary Designation form, which
may be found at www.phn.com..
Name (first, middle initial, last)
5
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Spousal Retirement Savings Plan (Spousal RSP)
Spouse’s or common-law partner’s SIN
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RETIREMENT SAVINGS PLAN APPLICATION
Retirement
Savings Plan
(RSP)
4
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1. This information
will help us connect
your existing
investments to
this account.
Your approximate net worth
$0 – $49,999
$50,000 – $99,999
$100,000 – $199,999
$200,000 – $499,999
$500,000 – $999,999
$1,000,000+
Your occupation or nature of business
Have you borrowed money to make
this investment? (see Leveraged
Investing on page 4)
Yes
No
1 | Phillips, Hager & North’s Copy
*As defined in the Declaration of Trust.
4. Appoint a beneficiary or select “Your Estate.” We require a
birthdate and, if available, a SIN for your beneficiary. You must
ensure that your beneficiary is permitted by the province that governs
your plan.
Retirement Savings Plan Account Application
5. This information enables us to ensure that your investment activity
matches your long-term objectives. You must complete this section in
its entirety to open the RSP.
Retirement
Savings
Plan Application
3. Select your
Plan type.
• For a Spousal
RSP, enter the
contributing
spouse’s
information.
• For a locked-in
plan, enter the
jurisdiction of the
plan (i.e., is your
plan governed
federally, or by a
specific province).
6 Fund Selection
Select the fund or funds in which the Plan is to invest. Please
indicate a dollar amount or a percentage. The minimum total investment is $25,000.
Fund
Amount
or
Percent
Fund #
Canadian Money Market Fund
$
%
120
$U.S. Money Market Fund†
$
%
500
Short Term Bond & Mortgage Fund
$
%
250
Bond Fund
$
%
110
Total Return Bond Fund
$
%
340
High Yield Bond Fund
$
%
280
Balanced Fund
$
%
350
Canadian Income Fund
$
%
490
Dividend Income Fund
$
%
7
Initial Deposit
Cheque, made payable to State Street Trust Company Canada
Amount
$
Electronic Funds Transfer from an account with a Canadian
financial institution. Please attach a blank cheque marked void.
Amount
$
150
U.S. Dividend Income Fund
$
%
460
Canadian Equity Fund
$
%
130
U.S. Equity Fund
$
%
160
Please indicate how the total in Section 6
will be deposited.
Transfer from another institution (please complete the Transfer Form
for Registered Investments).
Transfer from your Phillips, Hager & North investment account.
Account number
Amount
Overseas Equity Fund
$
%
410
Global Equity RSP Fund
$
%
330
Global Equity Fund
$
%
370
Name of PH&N fund(s) to use as source
Canadian Growth Fund
$
%
140
1.
%
U.S. Growth Fund
$
%
260
Community Values Bond Fund
$
%
610
2.
%
Community Values Balanced Fund
$
%
640
3.
%
Community Values Canadian Equity Fund
$
%
620
4.
%
Community Values Global Equity Fund
$
%
630
$
100%
Total
† In U.S. dollars.
8 Automatic Transactions
$
Percent
Please select the option or options you would like to arrange. The minimum total investment for each automatic transaction
is $100.00. The $U.S. Money Market Fund is not available for these options.
„ Automatic Purchases of PH&N funds from your bank account (also
known as Pre-Authorized Chequing). Please attach a blank cheque marked
void if you did not provide one in Section 7.
If these purchases are for a Spousal RSP, the contributing spouse or
common-law partner must sign below to authorize automatic purchases.
Start date (yyyy/mm/dd)
End date, if applicable (yyyy/mm/dd)
Signature of spouse or common-law partner (if applicable)
„ Automatic Transfers within your PH&N account (also known as Dollar
Cost Averaging).
Transfer from (name of fund)
Start date (yyyy/mm/dd)
Frequency:
D
End date, if applicable (yyyy/mm/dd)
Biweekly
Monthly
Semi-annually
Semi-monthly
Quarterly
Annually
Frequency:
Biweekly
Monthly
Semi-annually
Semi-monthly
Quarterly
Annually
Name of fund
Amount
1.
$
2.
$
3.
$
4.
$
Transfer to (name of fund)
Amount
1.
$
2.
$
3.
$
4.
$
„ When fund residual is less than full payment, invest in:
Name of PH&N fund
OTHER INFORMATION
9 Dealer Information
(if applicable)
Dealer name
10 Duplicate Mailings
Dealer #
Rep #
Our clients receive mailings, such as quarterly reports, for each of their accounts. If your household has more than one account, you
can reduce the number of mailings you receive by completing a Duplicate Mailing form, which may be found at www.phn.com.
11 Telephone & Internet Access
If you have telephone transactions and/or Internet viewing access for other PH&N accounts
and would like to have this new account included in your existing access, please initial here:
Your initials
„ If you are not registered for telephone transactions and/or Internet viewing access with PH&N and would like to arrange for this service, please complete a
Telephone Transactions and/or Internet Access Agreement, which may be found at www.phn.com.
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9. If you are setting up the RSP through another dealer, please have
the dealer complete this section.
10. If more than one member of your household holds an account with
PH&N, complete our Duplicate Mailing form to reduce the number of
mailings you receive.
11. To view your account activity online, or to request transactions
by telephone, complete our Telephone Transactions and/or Internet
Access Agreement.
6. Select the fund
allocation for your
initial deposit.
7. Indicate the
source of the
funds for your
initial deposit. If
you are paying by
cheque, ensure it
is made payable to
State Street Trust
Company Canada.
8. For additional
information, see the
box to the lower right
• For an Automatic
Purchase plan,
ensure you provide
appropriate banking
information. For
contributions to a
spousal account,
the contributing
spouse’s signature
is required.
• For an Automatic
Transfer plan,
ensure you indicate
a fund allocation
for any residual
amount.
E
SIGNATURE
12 Your Signature as RSP Planholder and PH&NIF Account Holder
By signing here, you confirm that you have read, understand and agree
to the following: for the Plan, the terms and conditions as set out in the Retirement Savings Plan Application, the Planholder Agreement, the Declaration of Trust, and
any relevant addendum to the Plan; for the Account, the terms and conditions as set out in the Retirement Savings Plan Account Application, the Client Agreement,
the disclosure on Leveraged Investing, and our Ten Privacy Principles. You also confirm that you request State Street Trust Company Canada to apply for registration
of the Plan as an RSP under the Income Tax Act (Canada).
Your signature
Date (yyyy/mm/dd)
FOR PH&N USE ONLY
PH&NIF registered representative
Number
Date (yyyy/mm/dd)
PH&NIM Client Services representative as agent
for State Street Trust Company Canada
Number
Date (yyyy/mm/dd)
INSTRUCTIONS
Account number
Manager code
PLANHOLDER AGREEMENT
“Phillips, Hager & North” is a registered trade name for Phillips, Hager &
North Investment Management Ltd. (“PH&NIM”) and its wholly-owned
subsidiary Phillips, Hager & North Investment Funds Ltd. (“PH&NIF”).
PH&NIM is the Manager of the Phillips, Hager & North investment funds;
the Portfolio Manager for discretionary investment accounts; the
Administrator of the Phillips, Hager & North Investment Management Ltd.
Multiple Retirement Savings Plans (“PH&N Multiple RSP”) and agent
for the trustee. PH&NIF is a Mutual Fund Dealer through which all selfmanaged investment accounts are maintained.
Unless otherwise indicated, throughout this document and in our other RSP
documents, the words you and your refer to the annuitant (“the planholder”)
under the PH&N Multiple RSP and the account holder of the RSP
Account. We, us and our refer to PH&NIM, PH&NIF and/or Phillips, Hager
& North (PH&N).
Applicant Information (Part A)
Please complete all sections under Applicant Information if you wish to
open a PH&N Multiple RSP.
When you sign this Retirement Savings Plan Application (in Part E for
Part B), you confirm that you understand and agree that:
• You are applying to become an annuitant under the Phillips, Hager &
North Investment Management Ltd. Multiple Retirement Savings Plan
(“the PH&N Multiple RSP”). You have read and agree to the terms and
conditions of the enclosed Declaration of Trust. This PH&N Multiple RSP
application (“the Application”), the Declaration of Trust and any
applicable locking-in addendum constitute “the Plan” and may be referred
to herein as “your Plan” or “your RSP”. You instruct State Street Trust
Company Canada to apply for registration of your Plan as a retirement
savings plan under the Income Tax Act (Canada) (the Act) and any
applicable provincial income tax legislation.
• You have read a copy of the Simplified Prospectus for the Phillips, Hager
& North investment funds. You understand that the funds available for
investment under the Plan are managed by Phillips, Hager & North
Investment Management Ltd. and that the trustee is not responsible for the
management or investment performance of such funds.
Retirement Savings Plan Application (Part B)
By completing this Retirement Savings Plan Application, you are applying
to become an annuitant under the PH&N Multiple RSP. Please complete
one Retirement Savings Plan Application for each Plan you would like
to establish.
• You are the only person who can give us instructions in connection with your
RSP or receive information about your RSP unless you advise us otherwise.
RSP Account Application (Part C)
By completing this RSP Account Application, you are applying to establish
an investment account with PH&NIF to which contributions to your RSP
will be made.
• You understand that any payments from your RSP are taxable income
under the Act.
If you need help completing this Application, please contact Phillips, Hager
& North at 1-800-661-6141.
Once you have completed this document, please return the top copy to us in
the enclosed postage paid return envelope, and send to:
Phillips, Hager & North
Vancouver
or
P.O. Box 7600, Station Terminal
Vancouver, BC V6B 9Z9
Toronto
P.O. Box 14215, Station BRM B
Toronto, ON M7Y 2S1
• You request that all documents and material delivered to you in connection
with your RSP be written in English. Vous avez demandé que tous les
documents qui vous sont remis pour ce compte soient en anglais.
• You are responsible for calculating your allowable annual contribution
that can be deducted for income tax purposes unless this responsibility
has been formally delegated to your Portfolio Manager under a
discretionary management agreement.
• If your RSP is locked-in, you have read and agree to the terms and
conditions of the applicable Locked-in Addendum. If information within
the Locked-in Addendum and Declaration of Trust conflicts, the
Locked-in Addendum has priority over the Declaration of Trust.
• You can determine the applicable legislation that governs your RSP by
contacting the employer that the RSP originated from or by contacting the
institution that currently holds the RSP.
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Consider Automatic Transactions
• An Automatic Purchase Plan (also known as a
Pre-authorized Contribution Plan or PAC) is a method for
making ongoing contributions to your RSP. Regular contributions
to your account give you the advantages of investing regularly in
up and down markets, while compounding interest. They also
relieve the strain of making a lump-sum payment.
• An Automatic Transfer Plan (also known as Dollar-Cost
Averaging or DCA) will enable you to gradually switch units from
one fund to another over a period of time. Automatic transfers
are used to smooth out the effects of fluctuating markets.
12. By signing
here, you confirm
that you have read
and understand the
terms and conditions
of both the Plan
and the Account,
as set forth on
the back of the
second layer of the
application.
Before you send in your RSP application,
please ensure you have:
Completed your Account Objectives & Investor Profile (Section 5)
Provided fund allocations (Section 6)
Provided directions for your initial deposit (Section 7)
A
ttached a completed Transfer Form for Registered
Investments, if required
M
ade your cheque payable to State Street Trust Company
Canada, if required
A
ttached a void cheque providing correct banking information
(Sections 7 and 8), if required
A
ttached a completed Telephone Transactions and/or Internet
Access Agreement, or added this account to existing access
(Section 11)
Signed the application form (Section 12)
We’re here to assist you
If you would like help completing your RSP Plan and Account
Application, we invite you to contact us.
Call us at 1-800-661-6141 or send us your questions by email
to [email protected]
Publication date: February 20, 2006
VANCOUVER
Waterfront Centre
20th Floor
200 Burrard Street
Vancouver, British Columbia
Canada V6C 3N5
VICTORIA
St. Andrew’s Square I
Suite 312
737 Yates Street
Victoria, British Columbia
Canada V8W 1L6
CALGARY
Bankers Hall
West Tower
Suite 4430
888 - 3rd Street S.W.
Calgary, Alberta
Canada T2P 5C5
TORONTO
Suite 2320
1 Adelaide Street East
Box 207
Toronto, Ontario
Canada M5C 2V9
MONTREAL
Tour McGill College
Suite 1640
1501 McGill College Avenue
Montreal, Quebec
Canada H3A 3M8
INVESTMENT FUNDS ADVICE & INFORMATION
Telephone: 1-800-661-6141 Facsimile: 1-800-666-9899 Website: www.phn.com Email: [email protected]