Client Information Change Form
2. CLIENT ADDRESS
ADDRESS
Fax to: 416.413.0593
Client Services Telephone: 416.964.0028 Or 1.800.387.2087
1. ACCOUNT INFORMATION
DEALER / ADVISOR NO.CLIENT NAME (LAST) FIRST
CLIENT NAME (LAST) FIRST ACCOUNT NO.
3. DEALER/ADVISOR
NOTE: Client and Authorized Dealer must sign for a Dealer Change. Client or Authorized Dealer must sign for an Advisor
change.
ADVISOR NAME (PLEASE PRINT)
ADVISOR NO.
DEALER NO.DEALER NAME (PLEASE PRINT)
100-04-105E (09/25/2020)
You authorize B2B Bank Dealer Services (“B2BBDS”) to share updates to your personal information with B2B Bank if your investment account is associated with a B2B Bank Investment
Loan. You authorize B2B Bank to update your B2B Bank accounts with your updated personal information that includes your personal address (residential and mailing), phone and cell
number(s), and email address.
You authorize B2BBDS to share updates to this information with B2B Bank if your investment account is associated with a B2B Bank investment loan.
NOTE: 2 signatures are required - either Client and Advisor/Authorized Dealer OR Advisor and Authorized Dealer
Group Locked-In or RRIF IPP
Indicate if the account is one of these accounts (if not, leave blank):
Authorized Dealer: By signing this form, you attest that client authorization for the address change has been obtained.
Authorized Dealer: By signing this form, you attest that the assets being received have been reviewed and that your dealer is properly registered/licensed to offer, advise on and
supervise these assets.
ADVISOR SIGNATURE
CLIENT SIGNATURE
DATE (mm/dd/yyyy)
CLIENT SIGNATURE
DATE (mm/dd/yyyy)
DATE (mm/dd/yyyy)
DATE (mm/dd/yyyy)
AUTHORIZED DEALER SIGNATURE
(i.e. Branch Manager)
CLIENT SIGNATURE
ADVISOR SIGNATURE
DATE (mm/dd/yyyy)
CLIENT SIGNATURE
DATE (mm/dd/yyyy)
DATE (mm/dd/yyyy)
DATE (mm/dd/yyyy)
AUTHORIZED DEALER SIGNATURE
(i.e. Branch Manager)
POSTAL CODE
COUNTRY
PROVINCE
CITY
EMAIL ADDRESS
( )
BUSINESS TELEPHONE NUMBER
( )
CELL TELEPHONE NUMBER
( )
RESIDENCE TELEPHONE NUMBER
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Change residence address Change mailing address
5. BANKING INFORMATION – Attach a Void Cheque
Change my banking information for the following:
NOTE: Bank account holder(s) must sign.
EFFECTIVE DATE (mm/dd/yyyy)
BANK NAME BANK TRANSIT NO. BANK ACCOUNT NO.
SWP (INVESTMENT & TFSA
ACCOUNTS ONLY) (EFT)
PAC
RIF/LIF/LRIF/PRIF/
RLIF (EFT)
ANNUAL ACCOUNT
FEE PAC
CHANGE BANKING INFORMATION AT FUND COMPANY FOR CASH DISTRIBUTIONS (INDICATE FUND CODES):
You authorize B2BBDS to share updates to this information with B2B Bank if your investment account is associated with a B2B Bank investment loan.
LOANS (B2B BANK INVESTMENT
LOAN PAYMENT)
6. CLIENT NAME
PREVIOUS
PREVIOUS SIGNATURE
NOTE: Client must sign both previous and new. Dealer must signature guarantee or attach a legal document with client’s new name.
NEW
FIRST NAMELAST NAME
FIRST NAMELAST NAME
NEW SIGNATURE
DEPOSITOR SIGNATURE
DATE (mm/dd/yyyy)
DATE (mm/dd/yyyy)
DEPOSITOR SIGNATURE
ADVISOR SIGNATURE
DATE (mm/dd/yyyy)
ADVISOR SIGNATURE
DATE (mm/dd/yyyy)
SIGNATURE GUARANTEE
DATE (mm/dd/yyyy)
You authorize B2B Bank Dealer Services (B2BBDS”) to share updates to your personal information with B2B Bank if your investment account is associated with a B2B Bank Investment
Loan. You authorize B2B Bank to update your B2B Bank accounts with your updated personal information that includes your legal name.
100-04-105E (09/25/2020)
4. ANNUAL ACCOUNT FEE PAYMENT METHOD – The method chosen will apply to all of your accounts and replaces any
previously chosen method
Charge my chequing account as per the banking information in section 5. This bank
account will be used each year for withdrawal of annual account fees on or about
June 1, which will vary based on the applicable fee schedule provided. Unpaid fees
will be collected from your B2BBDS account(s). Please see the Pre-Authorized
Debit (PAD) Terms & Conditions below for more information on the CPA Rule H1
Requirements that apply to this fee payment option.
A
Deduct fees from my individual
B2BBDS Investment Account.
NOTE: Client must sign.
B
Deduct fees from my B2BBDS registered
account, including my B2BBDS tax-free
savings account, up to the fee applicable
per account, then from my B2BBDS
investment account(s), if any.
NOTE: Client must sign.
C
ByselectingoptionAandsigningthissection,youherebywaiveanypre-noticationrequirementsasspeciedbysections15(a)and(b)oftheCanadianPaymentsAssociationRuleH1
with regards to pre-authorized debits.
• You authorize B2B Bank Dealer Services (B2BBDS”) to debit the bank account provided for the amount(s) and in the frequencies instructed.
If this is for your own personal investment, your debit will be considered a Personal PAD by Canadian Payments Association denition. If this is for business purposes, it will be considered a Business PAD.
You have certain recourse rights if a debit does not comply with this agreement. For example, you have the right to receive reimbursement for any debit that is not authorized or is not consistent with
this pre-authorized debit agreement. To obtain more information on your recourse rights, you may contact your nancial institution or visit www.cdnpay.ca.
• You conrm that all persons whose signature are required to authorize transactions in the bank account have signed in below.
You may change these instructions or cancel this plan at any time, provided that B2BBDS receives at least 10 business days notice by phone or by mail. To obtain a copy of a cancellation form or for more
information regarding your right to cancel a pre-authorized debit agreement, please consult with your nancial institution or visit the Canadian Payments Association website at www.cdnpay.ca.
B2BBDS is authorized to accept changes to this agreement from my/our registered dealer or my/our advisor in accordance with the policies of B2BBDS, in accordance with the disclosure
and authorization requirements of the CPA.
You agree that the information in this form will be shared with the nancial institution, insofar as the disclosure of this information is directly related to and necessary for the proper application of the
rules applicable for pre-authorized debits.
• You acknowledge and agree that you are fully liable for any charges incurred if the debits cannot be made due to insufcient funds or any other reason for which you may be held accountable.
• You have requested this application form and all other documents relating hereto to be in English. J’ai exigé que ce formulaire et tous les documents y afférant soient rédis en anglais.
CLIENT SIGNATURE
DEPOSITOR SIGNATURE DATE (mm/dd/yyyy)
JOINT DEPOSITOR SIGNATURE
DATE (mm/dd/yyyy)
DATE (mm/dd/yyyy)
DATE (mm/dd/yyyy)
CLIENT SIGNATURE
ADVISOR SIGNATURE
DATE (mm/dd/yyyy)
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8. SUCCESSOR HOLDER AND BENEFICIARY DESIGNATION (optional) – applicable only for TFSA Accounts
NAME
RELATIONSHIP
ADDRESS
In the event of my death I hereby designate my spouse*, if living at my death, as the
successor holder of this B2BBDS Tax-free Savings Account to acquire all rights I have as
the holder thereof. I reserve the right to revoke this designation.
A
In the event that the successor holder designated by me in A predeceases me or where I
have not named a successor holder in A, I hereby designate the following person as my
designated beneciary entitled to receive the proceeds of this B2BBDS Tax-free Savings
Account in the event of my death. I reserve the right to revoke this designation.
B
In the absence of a designated beneciary or successor holder, the proceeds of this B2BBDS Tax-free Savings Account will be paid to your Estate.
Cauti on: 1. Thevalidityofadesignationofabeneciaryorsuccessorholderissubjecttothelawsofthejurisdictionwhereyouresidepermittingdesignationmadeotherwisethanby
way of a will.
2. Your designation of a successor holder and/or beneciary to this B2BBDS Tax-free Savings Account by means of this designation form will not be revoked or changed automatically by any
future marriage or divorce. Should you wish to change your successor holder or beneciary in the event of a future marriage or divorce, you will have to do so by means of a new designation.
3. This designation of successor holder and/or beneciary will apply to this B2BBDS Tax-free Savings Account only. If you have other tax-free savings accounts with B2B Trustco as trustee
for which you want a successor holder or beneciary to be designated, you must complete a separate designation for each of these accounts.
* Spouse refers to a person recognized as your spouse or common-law partner for the purposes of the Income Tax Act
(Canada). The person you designate as a successor holder must be your spouse at the time of your death.
SPOUSE’S NAME
SPOUSE’S SOCIAL INSURANCE NUMBER
I hereby revoke any previous successor holder designation and any previous beneciary designation with respect to this B2BBDS Tax-free Savings Account.
7. SUCCESSOR ANNUITANT AND BENEFICIARY DESIGNATION (optional) – applicable only to B2BBDS Registered Accounts,
with the exception of TFSA Accounts
For RSPs, Locked-in RSPs/LIRAs and RLSPs: In the event of my death, I hereby designate
the following person as my designated beneciary entitled to receive my interest in this Account if
living at my death. I reserve the right to revoke this designation.
A
For RIFs, LIFs, LRIFs, RLIFs and PRIFs: In the event of my death (pick one or both):
I hereby elect that my spouse, if living and remaining my spouse at the time of my
death shall continue to receive payments as successor annuitant under my Account
and to the extent possible and permitted by law shall acquire all rights I have as holder
thereof. I reserve the right to revoke this designation; or
B
Cauti on: AnydesignationmadeinSection8Aor8Baboveissubjecttothefollowing:
For the purposes of this designation, spouse refers to a person recognized as your spouse or
common-law partner for the purposes of the Income Tax Act (Canada).
Thevalidityofadesignationofabeneciaryorsuccessorannuitantissubjecttothe
applicablepensionlegislationandthelawsofthejurisdictionwhereyoureside,ifany,
permitting designations to be made otherwise than by way of a will.
In the absence of a designated beneciary or successor annuitant, the proceeds of your Account
will be paid to your estate.
Notwithstanding any designation by you to the contrary, your spouse (within the meaning of the
applicable pension legislation) may automatically be entitled to the benets under one or more of
your Accounts including your Locked-in RSP/LIRA, RLSP, LIF, RLIF, PRIF or LRIF.
Your designation above will not be revoked or changed automatically by any future marriage or
divorce. Should you wish to change your designated beneciary or successor annuitant, you will
have to do so by means of a new designation.
Any designation made above shall apply to this Account only. If you have other accounts for which
you wish to designate a beneciary or successor annuitant you must complete a separate
designation for each of these accounts.
I hereby revoke any previous successor annuitant designation and any previous beneciary designation with respect to this account.
NAME RELATIONSHIP
ADDRESS
SPOUSE’S SOCIAL INSURANCE NUMBER
SPOUSE’S NAME
NAME RELATIONSHIP
ADDRESS
NOTE: Client must sign.
B2B Bank Dealer Services includes B2B Bank Financial Services Inc. (an MFDA member), B2B Bank Securities Services Inc. (an IIROC member, Member — Canadian Investor Protection Fund) and B2B Bank
Intermediary Services Inc. (an AMF-regulated dealer operating in Quebec). B2B Bank is a trademark used under license.
If: (a) the successor annuitant named above, if any, predeceases me or is not my
spouse at the time of my death; or (b) I have not elected any successor annuitant
under my Account; then I hereby designate the following person as my designated
beneciary entitled to receive my interest in this Account if living at my death.
I reserve the right to revoke this designation.
ADVISOR SIGNATURE
DATE (mm/dd/yyyy)
CLIENT SIGNATURE
DATE (mm/dd/yyyy)
NOTE: Client must sign.
ADVISOR SIGNATURE
DATE (mm/dd/yyyy)
CLIENT SIGNATURE
DATE (mm/dd/yyyy)
100-04-105E (09/25/2020)
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