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Last Modified: August
nd Purchase Plan Authorization
© Questrade, Inc. All rights r
eserved. Member of IIROC and the Canadian Investor Pr
otection Fund.
ed trademark of Questrade, Inc.
Account number:
(if applicable)
I foresee being in receipt of cash dividends from various companies that conform to the eligibility list and that will be credited to my account at
Questrade, Inc. (“Questrade”). During the time I own the shares of said companies, I hereby request that Questrade reinvest said cash dividends, less
any applicable tax charges, that I may receive, under the following terms and conditions:
1. If I do not hold any securities at the time of an enrollment request, I will not be eligible to enroll in DRIP.
2. There will be no commission charge for the purchase of shares under this plan.
3. My shares must be held in street name in my account at Questrade.
4. I will be purchasing shares of the dividend paying company referred to herein.
5. My shares will be purchased at the then-prevailing market price on the date dividend is received in my account. I will only be permitted to
purchase whole shares and any residual balance of cash will remain in my account.
6. All my shares of the participating security must be included.
7. My participation in this plan may be terminated by me or by Questrade upon 30 days written notice prior to record date for any dividend. My
participation is automatically cancelled should I sell my position or transfer my shares to another account.
8. I can request additional eligible securities to be enrolled in this plan by providing written instruction to Questrade.
9. Unless my position is held in a registered account, I will receive a tax slip for my cash dividend. Since the purchase will not be processed via trade
entry, I must retain my monthly statements in order to calculate and report any capital gain or loss applicable.
10. If I notice any share(s) are not being reinvested into my account accurately, I will contact Questrade within 30 days of the date the dividend is to
be credited to my account.
11. If I sell any particular DRIP-enrolled stock and then buy it back, my new shares will not be automatically re-enrolled to my DRIP. I will need to give
written authorization to have them enrolled again.
12. This form is not applicable for mutual funds reinvestments. If I am looking to change the distribution preference of my mutual funds, I will contact
Questrade Client Services.
Client name (please print) Date
Client signature Account number
All eligible securities in my account OR
Individual securities (please specify below):