Deregistration/Withdrawal Request
For registered or investment accounts
4. AUTHORIZATION – For Power of Attorney, the documents must be attached.
Please provide photo ID for non-residents of Canada.
AMOUNT TYPE LEGEND – *Specify an amount
F All shares/units not subject to DSC (also known
as M + T free)
M Matured shares/units ONLY
T Shares/units allowed to be redeemed not subject
to DSC, and excluding matured shares/units
N$M MUTUAL FUNDS ONLY
N$M LABOUR SPONSORED INVESTMENT FUNDS (LSIFs)
B contributor disabled or terminally ill
C held longer than 5 - 8 years
J – death
L free of DSC
A – ALL
* D – Dollars
* P Percentage of shares
* S – Shares
ALL FUNDS
3. SELL – ONLY USE FOR MUTUAL FUNDS – Trades are executed by Fund Code only
SERVICE STANDARD FOR MUTUAL FUND TRADING – Trades faxed directly to Mutual Fund Trading by 12 noon (EST) and received in
good order will be processed on a best effort basis for that day’s trade date. However, same day Net Asset Value (NAV) is not guaranteed.
FAX ONLY ONCE. DO NOT SEND ORIGINAL. REQUESTS RECEIVED TWICE MAY BE DUPLICATED.
TO EXECUTE THIS REQUEST:
2. DEREGISTRATION / WITHDRAWAL DETAILS
DATE (mm/dd/yyyy)
X
CLIENT SIGNATURE (MANDATORY)
A. Source of Withdrawal – check one (ü)
(MANDATORY)
B. Amount – check one (ü)
(MANDATORY)
C. Delivery Instructions –
check one (ü)
D. Special Instructions –
check only if applicable
Cash – cash settled in B2B Bank Discount Brokerage
(“B2BBDB”) account
Wire Order – previously placed dealer trade
(complete section 3, indicate wire order numbers
and cash if applicable)
* For net deregistration/withdrawal, gross up
redemption to include B2BBDB fee and taxes.
** The mutual fund trade fee does not apply to wire
order trades.
Intermediary – B2BBDB to place trade (complete
section 3 for partial deregistration/withdrawal and
cash if applicable).
Full Deregistration/Withdrawal – entire
account will be sold
Gross – Partial Deregistration/Withdrawal
$_______________________________
(Proceeds will be reduced by applicable
taxes and fees)
Net – Partial Deregistration/Withdrawal
$_______________________________
(Proceeds will be net of applicable taxes
and fees)
EFT (void cheque attached)
EFT (banking information on le)
Bank a/c #
Wire (void cheque attached, charge
will apply)
Wire (banking information on le,
charge will apply)
Bank a/c #
Mail to client (send to address on
le) - default
Paydown or payout B2B loan
Payout B2B loan and EFT balance
to client's account
Apply withdrawal proceeds
to Income Plan where
minimum is applicable
Special withholding tax
amount
1. ACCOUNT INFORMATION
DEALER # ADVISOR #DEALER NAME ADVISOR NAME
INVESTMENT LOAN NUMBER
B2BBDB ACCOUNT NUMBER
CLIENT NAME (LAST NAME OR COMPANY/ORGANIZATION NAME)
(FIRST NAME)
100-03-203E (03/16/2020)
B2B Bank Discount Brokerage is a division of B2B Bank Securities Services Inc. (an IIROC member, Member — Canadian Investor Protection Fund).
B2B Bank is a trademark used under license.
FAX: 416.413.0733
DEALER I.D. NUMBER
FOR DEALER USE ONLY. B2BBDS DOES NOT MONITOR
SELL
FUND NAME FUND CODE WIRE ORDER #
AMOUNT
TYPE
ESTIMATE OF FEES
/CHARGES
DEALER USE ONLY. (OPTIONAL)
B2BBDS DOES NOT VALIDATE
THIS SECTION.
ESTIMATE
OF TAXES
DEALER USE ONLY. (OPTIONAL)
B2BBDS DOES NOT VALIDATE
THIS SECTION.
AMOUNT
DATE (mm/dd/yyyy)
X
CLIENT SIGNATURE (IF JOINT ACCOUNT)
DATE (mm/dd/yyyy)
X
ADVISOR SIGNATURE (MANDATORY)
_____________ %
_______________
_______________
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