Order Execution Only Account
PERSONAL INFORMATION – REGISTER OR CHANGE PREFERENCE FORM
A
INFORMATION ABOUT YOU (please print clearly)
To: BMO InvestorLine
From:
Last
Name
First
Name
Int.
Home Address
(number, street)
Suite
No.
City or
Town
Postal
Code
Prov.
Account Number 1 Account Number 2
B
SHARING OF PERSONAL INFORMATION WITHIN BMO FINANCIAL GROUP
I/We request that my name be added to the shared information list held by BMO InvestorLine. I/We understand that this means
I/we am opting-in to having BMO InvestorLine provide my personal information to other members of BMO Financial Group.
I/We request that my name be removed from the shared information list held by BMO InvestorLine. I/We understand that this
means I/we am opting-out of having BMO InvestorLine provide my personal information to other members of BMO Financial Group.
I acknowledge that I cannot opt out of having my personal information provided to relevant members of BMO Financial Group, where
I have requested a product or service that is offered jointly by BMO InvestorLine and other member(s) of BMO Financial Group.
C
DIRECT MARKETING
I request that my name be added to the direct marketing list held by BMO InvestorLine.
I request that my name be removed from the direct marketing list held by BMO InvestorLine.
Direct marketing does not include information:
Enclosed with or on your monthly or quarterly statement
Posted online on our web site or electronic bulletin boards
Conveyed to you in person by us
D
USE OF SOCIAL INSURACE NUMBER (SIN)
I request that my SIN not be used for administrative purposes within BMO InvestorLine’s internal electronic systems for
activities, such as statement processing.
I understand that I cannot opt out of having BMO InvestorLine use my SIN for income tax reporting purposes.
E
SIGNATURES
Applicant
Signature
Date
YY/MM/DD
Co-applicant's
Signature
(if applicable)
Date
YY/MM/DD
®Registered trade-marks of
Bank of Montreal, used under license.
BMO InvestorLine Inc. is a wholly owned subsidiary of
Bank of
Montreal.
Member - Canadian Investor Protection Fund and IIROC1098505 (11/11)
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