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RBC Direct Investing or RBC Dominion Securities PAYROLL (RBC Direct Investing)

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VPS 102437 Page 1 of 3
E-FORM 96694 (09/2018)
RBC Direct Investing
®
or RBC Dominion Securities
PAYROLL DEDUCTION AND SPOUSAL ALLOCATION
ROYAL CHOICES
PLAN™
Plan Provider (Please choose one):
RBC Direct Investing
RBC Dominion Securities
Plan Type (Please choose one):
Group RRSP
Non-Registered Group Investment Account
IMPORTANT INFORMATION
This form is used to instruct your
employer to forward contributions
from your pay (including lump sum
contributions) to your plan with RBC
Direct Investing or RBC Dominion
Securities.
A copy of this form MUST be received
by your payroll department at least
2 weeks prior to the date of your rst
contribution.
A separate application form
supplied by your plan provider (RBC
Direct Investing or RBC Dominion
Securities) must be completed in
conjunction with this form.
This form may also be used to (re)
allocate contributions to either or both
a Personal Plan and/or a Spousal
Plan (Group RRSP only).
AGENT AGREEMENT:
I appoint the Plan Sponsor, being my
employer, association, or trade union,
to act as my agent for the purpose of
administration of the Plan including,
without limiting the generality of the
foregoing, delivering my Application
to you, submitting my contributions to
you, delivering my directions to you
with respect to Guaranteed Investment
Certicates and Savings Deposits, and
my directions with respect to mutual
funds or other investments to Royal
Bank of Canada, Royal Mutual Funds
Inc., RBC Direct Investing Inc., and or
RBC Dominion Securities Inc. I further
acknowledge that the Plan Sponsor
may receive reports containing both my
personal information and my investment
details and holdings for all assets held
in my Group Savings Plan account
held at Royal Bank of Canada, Royal
Mutual Funds Inc., RBC Direct Investing
Inc., and or RBC Dominion Securities
Inc., including assets contributed from
personal sources, for the purposes of
administering the Group Savings Plan.
1. SPONSOR / EMPLOYER INFORMATION
Sponsor Name Alpha Code (Mandatory)
Address Group Plan Number (if known)
2. CONTRIBUTOR / EMPLOYEE INFORMATION
Name (First Name, Initial, Last Name) Social Insurance Number
Daytime Telephone Number Ext.
3a. PAYROLL DEDUCTION AUTHORIZATION
I hereby authorize my employer to deduct each pay period:
% of my pay; or $ ; or cents/hour.
3b. LUMP SUM CONTRIBUTION (includes bonus payments and transfers-in)
I am contributing a lump sum of $ (please specify amount).
4. CONTRIBUTION ALLOCATION AUTHORIZATION
Employee Contribution
(EE)
% Personal Account #:
% Spousal RRSP #:
Employer Contribution
(ER)
% Personal Account #:
% Spousal RRSP #:
Note: If only the Employer Contribution portion is restricted, a second Employee
Contribution plan must be opened.
(Please complete the Spousal Information section below if applicable).
5. SPOUSAL INFORMATION (Group RRSP Only)
Only complete this section if all or a portion of your contribution is to be allocated to a
Spousal Plan (as per section 4 above).
Spouse’s Name Spouse’s Social Insurance Number
6. SIGNATURE
Please initiate these instructions with the next payroll cycle. I agree with the terms of the
Agent Agreement on the left side of this form.
Employee Signature Date
Attention RBC Dominion Securities or RBC Direct Investing: A copy of this
signed form must be faxed to the Group Financial Services, Service Centre
at 1-800-263-7777 immediately upon receipt.
RBC Direct Investing Inc., RBC Dominion Securities Inc. and Royal Bank of Canada are separate corporate entities which are aliated. RBC Direct Investing Inc. and RBC
Dominion Securities Inc. are wholly owned subsidiaries of Royal Bank of Canada, are Members of the Investment Industry Regulatory Organization of Canada and the Canadian
Investor Protection Fund. Royal Bank of Canada and certain of its issuers are related to RBC Direct Investing Inc. RBC Direct Investing Inc. does not provide investment advice or
recommendations regarding the purchase or sale of any securities. Investors are responsible for their own investment decisions. RBC Direct Investing is a business name used by
RBC Direct Investing Inc.
®
/™ Trademark(s) of Royal Bank of Canada. RBC and Royal Bank are registered trademarks of Royal Bank of Canada. Used under license. © Royal Bank
of Canada 2018. All rights reserved.
PART 1 – RBC COPY
VPS 102437 Page 2 of 3
E-FORM 96694 (09/2018)
RBC Direct Investing
®
or RBC Dominion Securities
PAYROLL DEDUCTION AND SPOUSAL ALLOCATION
ROYAL CHOICES
PLAN™
Plan Provider (Please choose one):
RBC Direct Investing
RBC Dominion Securities
Plan Type (Please choose one):
Group RRSP
Non-Registered Group Investment Account
IMPORTANT INFORMATION
This form is used to instruct your
employer to forward contributions
from your pay (including lump sum
contributions) to your plan with RBC
Direct Investing or RBC Dominion
Securities.
A copy of this form MUST be received
by your payroll department at least
2 weeks prior to the date of your rst
contribution.
A separate application form
supplied by your plan provider (RBC
Direct Investing or RBC Dominion
Securities) must be completed in
conjunction with this form.
This form may also be used to (re)
allocate contributions to either or both
a Personal Plan and/or a Spousal
Plan (Group RRSP only).
AGENT AGREEMENT:
I appoint the Plan Sponsor, being my
employer, association, or trade union,
to act as my agent for the purpose of
administration of the Plan including,
without limiting the generality of the
foregoing, delivering my Application
to you, submitting my contributions to
you, delivering my directions to you
with respect to Guaranteed Investment
Certicates and Savings Deposits, and
my directions with respect to mutual
funds or other investments to Royal
Bank of Canada, Royal Mutual Funds
Inc., RBC Direct Investing Inc., and or
RBC Dominion Securities Inc. I further
acknowledge that the Plan Sponsor
may receive reports containing both my
personal information and my investment
details and holdings for all assets held
in my Group Savings Plan account
held at Royal Bank of Canada, Royal
Mutual Funds Inc., RBC Direct Investing
Inc., and or RBC Dominion Securities
Inc., including assets contributed from
personal sources, for the purposes of
administering the Group Savings Plan.
1. SPONSOR / EMPLOYER INFORMATION
Sponsor Name Alpha Code (Mandatory)
Address Group Plan Number (if known)
2. CONTRIBUTOR / EMPLOYEE INFORMATION
Name (First Name, Initial, Last Name) Social Insurance Number
Daytime Telephone Number Ext.
3a. PAYROLL DEDUCTION AUTHORIZATION
I hereby authorize my employer to deduct each pay period:
% of my pay; or $ ; or cents/hour.
3b. LUMP SUM CONTRIBUTION (includes bonus payments and transfers-in)
I am contributing a lump sum of $ (please specify amount).
4. CONTRIBUTION ALLOCATION AUTHORIZATION
Employee Contribution
(EE)
% Personal Account #:
% Spousal RRSP #:
Employer Contribution
(ER)
% Personal Account #:
% Spousal RRSP #:
Note: If only the Employer Contribution portion is restricted, a second Employee
Contribution plan must be opened.
(Please complete the Spousal Information section below if applicable).
5. SPOUSAL INFORMATION (Group RRSP Only)
Only complete this section if all or a portion of your contribution is to be allocated to a
Spousal Plan (as per section 4 above).
Spouse’s Name Spouse’s Social Insurance Number
6. SIGNATURE
Please initiate these instructions with the next payroll cycle. I agree with the terms of the
Agent Agreement on the left side of this form.
Employee Signature Date
Attention RBC Dominion Securities or RBC Direct Investing: A copy of this
signed form must be faxed to the Group Financial Services, Service Centre
at 1-800-263-7777 immediately upon receipt.
RBC Direct Investing Inc., RBC Dominion Securities Inc. and Royal Bank of Canada are separate corporate entities which are aliated. RBC Direct Investing Inc. and RBC
Dominion Securities Inc. are wholly owned subsidiaries of Royal Bank of Canada, are Members of the Investment Industry Regulatory Organization of Canada and the Canadian
Investor Protection Fund. Royal Bank of Canada and certain of its issuers are related to RBC Direct Investing Inc. RBC Direct Investing Inc. does not provide investment advice or
recommendations regarding the purchase or sale of any securities. Investors are responsible for their own investment decisions. RBC Direct Investing is a business name used by
RBC Direct Investing Inc.
®
/™ Trademark(s) of Royal Bank of Canada. RBC and Royal Bank are registered trademarks of Royal Bank of Canada. Used under license. © Royal Bank
of Canada 2018. All rights reserved.
PART 2 – EMPLOYER COPY
VPS 102437 Page 3 of 3
E-FORM 96694 (09/2018)
RBC Direct Investing
®
or RBC Dominion Securities
PAYROLL DEDUCTION AND SPOUSAL ALLOCATION
ROYAL CHOICES
PLAN™
Plan Provider (Please choose one):
RBC Direct Investing
RBC Dominion Securities
Plan Type (Please choose one):
Group RRSP
Non-Registered Group Investment Account
IMPORTANT INFORMATION
This form is used to instruct your
employer to forward contributions
from your pay (including lump sum
contributions) to your plan with RBC
Direct Investing or RBC Dominion
Securities.
A copy of this form MUST be received
by your payroll department at least
2 weeks prior to the date of your rst
contribution.
A separate application form
supplied by your plan provider (RBC
Direct Investing or RBC Dominion
Securities) must be completed in
conjunction with this form.
This form may also be used to (re)
allocate contributions to either or both
a Personal Plan and/or a Spousal
Plan (Group RRSP only).
AGENT AGREEMENT:
I appoint the Plan Sponsor, being my
employer, association, or trade union,
to act as my agent for the purpose of
administration of the Plan including,
without limiting the generality of the
foregoing, delivering my Application
to you, submitting my contributions to
you, delivering my directions to you
with respect to Guaranteed Investment
Certicates and Savings Deposits, and
my directions with respect to mutual
funds or other investments to Royal
Bank of Canada, Royal Mutual Funds
Inc., RBC Direct Investing Inc., and or
RBC Dominion Securities Inc. I further
acknowledge that the Plan Sponsor
may receive reports containing both my
personal information and my investment
details and holdings for all assets held
in my Group Savings Plan account
held at Royal Bank of Canada, Royal
Mutual Funds Inc., RBC Direct Investing
Inc., and or RBC Dominion Securities
Inc., including assets contributed from
personal sources, for the purposes of
administering the Group Savings Plan.
1. SPONSOR / EMPLOYER INFORMATION
Sponsor Name Alpha Code (Mandatory)
Address Group Plan Number (if known)
2. CONTRIBUTOR / EMPLOYEE INFORMATION
Name (First Name, Initial, Last Name) Social Insurance Number
Daytime Telephone Number Ext.
3a. PAYROLL DEDUCTION AUTHORIZATION
I hereby authorize my employer to deduct each pay period:
% of my pay; or $ ; or cents/hour.
3b. LUMP SUM CONTRIBUTION (includes bonus payments and transfers-in)
I am contributing a lump sum of $ (please specify amount).
4. CONTRIBUTION ALLOCATION AUTHORIZATION
Employee Contribution
(EE)
% Personal Account #:
% Spousal RRSP #:
Employer Contribution
(ER)
% Personal Account #:
% Spousal RRSP #:
Note: If only the Employer Contribution portion is restricted, a second Employee
Contribution plan must be opened.
(Please complete the Spousal Information section below if applicable).
5. SPOUSAL INFORMATION (Group RRSP Only)
Only complete this section if all or a portion of your contribution is to be allocated to a
Spousal Plan (as per section 4 above).
Spouse’s Name Spouse’s Social Insurance Number
6. SIGNATURE
Please initiate these instructions with the next payroll cycle. I agree with the terms of the
Agent Agreement on the left side of this form.
Employee Signature Date
Attention RBC Dominion Securities or RBC Direct Investing: A copy of this
signed form must be faxed to the Group Financial Services, Service Centre
at 1-800-263-7777 immediately upon receipt.
RBC Direct Investing Inc., RBC Dominion Securities Inc. and Royal Bank of Canada are separate corporate entities which are aliated. RBC Direct Investing Inc. and RBC
Dominion Securities Inc. are wholly owned subsidiaries of Royal Bank of Canada, are Members of the Investment Industry Regulatory Organization of Canada and the Canadian
Investor Protection Fund. Royal Bank of Canada and certain of its issuers are related to RBC Direct Investing Inc. RBC Direct Investing Inc. does not provide investment advice or
recommendations regarding the purchase or sale of any securities. Investors are responsible for their own investment decisions. RBC Direct Investing is a business name used by
RBC Direct Investing Inc.
®
/™ Trademark(s) of Royal Bank of Canada. RBC and Royal Bank are registered trademarks of Royal Bank of Canada. Used under license. © Royal Bank
of Canada 2018. All rights reserved.
PART 3 – CLIENT COPY
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