22271 (05/2016)
TRANSFER AUTHORIZATION FOR REGISTERED INVESTMENTS
(RSP, LIRA, LRSP, RIF, LRIF, LIF, PRIF, TFSA)
This form can be used for RSP to RSP transfers (except for transfers due to death), RSP to RIF transfers, RIF to RIF transfers, and TFSA to TFSA transfers.
Please note: The data entered on this form may be scanned and stored electronically. Please print neatly in block letters within the spaces provided to ensure
completeness, accuracy and machine readability.
Date (DD/MM/YYYY)
A:
Client
Identication
Last Name First Name Initial
Address
City Prov. Postal Code
Social Insurance Number Home Telephone Number Business Telephone Number
B:
Receiving
Institution
Receiving Institution Name
RBC Global Asset Management Inc.
Contact Name
Attn: Dealer Relations
Address
RBC Investor & Treasury Services
155 Wellington St.W., 3rd Floor
City
Toronto
Prov.
ON
Postal Code
M5V 3L3
Telephone Number
1-800-662-0652 Option 2
Fax Number
1-416-955-5171
C: Dealer
For use by
Mutual Fund
Brokers/Dealers
only
Dealer Name Dealer Code
Dealer Address
City Prov. Postal Code
Rep Name Rep Code
Business Telephone Number Business Fax Number Dealer Account Number Fund Co. Account Number
Registered Type: Investment Instructions:
RRSP
Spousal
RRSP
LIRA
LRSP
TFSA
RRIF
Spousal
RRIF
LRIF
LIF
PRIF
Investment Name Symbol %/$ Amount
D:
Client Direction
to
Relinquishing
Institution
Relinquishing Institution Name
Address
City Prov. Postal Code
Client Account Number
Transfer: (check one box only)
All in cash* All as is (in Kind)
All assets* - but mixed in Cash and as is (in Kind),
see list below or attached list
Partial, as listed below
or on attached list
* Please refer to statement in bold in Client Authorization section D below.
In Kind
In Cash
Investment Amount Symbol and/or Certicate Number
FOR USE BY
RELINQUISHING INSTITUTION
Shares/Unit
Dollars
Investment Description
Delay Delivery Until
D D M M Y Y Y Y
In Kind
In Cash
Investment Amount Symbol and/or Certicate Number
Shares/Unit
Dollars
Investment Description
Delay Delivery Until
D D M M Y Y Y Y
In Kind
In Cash
Investment Amount Symbol and/or Certicate Number
Shares/Unit
Dollars
Investment Description
Delay Delivery Until
D D M M Y Y Y Y
E:
Client
Authorization
I hereby request the transfer of my account and its investments as described above.
WHERE I HAVE REQUESTED A TRANSFER IN CASH, I AUTHORIZE THE LIQUIDATION OF ALL OR PART OF MY INVESTMENTS AND AGREE TO PAY ANY
APPLICABLE FEES, CHARGES OR ADJUSTMENTS.
Signature of Account Holder Date (DD/MM/YYYY) I consent to the transfer of the account.
Signature of Irrevocable Beneciary (if applicable)
Date (DD/MM/YYYY)
D D M M Y Y Y Y D D M M Y Y Y Y
F:
For use By
Relinquishing
Institution Only
Account Type RRSP LIRA LRSP RRIF LRIF LIF PRIF TFSA Qualied Non Qualied
Spousal Plan:
No Yes
Last Name Social Insurance Number
Spouse’s Given Name
Locked-in Funds:
No Yes
$
Governing Legislation
If ‘Yes’, attach Locked-in conrmation
Contact Name
Telephone Number Fax Number
Authorized Signature
Date (DD/MM/YYYY)
D D M M Y Y Y Y
Copy 1 – RBC INVESTOR SERVICES Copy 2 – CLIENT COPY Copy 3 – DEALER
RBC Funds are offered by RBC Global Asset Management Inc. and distributed through authorized dealers. ® Registered trademark of Royal Bank of Canada.
RBC Global Asset Management is a trademark of Royal Bank of Canada. Used under licence. ® RBC Global Asset Management Inc. 2016.
