For LIF governed by AB, ON and MB Plan value on January 1: $___________________ Transfers out in current year: $___________________
& LRIF governed by NL and ON
Transfers in current year: $___________________ Income payments in current year: $___________________
Current year’s investment earnings: $___________________
Original (creation) date of plan (LRIF only): _______________
Date (DD/MM/YY)
( )
( )
Contact Name Telephone Number Fax Number
Authorized Signature Date (DD/MM/YY)
Receiving Institution Name Contact Name
( )
Address Telephone Number
( )
City Province Postal Code Fax Number
Group Plan Number (if applicable)
Client Account/Policy Number
A:
Client
Identification
B:
Receiving
Institution
Information
For use by
Mutual Fund
Brokers/Dealers
only
Mackenzie Financial Corporation, as agent for B2B Trustco, agrees to administer all locked-in funds transferred under this transfer
authorization in accordance with the governing pension legislation indicated in Section E below. Any subsequent transfer of these locked-
in funds to another trustee or financial institution will be made only to another registered plan, which will continue to be administered in
accordance with the requirements indicated below. No transfer of locked-in funds will be permitted unless the receiving plan is
appropriately registered and in compliance with the applicable pension legislation, regulations and the
Income Tax Act (Canada)
.
Relinquishing Institution Name Group Plan Number (if applicable)
Address Client Account/Policy Number
City Province Postal Code
Transfer: (check one box only for asset transfer instructions and an additional box if asset list is attached)
All in kind (as is) Cash balance only as at date of transfer by Relinquishing Institution Partial*; see list below or check here if list attached
All in cash* All assets*, but mixed in cash and in kind; see list below or check here if list attached
*Please refer to statement in bold in Client Authorization section below.
C:
Client Direction
to Relinquishing
Institution
Locked-In
Confirmation
Dealer Name Dealer Number Dealer Account Number
( )
( )
Agent Name Agent Number Business Telephone Number Business Fax Number
Investment Instructions:
Investment Name Symbol % / $ Amount
RRSP
Spousal RRSP
LRSP
RLSP
RRIF
Spousal RRIF
LRIF
PRIF
LIRA
LIF
RLIF
TFSA
Non-Registered
Account Type:
Investment Amount Symbol and/or Certificate Number or Policy No Investment Description
In Kind In Cash
Shares/Units Dollars
In Kind In Cash
Shares/Units Dollars
D:
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/YY) Signature of Irrevocable Beneficiary/Former Spouse (if applicable) Date (DD/MM/YY)
Account/Policy Holder Last Name or Non-Personal Name First Name Initial(s)
Joint Account/In Trust For/Policy Last Name, Joint Holder/In Trust For First Name, Social Insurance Number (SIN)
(
)
Address Home Telephone Number
( )
City Province Postal Code Business Telephone Number
Social Insurance Number (SIN)
MACKENZIE FINANCIAL CORPORATION (as Agents for B2B Trustco)
180 QUEEN STREET WEST
TORONTO ONTARIO M5V 3K1
CLIENT RELATIONS DEPARTMENT
800 387-0614
866 766-6623
E:
For Use By
Relinquishing
Institution Only
Account Type: RRSP LIRA LRSP RRIF Qualified Non-qualified PRIF RLIF RLSP LRIF
LIF Federal LIF Old LIF New LIF TFSA
Non-Registered Plans Non Registered Investment Account Non Registered Joint Investments Account
Spousal Plan: No Yes If Yes:
Locked-In: No Yes If yes, locked-in confirmation attached Locked-in funds: $ ____________________ Governing legislation ____________________
The default is “unisex;” if sex-distinct For Plans governed by Manitoba PBA, if Death Benefit waiver attached
If spouse waiver/consent form attached Assets derived from a PRPP
For LIF governed by Manitoba PBA: Is the transferor aware of a one-time transfer under section 21.4 of the Manitoba PBA: No Yes
Last Name First Name Initial
Social Insurance Number
Authorized B2B Trustco
Signing Officer/Agent
FM1307 1515703 03/21
TRANSFER AUTHORIZATION FOR REGISTERED & NON-REGISTERED ACCOUNTS
(RRSP, LIRA, LRSP, RRIF, LRIF, LIF, RLIF, RLSP, PRIF, TFSA, NON-REGISTERED)
• This form can be used for transferring the registered plans listed above except
u RRIF to RRSP transfers, v RRIF or RRSP to TFSA transfers, w TFSA to RRIF or RRSP transfers, x transfers due to death and y transfers due to marital breakdowns.
• Data entered on this form may be scanned and stored electronically. Please print neatly to ensure completeness, accuracy and machine-readability.
Signature of Joint Subscriber (if applicable) Date (DD/MM/YY)
Management company
code : MFC
click to sign
signature
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click to sign
signature
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click to sign
signature
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click to sign
signature
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