Tax-Free Savings Account
Designation of Successor Holder
and/or Beneficiary
This form allows you to designate a successor holder or a beneficiary or both in your Tax-Free Savings Account ("Account").
Successor holder: Only your spouse or common-law partner, as defined in the Income Tax Act (Canada), can be a successor holder. In the
event of your death, the name on the Account is changed to the name of the successor holder, who will continue to hold and operate the
Account as their own.
Beneficiary: You can designate a beneficiary in your Account. In the event of your death, the beneficiary will receive the proceeds in the
Account and the Account will be closed if:
1. You have not designated a successor holder, or
2. The designated successor holder was not your spouse or common-law partner at the time of your death or has pre-deceased you.
Important Reminder: Your designation of a successor holder or beneficiary of this Account will not be revoked or changed automatically
by any future marriage, divorce or relationship breakdown. Should you wish to change your successor holder or beneficiary in the event of a
marriage, divorce, relationship breakdown or for any other reason, you will have to do so by means of a new designation. You will need to
complete a new designation that will revoke all previous successor holder and beneficiary designations you have made in the past for the
Account referenced in this form. Therefore, if you have both a successor holder and a beneficiary designation in place for a particular
tax-free savings account, you should complete and sign a new successor holder and beneficiary designation form every time you make a
change to either.
Account Holder's Name:
Title First Name Middle Name Last Name
Tax-Free Savings Account Type: TD Canada Trust Tax-Free Savings Account
TD Mutual Funds Tax-Free Savings Account
TD Waterhouse Tax-Free Savings Account
Branch Number: Account Number:
Your Beneficiary/Successor Holder
(In Quebec, the designation of a beneficiary and/or successor holder can be made only in a will or marriage contract.)
I revoke any prior designation of successor holder and/or beneficiary made by me with respect to the Account.
I designate , my spouse or common-law
Title First Name Middle Name Last Name
partner (if he or she survives me), to become the successor holder of the Account on my death.
I designate the beneficiary or beneficiaries named below to receive the proceeds of the Account on my death, subject to the provisions
of the Account and of applicable law.
Names of Beneficiaries Relationship Percent
If the total does not add up to 100%, the remaining portion will be paid to my estate. Total %
On my death, and if I do not designate a successor holder who survives me, The Canada Trust Company ("Trustee") will, upon receipt of all
documentation which the Trustee may reasonably require, distribute the net proceeds of the Account in accordance with the operative
beneficiary designation, if any. If any designated beneficiary predeceases me, the portion of that beneficiary's entitlement to the net proceeds
will be paid to my estate. If no designated beneficiary survives me, the net proceeds will be paid to my estate. On making any such payment,
the Trustee shall be released from all further obligations under the Account.
Signature of Account Holder Date (mm/dd/yyyy)
For Internal Use Only
Employee ID Transit No.
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