TFSA Application Form - Fidelity

Transcription

This document contains both information and form fields. To read information, use the Down Arrow from a form field.APPLICATION F ORMTax-free savings account

Application for Tax-Free Savings AccountReminder: Use the most up-to-date version of this application. Visit fidelity.ca for the latest available forms.YOUR INVESTMENTPROFESSIONALfor all transactionsTYPE OF ACCOUNTDealer company’s nameDealer codeInvestment professional’s nameRep. codePhone #( ) -New accountNote: All payments out of theaccount will be made to theregistered owner(s).Fidelity account no.HOLDER INFORMATIONYou must be a Canadian resident and 18 years of age or older to contribute to a TFSA.(all information is mandatory)Mr.Mrs.Dealer Cross Reference no.Dr.Ms.MissDate of Birth(dd/mm/yyyy)Last NameFirst NameSINPhone NumberHome:Email addressInitial( ) -( ) -Cell:Street AddressEnglishApt/SuiteCityProvincePostal CodeFrenchSUCCESSOR HOLDERAND/OR BENEFICIARY(IES)INFORMATION(optional) If you wish to designate morethan two beneficiaries, pleaseuse the Beneficiary/SuccessorHolder Designation Form forRegistered Accounts, availableat Fidelity.ca under Advisorresources Forms.PreferredContact #For all provinces and territories except Quebec: The validity of a successor holder/beneficiary designation is subjectto provincial/territorial succession legislation. For the Province of Quebec: Under the laws of Quebec, a designation ofsuccessor holder/beneficiary may be made in a will or other written document that meets the requirements of a testamentarydisposition. The successor holder/beneficiary designation made on this application cannot be given effect and will bedefaulted to the estate.1. Designation of successor holder (for all provinces and territories, except Quebec)In the event of my death, I designate my spouse or common-law partner, by naming them below, to be the successor holder of the Plan. If I have designatedboth successor holder and beneficiary (under Designation of Beneficiary(ies) section below), and both are alive at my death, then the successor holderdesignation takes precedence. The successor holder may, after my death, revoke or change the beneficiary(ies).Last NameFirst NameSIN2. Designation of beneficiary(ies) (for all provinces and territories, except Quebec)If I have designated my spouse as successor holder, the following beneficiary designation will be effective only if my successor holder predeceases me or isnot my spouse or common-law partner on the date of my death. I designate the person(s) named below as the beneficiary(ies) under the Plan, provided thisperson(s) is living at the date of my death. If a beneficiary I have designated below dies before, then that beneficiary’s percentage entitlement will be sharedamong any other beneficiary(ies) I have designated who survive me, in proportion to their percentage entitlement. If I do not designate any beneficiaries,payment will be made to my estate. I reserve the right to revoke this designation. I understand that I must deliver any change to my beneficiary designation toFidelity in writing, in a form acceptable to Fidelity.Last NameFirst NameRelationshipAllocation %Caution: Your successor holder/beneficiary designation will remain unchanged on our records until you make a change by notifying us in writing. You shouldreconsider your successor holder/beneficiary designation if there are changes in your personal circumstances, such as marriage or divorce.INVESTMENT SELECTION Fund codes available atfidelity.ca/fundcodes In the event of a discrepancybetween the code and the name,we will treat the code as correctand process accordingly.Wire Order Purchase (provide wire order # below)Transfer from a non-Fidelity account (attach transfer form)Direct Purchase (attach cheque)Transfer from an existing Fidelity accountNOTE: For One-time PAC requests, use the SYSTEMATIC PURCHASES (PAC) section of this application.Fund CodeFund NameAmount %Sales Charge %(ISC only)Distributions*Wire Order NumberReinvestDeposit For more Fidelity Tax-SmartCashFlow options, use theFidelity Tax-Smart CashFlowforms available at Fidelity.caunder Advisor resources Forms.TOTAL INVESTMENT AMOUNT* For TFSA accounts, you may choose to have distributions reinvested,directly deposited to your bank account. If you choose direct deposit,you will need to attach a personalized void cheque to the applicationform. Please note that for Fidelity Tax-Smart CashFlow series and/or aseries of a fund that pays monthly distributions at a fixed rate, the defaultdistribution option will be cash unless otherwise indicated. If bankinginstructions are not provided, payments will be issued by cheque.FCAN-47480303/21

SYSTEMATIC EXCHANGES Fund code takes priority overfund name. Only available between the sameload option.* The last run date is the actuallast systematic exchange date.SYSTEMATIC PURCHASES(PAC) If your PAC date does not fallon a business day, Fidelity willprocess the PAC on the nextbusiness day. Fund code takes priority overfund name. It may take up to 48 hours forfunds to be withdrawn from yourbank account from the date thePAC is scheduled to run.* The last run date is the last datefunds will be withdrawn fromyour bank account.** The Annual Increase will beapplied to the 1st run date ofeach calendar year.I authorize Fidelity to exchange funds within my Fidelity account as follows:FREQUENCY OPTIONS (choose one)WeeklyStart Date(dd/mm/yyyy)Bi-WeeklyMonthlyLast run date*Twice a MonthEvery 2 MonthsSecond Run Date From Fidelity FundFor twice a monthonly (dd/mm/yyyy) Fund Code Fund NameSemi-annuallyAmount I authorize Fidelity Investments to debit the bank accountindicated on the attached void cheque for the amount(s) and inthe frequencies indicated. If I have elected to increase the amountindicated by specifying a percentage in the column below entitled“Annual Increase (0.00 – 100%)”, I authorize Fidelity Investmentsto increase said amount by the percentage specified unless Iprovide instructions to Fidelity Investments to cancel or amendthe annual increase instructions in accordance with the noticerequirements set out below. If I transfer my account to a differentbranch of the same institution, this authorization will still be valid.Failure to make the payment will not give rise to any liability forFidelity Investments. I may change these instructions or cancelthis plan at any time, provided Fidelity Investments receives atleast 10 business days notice by phone or by mail. I have certainrecourse rights if a debit does not comply with this agreement.Bank Account Holder SignatureQuarterlyTo Fidelity FundUnitsEvery 2 WeeksOne TimePACStart Date(check ifapplicable) (dd/mm/yyyy)Fund CodeJoint Bank Account Holder SignatureMonthlyLast run date*Twice a MonthSecond Run DateFor twice a monthonly (dd/mm/yyyy) Fund CodeEvery 2 MonthsQuarterlySemi-annuallyFund NameAnnuallyAmount ( )TOTAL DOLLAR AMOUNT SYSTEMATIC WITHDRAWALS(SWP) If your SWP date does notfall on a business day, Fidelitywill process the SWP on thepreceding business day. Fund code takes priority overfund name.See Fidelity EFT Policy in Regardsto SWPs on Tips page.* The last run date is the last datefunds will be deposited to yourbank account.** The Annual Increase will beapplied to the 1st run date ofeach calendar year.for PAC, SWP, DWP paymentsAnnual IncreaseISC Sales(0.00 – 100.00%)** Charge %0I authorize Fidelity to make regular withdrawals from my Fidelity account as shown below.FREQUENCY OPTIONS (choose one)WeeklyStart Date(dd/mm/yyyy)Every 2 WeeksMonthlyLast run date*Twice a MonthEvery 2 MonthsQuarterlySecond Run DateFor twice a monthonly (dd/mm/yyyy) Fund Code Fund NameSemi-annuallyAnnuallyAmount ( )Attach a void chequeGrossAnnual Increasefor the direct deposit ofNet(0.00 – 100.00%)** your payment to yourbank account.Direct deposit may takeup to 48 hours to poston your bank account.TOTAL DOLLAR AMOUNT BANKING INFORMATIONFund NameFor example, I have the right to receive reimbursement for anydebit that is not authorized or is not consistent with this preauthorized debit agreement (PAD).(To obtain more information on recourse rights and/or a sampleof a cancellation form, or more information on your right tocancel a PAD Agreement, contact your financial institution or visitwww.cdnpay.ca.) By Canadian Payment Association definition, if thisis for your own personal investment, your debit will be considered aPersonal PAD. If this is for business purposes, it will be considereda Business PAD. By signing this form, I hereby waive any prenotification requirements as specified by section 15(a) and (b) ofthe Canadian Payments Association Rule H1 with regards to preauthorized debits. I confirm that all persons whose signatures arerequired to authorize transactions in the bank account, as per theattached void cheque, have signed this agreement below.FREQUENCY OPTIONS (choose one)WeeklyAnnually0ATTACH YOUR BANKING INFORMATION TO THIS APPLICATION FORM.Fidelity EFT Policy: To help protect our investors, Fidelity Investments requires one of the following: A copy of a personalized void cheque with client name and Online Bank Form, with or without void cheque image, with clientbanking information pre-printed/embossed on the cheque.name and bank account details. Bank stamp and signature mustCounter cheques will not be accepted.be provided if indicated on the Online Bank Form. A letter from a recognized Canadian Bank or Credit Union issued 10 business days are required before the start date to set up oron an official bank form or letterhead, with client name and bankchange a PAC or SWP plan.account details. Bank stamp and signature must be provided ifNOTE: Payments can only be made payable to the beneficialindicated on the bank form or letterhead.owner/client name(s) on the Fidelity account.FIDELITY CONFIDENTIAL INFORMATIONFCAN-47480303/21

Application for Tax-Free Savings AccounteDELIVERYAn eDelivery notification will be sentto the email addresses provided inthe “Account holder information”section of the application form. Youmust provide Fidelity a valid emailaddresses and notify Fidelity of anyfuture changes to the email addresses.Register my account(s) for eDeliveryConfirmation, Statements, Tax slips/receipts and Annual regulatory noticeIf you selected Online delivery of your account documents, please check the box below to accept the terms and conditions.Please read the eDelivery agreement below.Fidelity Investments Application form eDelivery Terms and ConditionsI/we acknowledge the following: By selecting “Online” delivery for my Confirmations, Statements, Taxslips/receipts and Annual regulatory notice (“Account Documents”),I/we am/are consenting to receiving electronic notification whenthe Account Documents are available online through the Fidelitywebsite (eDelivery). If enrolled in eDelivery, I/we understand it is my/our responsibility to access and view these documents when theybecome available at fidelity.ca/investorlogin; I/we understand that once enrolled for eDelivery, I/we am/areconsenting to have Account Documents for all accounts associatedwith my/our Fidelity user ID delivered according to the preferencesI/we have selected; I/we am/are responsible for providing Fidelity with a validemail address; I/we understand that I/we will need to register for My Accountsat fidelity.ca/investorlogin in order to access and retrieve theAccount Documents; I/we am/are required to have internet access, an internetbrowser, and an appropriate version of Adobe Acrobat Readerin order to retrieve, view, save and monitor the availability ofthe Account Documents; If the email address I/we provide is different from an existingemail address on My Accounts, Fidelity will update My Accountswith the email address I/we have entered on this application form; By consenting to this service I/we understand that I/we will notreceive the Account Documents by mail; “Statements” refers to any account statement, including butnot limited to, enhanced account and performance reporting,where applicable; I/we acknowledge that printed copies of the Account Documentswill be sent to me/us by mail if delivery of the email notificationfails; and I/we can revoke my/our consent at any time by contacting Fidelity,and Fidelity will send the Account Documents by mail.For more on how Fidelity uses your personal information,please read our privacy policy.Email address:I/we have read, understood and accept the eDelivery agreementPRIVACY PROTECTIONNOTICEI consent and agree to Fidelity collecting personal information,including my name, address, telephone number, social insurancenumber, date of birth and account holdings (the “Information”),from me or from other sources such as my Dealer or other financialinstitutions, and from third parties who represent that they havethe right to disclose the Information, and using such Information to:administer my account; provide my Dealer and me with transactionconfirmations, statements, tax receipts, or other information orservices my Dealer or I request; process pre-authorized debittransactions; and as otherwise required or permitted by law.Fidelity may disclose the Information to its employees, agents andthird parties who are bound to maintain its confidentiality (includingmy Dealer, third party service providers, other financial institutionsand any governmental authority) as necessary to administer myaccount or as required by law, including to comply with requestsYOUR SIGNATUREfor all transactionsI acknowledge that I have received a copy of the current fund factsof the fund(s) selected and understand that these transactions aremade under the terms and conditions therein. I understand thatmutual funds are not insured under the Canada Deposit InsuranceCorporation Act or la Régie de l’assurance-dépôts du Québec. Icertify that the information provided by me on this application iscomplete and true in all respects. I request that this application andall documentation relating to my account or Plan be provided to mein English. Je vous prie de me faire parvenir la présente demandeainsi que toute la documentation afférente à mon compte ou à monRégime en anglais.for information from regulatory bodies and for income tax reportingpurposes. If a service provider is located in a jurisdiction outside ofCanada, it is bound by, and the Information may be disclosed inaccordance with, the laws of that jurisdiction.If I provide personal information about another individual (such as myspouse or beneficiary), I will have first obtained appropriate consentfrom that individual to the collection, use and disclosure of theirpersonal information in the course of the administration of my account,including the purposes described above.I may obtain access to the Information at any time from Fidelityand review its content and accuracy, and have it amended asappropriate; however, access may be restricted in accordance withapplicable law.For more information please see Fidelity’s Privacy Policy atfidelity.ca.TO: Computershare Trust Company of Canada (The “Trustee”) – Irequest Computershare Trust Company of Canada to act as Trusteeof my Fidelity Investments Tax Free Savings Account (the “Plan”) andto file an election with the Minister of National Revenue to registermy qualifying arrangement under section 146.2 of the Income Tax Act(Canada). I acknowledge and agree to be bound by the terms andconditions set out in the Declaration of Trust set forth on the reverseside hereof, as amended from time to time. I acknowledge that I amsolely responsible for determining the amount of contributions to thePlan. I understand that I am responsible for notifying the Trustee whenI become a non-resident for Canadian tax purposes. I acknowledgethat I am solely responsible and liable for certain tax consequencesarising in connection with the Plan being non-compliant with theIncome Tax Act provisions.Accepted by Fidelity Investments Canada ULC, as agent for Computershare Trust Company of Canada, Trustee.Date (dd/mm/yyyy)00/000/0000Visit us online at fidelity.caor call Fidelity Client Services at1 800 263-4077or fax us at 1 800 387-8092Your Signature/ Holder’s SignatureAuthorized SignatureXXFidelity Investments Canada ULC483 Bay Street, Suite 300Toronto, Ontario M5G 2N7 Fidelity Investments is a registered trademark of Fidelity Investments Canada ULC.FCAN-47480303/2163.108359E

Application for Tax-Free Savings AccountTips for completing this formPlease print all information clearly.Complete the Holder information sectioncompletely and carefully.PAC plan applicationTo apply for a PAC plan, please attach avoid personalized cheque.The application cannot be processed without it.The Holder needs to sign the formAttach all required documents to Fidelity’s copy,including cheques.The Holder’s signature in the section calledYour Signature applies to all informationprovided on the form.When completing any investment selection Copy the fund code carefully from fidelity.caSend or fax the signed form withthe initial payment to Fidelity at Abbreviate the fund name, eliminating the words “Fidelity”483 Bay Street, Suite 300Toronto ON M5G 2N7and “Fund.” For example, to choose the Fidelity CanadianGrowth Company Fund, simply print “Canadian GrowthCompany” or “Cdn Growth Co.” We use this name toverify the code you have written. If there is a discrepancybetween the fund code and the fund name indicated, wewill assume the fund code is correct.Fax us at 1 800 387-8092The Holder gets the second copy, and theinvestment professional gets the last copy. Check one box to show whether you are using dollaramounts or percentages. Indicate how you would like your distributions – reinvestedor deposited directly into your bank account. If you choosedirect deposit, you will need to attach a void cheque tothe form.Fidelity EFT Policy in regards to SWPs: To help protect ourinvestors, Fidelity Investments requires one of the following: A copy of a personalized void cheque with client name andbanking information pre-printed/embossed on the cheque.Counter cheques will not be accepted. A letter from a recognized Canadian Bank or CreditUnion issued on an official bank form or letterhead, withclient name and bank account details. Bank stamp andsignature must be provided if indicated on the bank formor letterhead. An Online Bank Form, with or without void cheque image,with client name and bank account details. Bank stampand signature must be provided if indicated on the OnlineBank Form.Note: SWP payments can only be made payable to thebeneficial owner/client names on the Fidelity account. Fidelity Investments is a registered trademark of Fidelity Investments Canada ULC.FCAN-47480303/21

FI D EL I T Y I N V ES T MEN T STA X- F REE S AV I N G S A CCO U N TD ECL A RAT I O N O F T RU S TWe, Computershare Trust Company of Canada, a trust company incorporatedunder the laws of Canada and having an office in the City of Toronto in theProvince of Ontario, hereby declare that we accept the office of trustee foryou, the accountholder named on the application form accompanying thisdeclaration (the “Application”) under the Fidelity Investments Tax-FreeSavings Account (the “Account”) on the following terms and conditions. Youacknowledge that we have retained Fidelity Investments Canada ULC (the“Agent”) as our agent to perform on our behalf certain of our duties andresponsibilities under this declaration.1.COMPLIANCE: The Account will at all times comply with all relevantprovisions of the Act and any applicable provincial or territorial legislationwith respect to TFSAs. You will be bound by the terms and conditionsimposed on the Account by all applicable legislation.2.REGISTRATION AND MINIMUM AGE: We will submit the Accountfor registration in accordance with the Act. At the time of opening theAccount, you represent that you have attained at least 18 years of age.We will maintain the account for your exclusive benefit and in your name.3.DEALER: In this declaration, a “Dealer” means the person or entity acting(or representing that it acts) as or on behalf of your investment advisor,broker or dealer in connection with the Account. You acknowledge thata Dealer is your agent and not our agent. We are entitled to accept andact on any notice, authorization or other communication that we believein good faith to be given by you or Dealer on your behalf. Any referencein this declaration to your instructions or requests includes instructions orrequests from your Dealer on your behalf. We are under no obligationto verify that a Dealer is properly authorized to act as your agent or isotherwise authorized to act on your behalf.4.CONTRIBUTIONS: Only you may make contributions to the Account. Atour sole discretion, we may accept or reject all or part of a contributionfrom any source permitted by the Act.5.INVESTMENTS: We will invest contributions to your Account in theinvestments selected by you at the then current offering price nextdetermined following the receipt of the contribution. In making yourinvestment selection, you may select securities of mutual funds managedby the Agent or other investments acceptable to the Agent in its solediscretion. In making investments for your Account, we will not be limitedto investments authorized by legislation governing the investment ofproperty held in trust. Cash distributions received by us in respectof investments held in your Account will be re-invested in additionalinvestments of the same type. In the absence of satisfactory investmentinstructions, we may invest cash in units of a money market fund managedby the Agent. We will hold the assets of the Account in trust, and willcustody such assets through the Agent or custodians appointed by theAgent. Only we and you shall have rights under the Account relating tothe amount and timing of distributions and investing of contributions.6.YOUR RESPONSIBILITIES: You acknowledge and assume responsibility forthe following:(a) assessing the appropriateness of any investment, selectinginvestments for your Account, obtaining appropriate advice, orauthorizing a Dealer to any of these things for you;(b) ensuring that contributions to your Account do not exceed themaximum contribution limits permitted under the Act and that you donot make contributions while you are a non-resident of Canada; and(c) ensuring that your Account’s contributions and investments complywith the rules under the Act or any other applicable legislation,including that any security held in your Account is a qualifiedinvestment for the Account under the Act and is not a “prohibitedinvestment” for the Account under the Act.We will not be responsible for any tax payable in respect of non-qualifiedinvestments, excess contributions or payments from your Account, orfor loss resulting from the sale or other disposition of securities of yourAccount.7.NON-QUALIFIED INVESTMENTS AND PROHIBITED INVESTMENTS:If the Account becomes liable for tax, interest, or penalties under theAct or similar provincial legislation, you authorize us to redeem sufficientassets of your Account to pay the liability and we will not be liable for anyresulting loss. We will exercise the care, diligence and skill of a reasonablyprudent person to minimize the possibility that the Account holds a nonqualified investment. Other than as set out in this declaration, we will notbe liable for ascertaining whether any investment made on your directionis or remains a qualified investment for TFSAs under the Act. Subject toSection 22, we will not be liable for any tax payable in respect of anynon-qualified investment or prohibited investment directed by you ormade or held in the trust established hereunder. We will not otherwise beliable for the making, retention or sale of any investment or reinvestmentas herein provided or for any loss or diminution of the assets comprisingthe Account.8.WITHDRAWALS: Following receipt of satisfactory instructions from you(or your legal representative) or your Dealer on your behalf, we will paydistributions to you from your Account for any purpose, including refundsmade in order to reduce the amount of tax otherwise payable by you asa result of excess contributions made contrary to the Act. We will not beresponsible for determining the amount of any such refund. If the valueof your Account is less than 500, we may make a payment to you fromyour Account equal to the value of your Account. We may, in our solediscretion, sell any of the assets in the Account in order to make theforegoing payments and we will not be responsible for any resulting loss.9.TRANSFERS: We will accept transfers to the Account from any sourcespermitted by the Act, including a transfer to the Account from anotherTFSA held by you or from a TFSA of your spouse or former spouse wherethe transfer relates to a division of property arising from a breakdown ofthe relationship in accordance with the Act. You may direct us to transfer allor part of the assets of your Account to the issuer of another TFSA held byyou. Upon receipt of satisfactory written directions from you or your Dealerand subject to the conditions imposed by this declaration, the Act, andapplicable provincial legislation, we will transfer the assets of the Accountrequested to be transferred, together with all the necessary informationfor the continuance of the Account, to the issuer of the recipient Account.You or your Dealer may instruct us to sell or transfer specific securities toeffect the transfer. If you or your Dealer fail to provide us with satisfactoryinstructions, we may sell or transfer the securities we deem appropriate, inour sole discretion, to effect the transfer. If we receive instructions to transfersome of the assets of your Account, we may request instructions to transferall of the assets of your Account and we may delay the transfer until we havereceived the instructions.10. RELATIONSHIP BREAKDOWN AND PAYMENTS INTO COURT ANDTO THIRD PARTIES: To the extent and in the manner permitted byapplicable law, we will make a payment or payments out of your Accountto effect a division of property, provided such payment is made pursuantto decree, order, or judgment of a competent tribunal or under a writtenseparation agreement in the settlement of rights arising out of or on thebreakdown of your marriage or other conjugal relationshipIf there is a dispute about:(a) the validity of enforceability of any legal demand or claim against theassets of the Account; or(b) the authority of a person or personal representative to apply for andaccept receipt of the proceeds payable under the Account on yourdeath,we and the Agent are entitled to either apply to a court for directions or paythe disputed amounts into court and, in either case, fully recover any legalcosts that either one incurs in this regard as expenses from the account.Where required by law, we and the Agent are entitled to make paymentsout of your Account to third parties without your prior authorization.11. SUCCESSOR HOLDER AND BENEFICIARY DESIGNATION: If you aredomiciled in a jurisdiction that by law permits you to validly designatea beneficiary other than by will, you may designate: (i) your spouse assuccessor holder of your Account; or (ii) one or more beneficiaries toreceive the assets of your Account in the event of your death. You mustmake, amend, or revoke the designation by way of written notice in aform acceptable to us and delivered to us. Any designation, amendment,or revocation will be valid only from the day following its receipt by us.FCAN-47480303/21

FI D EL I T Y I N V ES T MEN T STA X- FREE S AV I N G S A CCO U N TDECL A RAT I O N O F T RU S T12. PAYMENTS UPON YOUR DEATH: Upon receipt of satisfactory evidenceof your death, we will continue to hold the assets of your Account for yourspouse provided he or she is the successor holder of your Account. If yourspouse becomes the successor holder of your Account, he or she will bedeemed to be the holder of your Account with the same rights as if he or shehad been the original holder and all references to “you” in this declarationwill be deemed to refer to him or her. If your spouse is not the successorholder, we will hold the assets of your Account for payment in a lump sumto your designated beneficiary. If you have not designated a beneficiary orif the designated beneficiary predeceases you, the payment will be made toyour legal representatives or as required by law. The payment will be madesubject to the deduction of all proper charges, including tax required to bewithheld, after we receive the releases and other documents that we requirein our sole discretion.13. PROHIBITION: No advantage that is conditional on the existence of theAccount may be extended to you or to a person not dealing at arm’s lengthwith you, other than those advantages permitted under the Act and underany applicable provincial legislation. We reserve the right to prohibit anytransaction, investment, payment or transfer that is or may be prohibited orpenalized under the Act.14. SECURITY FOR A LOAN: If you use your interest in the Account assecurity for a loan or other indebtedness, then you will be responsible forensuring that the terms and conditions of the loan or other indebtednessare terms and conditions that persons dealing at arm’s length with eachother would have entered into, and it can be reasonably concluded thatnone of the main purpose for that use is to enable a person, other thanyou, or a partnership to benefit from the exemption for tax of any amountunder the Account.15. LOANS: We are prohibited from borrowing money or other property forthe purposes of the Account.16. PROOF OF AGE AND SOCIAL INSURANCE NUMBER: The statementof your age and social insurance number on the Application is deemed tobe a certification thereof and an undertaking by you to provide evidenceor proof thereof if requested by us.17. YOUR ACCOUNT: We will maintain an account for your exclusive benefitand in your name w

Wire Order Purchase (provide wire order # below) Transfer from a non-Fidelity account (attach transfer form) Direct Purchase (attach cheque) Transfer from an existing Fidelity account . Reminder: Use the most up-to-date version of this application. Visit . fidelity.ca. for the latest available forms. FCAN-474803 03/21. Fund Code