How to Complete Yo u r R S P A p p l i c a t i o n How to complete your Phillips, Hager & North RSP Plan & Account Application Applicant Information RSP Retirement Sav ings Plan Please complete all applicable sections of this application. If sections are left blank, Phillips, Hager & North will not be able to process your application. A 1 YOUR INFORMATION AS APPLICANT If you already have an account with us, please indicate the account number. If your company retirement plan is with us, please indicate the company name. Account number Company name 2 Full name (first, middle, last) Mr Mrs Ms Date of bir th (yyyy/mm/dd) Dr Social Insurance Number I I Mailing address (number, street, apar tment or suite number) City or town Province Postal code Work telephone number Home telephone number Email address ( ( B 3 ) Plan Information I Please select the type of Retirement Savings Plan you would like to open. If you would like to open more than one account, please complete a separate application for each new account. Applications may be found at www.phn.com. Beneficiary* Locked-in Account Name of contributing spouse* or common-law partner* (first, middle initial, last) I I I I I I I PH&N USE ONLY Jurisdiction: Please specify the jurisdiction that governs the pension plan from which the funds originated. Date of Birth (yyyy/mm/dd) Mr Mrs Ms Dr Relationship to you Social Insurance Number Province Postal code I Mailing address if dif ferent than yours (number, street, apar tment or suite number) City or town Work telephone number Home telephone number ( ( ) I I I I I I I Date of bir th (yyyy/mm/dd) or ) Your estate RETIREMENT SAVINGS PLAN ACCOUNT APPLICATION Securities regulators require us to obtain the following information before opening this account. These questions will help us develop a sense of your financial situation. Please indicate only one choice for each question. Your investment objective for Your investment experience Your investment knowledge Your estimated investment this account (see Investment time horizon for money in Stocks Excellent Objective on page 4) this account Bonds Good Growth Mutual Funds Fair Under 3 years Balanced None Limited 3 – 10 years Income More than 10 years Account Objectives and Investor Profile Your risk tolerance for this account (see Risk Tolerance on page 4) High Medium Low Your approximate annual income $0 – $24,999 $25,000 – $49,999 $50,000 – $74,999 $75,000 – $99,999 $100,000+ 2. Enter your information, as applicant. Your Social Insurance Number (SIN) is required for a registered plan. I Designation of a Beneficiary may not be permitted by law in some provinces. This designation cancels any previous Beneficiary designations. If you wish to name multiple Beneficiaries or Contingent Beneficiaries, please complete the appropriate Beneficiary Designation form, which may be found at www.phn.com.. Name (first, middle initial, last) 5 I I ) Spousal Retirement Savings Plan (Spousal RSP) Spouse’s or common-law partner’s SIN C I RETIREMENT SAVINGS PLAN APPLICATION Retirement Savings Plan (RSP) 4 I I 1. This information will help us connect your existing investments to this account. Your approximate net worth $0 – $49,999 $50,000 – $99,999 $100,000 – $199,999 $200,000 – $499,999 $500,000 – $999,999 $1,000,000+ Your occupation or nature of business Have you borrowed money to make this investment? (see Leveraged Investing on page 4) Yes No 1 | Phillips, Hager & North’s Copy *As defined in the Declaration of Trust. 4. Appoint a beneficiary or select “Your Estate.” We require a birthdate and, if available, a SIN for your beneficiary. You must ensure that your beneficiary is permitted by the province that governs your plan. Retirement Savings Plan Account Application 5. This information enables us to ensure that your investment activity matches your long-term objectives. You must complete this section in its entirety to open the RSP. Retirement Savings Plan Application 3. Select your Plan type. • For a Spousal RSP, enter the contributing spouse’s information. • For a locked-in plan, enter the jurisdiction of the plan (i.e., is your plan governed federally, or by a specific province). 6 Fund Selection Select the fund or funds in which the Plan is to invest. Please indicate a dollar amount or a percentage. The minimum total investment is $25,000. Fund Amount or Percent Fund # Canadian Money Market Fund $ % 120 $U.S. Money Market Fund† $ % 500 Short Term Bond & Mortgage Fund $ % 250 Bond Fund $ % 110 Total Return Bond Fund $ % 340 High Yield Bond Fund $ % 280 Balanced Fund $ % 350 Canadian Income Fund $ % 490 Dividend Income Fund $ % 7 Initial Deposit Cheque, made payable to State Street Trust Company Canada Amount $ Electronic Funds Transfer from an account with a Canadian financial institution. Please attach a blank cheque marked void. Amount $ 150 U.S. Dividend Income Fund $ % 460 Canadian Equity Fund $ % 130 U.S. Equity Fund $ % 160 Please indicate how the total in Section 6 will be deposited. Transfer from another institution (please complete the Transfer Form for Registered Investments). Transfer from your Phillips, Hager & North investment account. Account number Amount Overseas Equity Fund $ % 410 Global Equity RSP Fund $ % 330 Global Equity Fund $ % 370 Name of PH&N fund(s) to use as source Canadian Growth Fund $ % 140 1. % U.S. Growth Fund $ % 260 Community Values Bond Fund $ % 610 2. % Community Values Balanced Fund $ % 640 3. % Community Values Canadian Equity Fund $ % 620 4. % Community Values Global Equity Fund $ % 630 $ 100% Total † In U.S. dollars. 8 Automatic Transactions $ Percent Please select the option or options you would like to arrange. The minimum total investment for each automatic transaction is $100.00. The $U.S. Money Market Fund is not available for these options. Automatic Purchases of PH&N funds from your bank account (also known as Pre-Authorized Chequing). Please attach a blank cheque marked void if you did not provide one in Section 7. If these purchases are for a Spousal RSP, the contributing spouse or common-law partner must sign below to authorize automatic purchases. Start date (yyyy/mm/dd) End date, if applicable (yyyy/mm/dd) Signature of spouse or common-law partner (if applicable) Automatic Transfers within your PH&N account (also known as Dollar Cost Averaging). Transfer from (name of fund) Start date (yyyy/mm/dd) Frequency: D End date, if applicable (yyyy/mm/dd) Biweekly Monthly Semi-annually Semi-monthly Quarterly Annually Frequency: Biweekly Monthly Semi-annually Semi-monthly Quarterly Annually Name of fund Amount 1. $ 2. $ 3. $ 4. $ Transfer to (name of fund) Amount 1. $ 2. $ 3. $ 4. $ When fund residual is less than full payment, invest in: Name of PH&N fund OTHER INFORMATION 9 Dealer Information (if applicable) Dealer name 10 Duplicate Mailings Dealer # Rep # Our clients receive mailings, such as quarterly reports, for each of their accounts. If your household has more than one account, you can reduce the number of mailings you receive by completing a Duplicate Mailing form, which may be found at www.phn.com. 11 Telephone & Internet Access If you have telephone transactions and/or Internet viewing access for other PH&N accounts and would like to have this new account included in your existing access, please initial here: Your initials If you are not registered for telephone transactions and/or Internet viewing access with PH&N and would like to arrange for this service, please complete a Telephone Transactions and/or Internet Access Agreement, which may be found at www.phn.com. 2 | 9. If you are setting up the RSP through another dealer, please have the dealer complete this section. 10. If more than one member of your household holds an account with PH&N, complete our Duplicate Mailing form to reduce the number of mailings you receive. 11. To view your account activity online, or to request transactions by telephone, complete our Telephone Transactions and/or Internet Access Agreement. 6. Select the fund allocation for your initial deposit. 7. Indicate the source of the funds for your initial deposit. If you are paying by cheque, ensure it is made payable to State Street Trust Company Canada. 8. For additional information, see the box to the lower right • For an Automatic Purchase plan, ensure you provide appropriate banking information. For contributions to a spousal account, the contributing spouse’s signature is required. • For an Automatic Transfer plan, ensure you indicate a fund allocation for any residual amount. E SIGNATURE 12 Your Signature as RSP Planholder and PH&NIF Account Holder By signing here, you confirm that you have read, understand and agree to the following: for the Plan, the terms and conditions as set out in the Retirement Savings Plan Application, the Planholder Agreement, the Declaration of Trust, and any relevant addendum to the Plan; for the Account, the terms and conditions as set out in the Retirement Savings Plan Account Application, the Client Agreement, the disclosure on Leveraged Investing, and our Ten Privacy Principles. You also confirm that you request State Street Trust Company Canada to apply for registration of the Plan as an RSP under the Income Tax Act (Canada). Your signature Date (yyyy/mm/dd) FOR PH&N USE ONLY PH&NIF registered representative Number Date (yyyy/mm/dd) PH&NIM Client Services representative as agent for State Street Trust Company Canada Number Date (yyyy/mm/dd) INSTRUCTIONS Account number Manager code PLANHOLDER AGREEMENT “Phillips, Hager & North” is a registered trade name for Phillips, Hager & North Investment Management Ltd. (“PH&NIM”) and its wholly-owned subsidiary Phillips, Hager & North Investment Funds Ltd. (“PH&NIF”). PH&NIM is the Manager of the Phillips, Hager & North investment funds; the Portfolio Manager for discretionary investment accounts; the Administrator of the Phillips, Hager & North Investment Management Ltd. Multiple Retirement Savings Plans (“PH&N Multiple RSP”) and agent for the trustee. PH&NIF is a Mutual Fund Dealer through which all selfmanaged investment accounts are maintained. Unless otherwise indicated, throughout this document and in our other RSP documents, the words you and your refer to the annuitant (“the planholder”) under the PH&N Multiple RSP and the account holder of the RSP Account. We, us and our refer to PH&NIM, PH&NIF and/or Phillips, Hager & North (PH&N). Applicant Information (Part A) Please complete all sections under Applicant Information if you wish to open a PH&N Multiple RSP. When you sign this Retirement Savings Plan Application (in Part E for Part B), you confirm that you understand and agree that: • You are applying to become an annuitant under the Phillips, Hager & North Investment Management Ltd. Multiple Retirement Savings Plan (“the PH&N Multiple RSP”). You have read and agree to the terms and conditions of the enclosed Declaration of Trust. This PH&N Multiple RSP application (“the Application”), the Declaration of Trust and any applicable locking-in addendum constitute “the Plan” and may be referred to herein as “your Plan” or “your RSP”. You instruct State Street Trust Company Canada to apply for registration of your Plan as a retirement savings plan under the Income Tax Act (Canada) (the Act) and any applicable provincial income tax legislation. • You have read a copy of the Simplified Prospectus for the Phillips, Hager & North investment funds. You understand that the funds available for investment under the Plan are managed by Phillips, Hager & North Investment Management Ltd. and that the trustee is not responsible for the management or investment performance of such funds. Retirement Savings Plan Application (Part B) By completing this Retirement Savings Plan Application, you are applying to become an annuitant under the PH&N Multiple RSP. Please complete one Retirement Savings Plan Application for each Plan you would like to establish. • You are the only person who can give us instructions in connection with your RSP or receive information about your RSP unless you advise us otherwise. RSP Account Application (Part C) By completing this RSP Account Application, you are applying to establish an investment account with PH&NIF to which contributions to your RSP will be made. • You understand that any payments from your RSP are taxable income under the Act. If you need help completing this Application, please contact Phillips, Hager & North at 1-800-661-6141. Once you have completed this document, please return the top copy to us in the enclosed postage paid return envelope, and send to: Phillips, Hager & North Vancouver or P.O. Box 7600, Station Terminal Vancouver, BC V6B 9Z9 Toronto P.O. Box 14215, Station BRM B Toronto, ON M7Y 2S1 • You request that all documents and material delivered to you in connection with your RSP be written in English. Vous avez demandé que tous les documents qui vous sont remis pour ce compte soient en anglais. • You are responsible for calculating your allowable annual contribution that can be deducted for income tax purposes unless this responsibility has been formally delegated to your Portfolio Manager under a discretionary management agreement. • If your RSP is locked-in, you have read and agree to the terms and conditions of the applicable Locked-in Addendum. If information within the Locked-in Addendum and Declaration of Trust conflicts, the Locked-in Addendum has priority over the Declaration of Trust. • You can determine the applicable legislation that governs your RSP by contacting the employer that the RSP originated from or by contacting the institution that currently holds the RSP. 3 | Consider Automatic Transactions • An Automatic Purchase Plan (also known as a Pre-authorized Contribution Plan or PAC) is a method for making ongoing contributions to your RSP. Regular contributions to your account give you the advantages of investing regularly in up and down markets, while compounding interest. They also relieve the strain of making a lump-sum payment. • An Automatic Transfer Plan (also known as Dollar-Cost Averaging or DCA) will enable you to gradually switch units from one fund to another over a period of time. Automatic transfers are used to smooth out the effects of fluctuating markets. 12. By signing here, you confirm that you have read and understand the terms and conditions of both the Plan and the Account, as set forth on the back of the second layer of the application. Before you send in your RSP application, please ensure you have: Completed your Account Objectives & Investor Profile (Section 5) Provided fund allocations (Section 6) Provided directions for your initial deposit (Section 7) A ttached a completed Transfer Form for Registered Investments, if required M ade your cheque payable to State Street Trust Company Canada, if required A ttached a void cheque providing correct banking information (Sections 7 and 8), if required A ttached a completed Telephone Transactions and/or Internet Access Agreement, or added this account to existing access (Section 11) Signed the application form (Section 12) We’re here to assist you If you would like help completing your RSP Plan and Account Application, we invite you to contact us. Call us at 1-800-661-6141 or send us your questions by email to [email protected]. Publication date: February 20, 2006 VANCOUVER Waterfront Centre 20th Floor 200 Burrard Street Vancouver, British Columbia Canada V6C 3N5 VICTORIA St. Andrew’s Square I Suite 312 737 Yates Street Victoria, British Columbia Canada V8W 1L6 CALGARY Bankers Hall West Tower Suite 4430 888 - 3rd Street S.W. Calgary, Alberta Canada T2P 5C5 TORONTO Suite 2320 1 Adelaide Street East Box 207 Toronto, Ontario Canada M5C 2V9 MONTREAL Tour McGill College Suite 1640 1501 McGill College Avenue Montreal, Quebec Canada H3A 3M8 INVESTMENT FUNDS ADVICE & INFORMATION Telephone: 1-800-661-6141 Facsimile: 1-800-666-9899 Website: www.phn.com Email: [email protected]