A p p l i c a t i o n f o r a S i n g l e P r e m i u m Pa y o u t A n n u i t y Po l i cy
|
|
- Randolph Gardner
- 8 years ago
- Views:
Transcription
1 A p p l i c a t i o n f o r a S i n g l e P r e m i u m Pa y o u t A n n u i t y Po l i cy Registered and Non-Registered In this application, the terms you and your mean the owner of The Canada Life Payout Annuity Policy. The terms we, our and us mean The Canada Life Assurance Company. 1 of 6 : 188 CAN (01/12)
2 In which language would you like this policy to be issued? English French For a non-registered policy only - Have you applied for, or purchased a policy of life insurance within the past six months, or do you intend to apply for a policy of life insurance within the next three months? No Yes If this statement is not true, any annuity issued may be revised at Canada Life s discretion and may result in lower payments to the annuitant. Is the policy non-registered and is a third party involved with this policy? Consider if another individual or entity will give direction to the Owner regarding the purchase of this policy, paying premiums or making redemption requests OR will someone other than the Owner(s) sign the application on behalf of the Owner? No Yes If yes, the FSA is to complete the Third party section of this application. 1 Premium Information Cheque attached for $ Transfers Internal transfer from an existing policy (note that for funds transferring from a life insurance policy, a surrender form or letter of direction must be submitted with this application. (please complete transfer list below) Transfer from another carrier (please include copies of the required transfer forms) For RPP, LIRA or locked-in RRSP funds, please note that the pre-/post legislation splits will be required. If funds are locked-in, please provide the jurisdiction that the pension funds are locked-in under. (please complete transfer list below) TRANSFER LIST: For transfers from another carrier, please list the transferring institutions below with approximate amounts. For internal transfers, please indicate the existing contract number along with the approximate amounts. external carrier/internal policy no.: $ external carrier/internal policy no.: $ external carrier/internal policy no.: $ TOTAL $ Is the policy non-registered and the premium being applied $100,000 or more? No Yes If yes, complete Politically exposed Person Determination Form and submit with the application. 2 Request for Rate Guarantee Please fax your request to or locally at no later than midnight of the day following the day that the quote was produced. The terms and conditions of this rate guarantee can be found on page 5 of this form. Owner s Signature Date (d/m/y) 3 Primary Annuitant This is the person on whose life the annuity will be based. This person is also the Payee & Owner, unless otherwise stated in section 5 or 6. Your last name First name Initial Gender Social Insurance Number F M Your address (street, number and apartment) (If mailing address is a P.O. Box, General Delivery, or RR#, record civic address / physical location in Special Instructions section) City or Town Province Postal Code Date of birth (d/m/y) Occupation Acceptable proof of age must be submitted with this application. Line of Business 4 Co-Annuitant (Joint Annuity) Co-annuitant s last name First name Initial Gender Social Insurance Number F M Date of birth (d/m/y) Relationship to Primary Annuitant Acceptable proof of age must be submitted with this application. Occupation Line of Business 5 Owner Information Primary Annuitant or Primary and Co-Annuitant jointly (only available for non-registered funds) or Other (Complete section below) If Primary Annuitant IS NOT THE OWNER complete this section Last name/corporation name First name Initial Gender Social Insurance Number F M Address (street, number and apartment) (If mailing address is a P.O. Box, General Delivery, or RR#, record civic address / physical location in Special Instructions section) City or Town Province Postal Code Date of birth (d/m/y) Occupation Line of Business If the Owner is a corporation, non-corporation entity, or not-for-profit organization, additional information must be provided. Please complete Client Identity Verification section. Copy of this application and the Questionnaire for Owners which are Entities, Form and submit with the application. If the policy type is non-registered, complete the following Which valid document is being used to verify the Owner s identity: Document number: Birth Certificate Driver s License Passport Canadian government (federal or provincial) issued ID (please specify) Issue Date of Document (dd/mm/yyyy) Jurisdiction of Document (City, County, Province, Country) Expiry Date (dd/mm/yyyy) 2 of 6 : 188 CAN (01/12)
3 6 Payee (Select one) Primary Annuitant (Single Life) Joint Annuitants (primary annuitant and then to Co-Annuitant) Owner Joint Payees (Annuitants jointly, then to Survivor) Only available for non-registered funds If other, please complete below: Last name First name Initial Social Insurance Number Address (street, number and apartment) City or Town Province Postal Code (If mailing address is a P.O. Box, General Delivery, or RR#, record civic address / physical location in Special Instructions section) TRUSTEE FOR A CHILD If you have named a child as a payee and that child is a minor, you must also appoint a trustee. The trustee will receive any benefit payments that may become due while the child is still a minor. 7 Payment Information How would you like us to make our payments to you? (select one) Deposit to your bank account (please attach a blank cheque marked void or, if not available, complete the following banking information) Name & branch of your financial institution Your account number Your branch transit number If I select direct deposit, the Payee as indicated above, agrees to refund any amounts paid by Canada Life to which they are not entitled and the Payee directs the financial institution to return such amounts to us on our request. Cheque to be mailed to the Payee, as shown in section 6. 8 Policy Details Please attach the quotation which was produced for the annuity described below, and note any differences between the quotation and this application. Type of annuity: For locked-in RRSP, RPP or Locked-in Retirement Accounts, do you have a spouse as defined under the applicable legislation? No Yes: If yes and you are not selecting the minimum joint and survivor life annuity as defined under the applicable legislation, a spousal waiver form must be completed. Single Life with payments guaranteed Joint and Survivor Life with payments guaranteed Single Life with no income payments or other amounts to be Joint and Survivor Life with no income payments or other amounts to paid after the death of the Primary Annuitant if the death be paid after the death of both Annuitants if the death occurs after occurs after the first payment has been made *SIGN BELOW the first payment has been made *SIGN BELOW Single Life with Installment Refund Joint and Survivor Life with Installment Refund Single Life with Cash Refund Joint and Survivor Life with Cash Refund year Term Certain Annuity Other (describe fully) Term Certain to Annuitant s age 90 Reducing Payments (Applicable to Joint and Survivor Life Annuity) Term Certain to Spouse s age 90 No reduction on first death Spouse s date of birth dd/mmm/yyyy Reducing on later of first death and the end of the guarantee period to % of the annuity payment. Reducing on the later of the death of the Primary Annuitant and the end of the guaranteed period to % of the annuity payment. * I hereby acknowledge and understand that no income payments or other amounts are payable after the death of the Annuitant(s) under the policy, if the death occurs after the first payment has been made. I also understand that I may not designate a beneficiary under section 10 if this option is chosen. Signature of Owner: What date would you like your payments to begin? Choose any day between the 1st & the 28th (d/m/y) or one month after the date the funds are received. How often would you like to receive your payments? Monthly Quarterly Semi-annually Annually Subsequent income payments: Level Decreasing only once to $ on (d/m/y) (i.e. integrate with OAS and CPP/QPP for pension money only or OAS only). Increasing every year by % of the immediately preceding year s payment. NOTE: the maximum rate of increase is 4% for a registered policy and 6% for a non-registered policy. Death Benefit: (Payable if death takes place during the deferred period, before the First Payment Date) Return of Single Premium Return of Single Premium with % interest (to a maximum of 10%) on death of all annuitants. Income Payments to commence when due (for annuity certain plans only). No death benefit (applicable to single life or joint and survivor life annuities with no survivor and no guaranteed payments). No income payments or other amounts to be paid.*sign BELOW * I hereby acknowledge and understand that no income payments or other amounts are payable after the death of all Annuitants under the policy, if death occurs before any income payments begin. I also understand that I may not designate a beneficiary under section 10 if this option is chosen. Signature of Owner: 3 of 6 : 188 CAN (01/12)
4 9 Taxation For non-registered policies: I request Level Taxation (Prescribed Annuity), if applicable (not permitted for increasing annuities) I DO NOT want Level Taxation, and I understand the potential tax consequences. I request Accrual Taxation. I request Accrual Taxation in the deferred period and Level Taxation thereafter, if applicable. 10 Choosing Your Beneficiary The person you name below as the primary beneficiary, will receive your policy s death benefit if the annuitant dies. If the primary beneficiary dies before the annuitant does, the secondary beneficiary (if one is designated) will receive the death benefit. Should you wish to designate more than two beneficiaries, please either complete Form 584, Part C and attach it to this application or identify in Section 11 below. For applications signed in Quebec the designation of a spouse (married or civil union) as beneficiary is irrevocable unless you check the Revocable box below. For applications signed in all other provinces and territories a beneficiary is revocable unless you check the Irrevocable box below. Estate of last survivor of annuitant and any survivorship annuitant or REVOCABLE (Beneficiary may be changed by the Owner) IRREVOCABLE (I understand that the effect of my designating a beneficiary irrevocably is that while the beneficiary is living, I may not alter or revoke the designation without the consent of the beneficiary and I may not assign, exercise rights under or in respect of, surrender or otherwise deal with the contract without the consent of the beneficiary.) Primary beneficiary: Last name First name Relationship to You (owner) Contingent beneficiary: Last name First name Relationship to You (owner) Or No beneficiary (e.g. annuity has no guarantee) Trustee for beneficiary Only applicable where Quebec law does not apply If a trustee is appointed below, benefits to be paid under this policy to any beneficiary who, at the time payment is to be made, is a minor or is otherwise legally incompetent to give a valid discharge (according to the laws of the beneficiary s domicile), will be paid instead to the trustee, in trust for the beneficiary. Such payment will discharge Canada Life. The trust for any beneficiary will terminate once that beneficiary is both of age of majority and has legal capacity to give a valid discharge. The trustee is directed to deliver at that time, to the beneficiary, the assets then held in trust for that beneficiary. During the course of the trust, the trustee may apply trust assets for the support, maintenance, education, or other benefit of the beneficiary, and may exercise any right of the beneficiary under the contract, in the sole discretion of the trustee. Before completing this section, consider if you have already, in any document, made a trustee/administrator appointment which might apply. Consult with your legal advisor first. For Quebec only Benefits payable under this contract to a beneficiary who, at the time payment is to be made, is a minor, will be paid to his/her tutor(s), unless a valid trust has been established for the benefit of the minor, by will or by separate contract, to receive the benefits and we have been provided notice of the trust. If so, the trust should be named as the beneficiary in the section above, and the trustee should be named in the section below. Consult with your legal advisor first. Last name of trustee First name Relationship to You (owner) 11 Special Requests or Comments 12 Signatures By signing below, I acknowledge that I have had the opportunity to read and understand the application and the terms and conditions on the reverse. If you are signing on behalf of a corporation please indicate your title. Primary Annuitant s signature Signature of witness Dated at (city/prov.) Date (d/m/y) Co-Annuitant s signature Signature of witness Date (d/m/y) Owner s signature (if other than annuitant) Signature of witness Date (d/m/y) THE SECTION BELOW MUST BE SIGNED BY THE FINANCIAL SECURITY ADVISOR I certify that the identity of the Owner has been verified by reference to the Owner s birth certificate, driver s license, passport, or other Canadian government document (except as prohibited by law, which includes health cards in some provinces) indicated above as required by the Proceeds of Crime (Money Laundering) and Terrorist Financing Act. I certify that a) I have fully explained to the Owner the nature and effect of making an irrevocable designation of beneficiary b) the explanation was given to the owner not in the presence of the beneficiary, and c) the Owner indicated that he/she was aware of the irrevocable nature of the designation so made by him/her. d) For Quebec, I have fully explained to the Owner that where his/her spouse or civil union partner is named as beneficiary, the designation is automatically irrevocable unless he/she ticks the revocable box. I declare the application is complete and true to the best of my knowledge. I have provided the following information in writing to the Owner: a) the company or companies I represent; b) that I receive compensation (such as commissions or a salary) for the sale of life and health insurance products; c) that I may receive additional compensation in the form of bonuses, conferences, or other incentives; and d) any actual or potential conflicts of interest I may have with respect to this transaction. Primary Financial Security Advisor Name (Please PRINT) Agency Producer Code Secondary Financial Security Advisor Name (Please PRINT) Agency Producer Code Primary Financial Security Advisor s Signature Date (d/m/y) Secondary Financial Security Advisor s Signature 4 of 6 : 188 CAN (01/12)
5 What I Agree to When I Sign This Application By signing I confirm: the statements appearing in this application are true and are submitted as the basis for the policy to be made I am applying for a Canada Life Payout Annuity Policy and ask you to establish a policy as selected I understand the policy I have requested will not take effect until we have received your Single Premium and required documentation I understand that any amounts paid to me or my beneficiaries could be subject to income tax I authorize you to use my Social Insurance Number for identification, administrative and income tax reporting purposes in connection with my policy. if I have reserved an interest rate, I have read and agree to the interest rate guarantee agreement included with this application I accept any changes or additions noted in Section 11 I am aware of the implications should my answer to the question regarding applications or purchases of life insurance, located at the outset of this application, be inaccurate. Terms and Conditions for Rate Guarantees By signing in section 2 that a rate guarantee is requested, the Owner agrees to transfer the total amount of premium to The Canada Life Assurance Company. The Owner also acknowledges the commitment to transfer the funds is irrevocable. This agreement does not apply when funds within Canada Life are immediately available, such as funds from a DIA, RIB, FLEX, Generations or off-renewal transfer of a GIA, GII or RRIF. In these cases, the rate assigned will be a rate in effect on the date the transfer request is received. In order to hold the rate for non-registered funds, we will require the following no later than midnight of the day following the day that the quote was produced: a copy of the quote, signed application, including signature in section 2 and a copy of the cheque for the minimum, non-refundable deposit shown below. All items must be received, by fax, at our administrative office, in London, ON. Cheques for deposits should be made payable to Canada Life and be received in our administrative office, in London ON, within 3 days of receipt of the original fax. The entire premium must be paid in full by the end of the 45-day guarantee period. Deposit amounts as follows: 3% deposit required for premiums under $1 million 5% deposit for premiums $1 million or greater In order to hold the rate for 45 days for Registered funds, we will require the following no later than midnight of the day following the day that the quote was produced: A copy of the quote and signed application, including signature in section 2. All items must be received at our administrative office, in London ON. If the money is received by Canada Life more than 45 days after the date of this request, Canada Life has the right to give the less favourable of the rate basis in effect on the date of transfer and the guaranteed rate basis, but in no case will a more favourable rate than the guaranteed rate be given. If the actual amount received is greater than the estimated figure shown on this application by more than $5,000, Canada Life reserves the right to give the less favourable of the rate basis in effect on the date of the transfer and the guaranteed rate basis to the excess amount. This rate guarantee is not a guarantee of income but rather a guarantee of the rate basis used in the quotation. Note the rate basis is only one of the factors used to calculate the income or single premium. If the funds are not received on the exact policy date (i.e. effective date), Canada Life will re-quote based on the actual date of receipt, using the same guaranteed rate to determine the revised income or single premium amount but adjust the policy date to the date of receipt of payment. Personal information I understand that when I apply for any product or service, Canada Life establishes and adds to a confidential file that contains personal information concerning me. I have rights of access to, and correction of, this information. These rights may be exercised by writing to Ombudsman The Canada Life Assurance Company, at the address noted on page 6. The file is kept in the offices of Canada Life or in premises of a third party acting on behalf of Canada Life. Access to this personal information is limited to employees or persons authorized by Canada Life who require it to perform their duties, to persons to whom I have granted access, and as personal information may be collected, used, or disclosed in or from Canada or elsewhere, access may be had by persons authorized by laws of Canada or elsewhere, as applicable. I consent to Canada Life collecting, using, and disclosing personal information concerning me. I understand that Canada Life must obtain this information for the purpose of processing this application and, if approved, providing, administering and servicing the product(s) and/or service(s) applied for, advising me of products and services available from Canada Life, it subsidiaries, affiliates and strategic alliance partners, to help me plan for my financial security, investigating and processing claims, creating and maintaining records and fulfilling any purpose related directly to the preceding. Subject to legal or contractual restrictions, I may withdraw my consent at any time effective on receipt by Canada Life of my written withdrawal at Canada Life s head office or administrative offices. I understand that refusing to consent may result in my application being refused. I authorize the use of my social insurance or business numbers for tax reporting, identification and record keeping purposes. The parties hereto expressly wish the policy and all related documents be in English. Les parties aux présentes acceptent que la police et tous les documents s y rapportant soient rédigés en anglais I consent to Canada Life collecting, using and disclosing personal information concerning me from persons outside Canada Life including related companies and MIB, Inc formally known as the Medical Information Bureau, for the purpose of underwriting any annuity application. MIB Information MIB, Inc. is a not-for-profit membership organization of life insurance companies operating an information exchange on behalf of its members. I understand that if I apply to another MIB member company for life or health insurance coverage, or to which I have submitted a claim, MIB, upon request, will supply Canada Life with the information in its file. You may request a copy of your file by contacting MIB at MIB, Inc. 330, University Ave, Suite 501, Toronto, ON, M5G 1R7, Phone By signing this Application, I give you my consent to: 1. Obtain personal information about me from persons outside Canada Life (e.g. my financial security advisor, MIB, related companies), if this information is necessary for the purposes specified above, and 2. Disclose my personal information to your subsidiaries, affiliates, strategic alliance partners, service providers and my financial security advisor when disclosure is necessary for the purposes specified above. 3. Disclose my personal information to MIB as described in the MIB Information above Subject to legal or contractual restrictions, I may withdraw my consent by writing to the above address, however, absence of consent may affect\the services we are able to offer you. 5 of 6 : 188 CAN (01/12)
6 Please submit your application to: The Canada Life Assurance Company Attention: IRIS T424, 255 Dufferin Avenue, London, Ontario N6A 4K1 Third Party Determination The Proceeds of Crime (Money Laundering) and Terrorist Financing Act requires the existence of third parties affiliated with the policy, if any, to be determined and recorded. Please enter the information below. All required sections to be completed by advisor. If space is insufficient, use additional forms. Name: Date of Birth (dd/mm/yyyy) Relationship to owner/annuitant(s): Address (Address CANNOT be a P.O.Box, General Delivery, or RR number): Telephone number Occupation: Line of Business: If a corporation, registration number and country/province of incorporation (provide similar information for a non-corporate entity, e.g., partnership). If a third party is signing the application for the owner(s), the third party signer must be identified by valid government-issued identification, of the third party s choosing and must indicate the type of third party. Please enter the information below. attorney (power of attorney)/mandatary payor trustee executor collateral assignee/hypothecary creditor other Which valid document are you using to verify the identity? [complete all sections] Birth certificate Driver s license Document number: Passport Other ID, please specify*: Document issue date (dd/mm/yyyy) Jurisdiction of document (City, County, Province, Country) Document expiry issue date (dd/mm/yyyy) * Health card may not be acceptable document in all provinces. I cannot determine but have reasonable grounds to suspect there is a third party. (Describe grounds below) Client Identity Verification (Provide Owner Information in the Appropriate Category Below.) Canada Life will conduct a corporate search to verify the corporation s existence. Corporation or Non-corporate entity (For non-corporate entity, review partnership agreement or articles of association) Full legal name of corporation or non-corporate entity (e.g. association, partnership): Registration number (provide as much detail as possible) 1) Incorporation number (if available): 2) Other registration number: (If incorporation number not available, or for a non-corporate entity) Type of number: Jurisdiction of issue: Federal or Province/Territory of 3) Jurisdiction (of incorporation / formation) Federal or Province/Territory of Verifying existence: For corporate entities, the insurer will verify existence. If the owner is a non-corporate entity, the advisor must verify the entity s existence by referring to paper or electronic documentation (e.g. partnership agreement). Indicate if the documentation viewed was: on paper (attach a photocopy) or electronic (provide type and source) Type of electronic documentation (e.g. partnership agreement) Source of electronic documentation (e.g. web site; provide particulars) Signing official(s): (See Identification documents described in section 5 of the application.) Name Title Type of document Document number Place of Issue Document check list: Proof of age for annuitant(s) (e.g. birth certificate, passport, citizenship, etc.) A void cheque, for direct deposit A copy of the quotation Copies of the required transfer forms (e.g. RRIF T2030 form, Pension funds T2037 form) Please note that original transfer form should be sent to the transferring company and a copy should be forwarded to our administrative office. For internal transfers, please include the appropriate surrender form or letter of direction with original signatures. The Canada Life Assurance Company The Canada Life Assurance Company Head Office 330 University Avenue Administrative Office 255 Dufferin Avenue Toronto Ontario M5G 1R8 London, Ontario N6A 4K1 6 of 6 : 188 CAN (01/12)
Application for a. Single Premium Immediate Annuity
Application for a Single Premium Immediate Annuity BMO Life Assurance Company 60 Yonge Street, Toronto, Ontario, Canada M5E 1H5 Tel 416-596-3900 Fax 416-596-4143 Toll Free 1-877-742-5244 348E (2010/11/18)
More informationSingle Premium Immediate Annuity (SPIA) Application
Single Premium Immediate Annuity (SPIA) Application Cheques must be made payable to Transamerica Life Canada Highlighted sections must be completed to avoid delay Not available for corporate ownership
More informationApplication for Fixed and Life Annuity For registered and non registered contract
POU Client Services Tel. 506-853-6040/1-888-577-7337 Fax 506-853-9369/1-855-577-3864 financial.services@assumption.ca Application for Fixed and Life Annuity For registered and non registered contract 1.
More informationEMPIRE LIFE GUARANTEED INVESTMENT FUNDS 75/100 APPLICATION FOR A NOMINEE/INTERMEDIARY ACCOUNT
VERSION DATE: NOVEMBER 2014 EMPIRE LIFE GUARANTEED INVESTMENT FUNDS 75/100 APPLICATION FOR A NOMINEE/INTERMEDIARY ACCOUNT Upon receiving confirmation of your contract purchase please record your contract
More informationAdministration PIVOTAL SOLUTIONS/PIVOTAL SOLUTIONS DSC. Savings and Retirement. Retirement Income Fund Life Income Fund
Administration PIVOTAL SOLUTIONS/PIVOTAL SOLUTIONS DSC Savings and Retirement Retirement Income Fund Life Income Fund Name of Advisor (please print) Advisor Code OR FundSERV Sales Rep. ID (only one - whichever
More informationPayout Annuity. product guide
Table of contents What is a Single Premium Annuity?............................................................................. 2 Who will benefit from a Payout Annuity?.......................................................................
More informationI request a refund in accordance with paragraph 7(b); or
CIBC RETIREMENT SAVINGS PLAN AGREEMENT 1. ESTABLISHMENT OF PLAN: Canadian Imperial Bank of Commerce ( CIBC ) agrees to hold on deposit in a CIBC Retirement Savings Plan (the Plan ) contributions received
More informationSELF-DIRECTED RETIREMENT SAVINGS PLAN APPLICATION
SELF-DIRECTED RETIREMENT SAVINGS PLAN APPLICATION CALEDON TRUST COMPANY LIRA Locked in Retirement Account* LRSP Locked in Retirement Savings Plan* RSP - Retirement Savings Plan - Member Plan RSP - Retirement
More informationNon-registered plan, RSP, RIF, LIRA (QC), LIF, Annuity, Deferred Life Annuity, Deferred Life Annuity-LIRA (QC) Application/Instructions Form
Application/Instructions Form T097 (12-2015) Non-registered plan, RSP, RIF, LIRA (QC), LIF, Annuity, Deferred Life Annuity, Deferred Life Annuity-LIRA (QC) Application/Instructions Form Non-registered
More informationSelf-Directed Retirement Savings Plan Application
Self-Directed Retirement Savings Plan Application Annuitant Information Last Name, First Name and Initial Mr. Mrs. Ms. Miss Dr. (circle one) Street Address Apt. Date of Birth (mm/dd/yyyy) City Province
More informationApplication for Annuity Annuity Plus Foresters Retirement Income Funds Plus
foresters.com 105223 CAN (01/12) Application for Annuity Annuity Plus Foresters Retirement Income Funds Plus foresters.com Application for Annuity For purposes of all pages of this document the following
More informationApplication/Instructions Form. TFSA Savings Annuity T087 (06-2015)
Application/Instructions Form TFSA Savings Annuity T087 (06-2015) Application/Instructions Form TFSA Savings Annuity New client? Yes If so, complete the Contractholder s Identification section No If not,
More informationSun Life Financial Advisor Administration Guide
Sun Life Financial Advisor Administration Guide managed by CI Investments Inc. issued by Sun Life Assurance Company of Canada How to complete a SunWise Essential Series Signature Form........................................
More informationEach applicant must provide approved ID or W8/W9*
Page 1 of 8 CIBC Investor s Edge Investment Account Application ORDER EECUTION ONLY ACCOUNT CIBC Investor Services Inc. Please review the Account Agreements and Disclosures Booklet before completing this
More informationAccount Opening Checklist
Application Guide Non-registered (Investment) account Discount Brokerage Use this account opening guide to assist you in applying for an individually owned Discount Brokerage 1 Non-registered (Investment)
More informationmy plan Simplified Pension Plan for Employees of Bishop s University Member Booklet
my plan Simplified Pension Plan for Employees of Bishop s University Member Booklet Client ID 2RT-01 May 2015 Table of Contents Introduction... 1 What type of plan do I have?... 1 What are my responsibilities?...
More informationissued by Sun Life Assurance Company of Canada
Sun Life Assurance Company of Canada Application Form - January 2015 SunWise Essential Series 2 is an individual variable annuity contract issued by Sun Life Assurance Company of Canada, a member of the
More informationGroup Retirement Savings Plan for Ryerson University CUPE 3904 PT&S
Group Retirement Savings Plan for Ryerson University CUPE 3904 PT&S Prepared June 2009 Policy/Plan Number 42745 Ryerson Group Retirement Pension Plan Table of Contents An Introduction to your Group Plan,
More informationLife Insurance Conversion Notification of Conversion Privilege
Life Insurance Conversion Notification of Conversion Privilege Employer completes this section Company Name Group Policy and Division Number Employee s Name Date of Birth (dd/mm/yyyy) Group life insurance
More informationPrivate Capital Solutions. Tax-Free Savings Accounts (TFSA) Registered Retirement Savings Plans (RRSP)
Private Capital Solutions Tax-Free Savings Accounts (TFSA) Registered Retirement Savings Plans (RRSP) Computershare Forms Guide On the following pages you will find these applications forms. Tax-Free Savings
More informationMACHINISTS LODGE 692 HEALTH AND BENEFIT PLAN
MACHINISTS LODGE 692 HEALTH AND BENEFIT PLAN REVISED CARD CHECK HERE h APPLICATION FOR ENROLMENT AND BENEFICIARY DESIGNATION Please complete in ink and print clearly. This is a two-sided form please see
More informationPower of Attorney Form
Power of Attorney Form Account Holder Name(s): Application Reference #: Complete this form if you wish to authorize another person to have full power and authority over your Account(s) with TD Waterhouse
More informationSun Life Assurance Company of Canada
Sun Life Assurance Company of Canada Sun Guaranteed Investment Fund Solutions Income Series supplement Information folder and individual variable annuity contract issued by Sun Life Assurance Company of
More informationADDENDUM TO THE RETIREMENT SAVINGS PLAN DECLARATION OF TRUST ESTABLISHING A LOCKED-IN RETIREMENT ACCOUNT. Saskatchewan (LIRA)
ADDENDUM TO THE RETIREMENT SAVINGS PLAN DECLARATION OF TRUST ESTABLISHING A LOCKED-IN RETIREMENT ACCOUNT Saskatchewan (LIRA) 1. What the Words Mean: Please remember that in this Addendum, I, me and my
More informationLONDON LIFE ESTATE PROTECTION FUNDS POLICY
LONDON LIFE ESTATE PROTECTION FUNDS POLICY INFORMATION FOLDER OCTOBER 2015 London Life Insurance Company. This document is not an insurance contract. This information folder is not an insurance contract.
More informationEMPIRE CLASS SEGREGATED FUNDS INFORMATION FOLDER AND POLICY PROVISIONS THE EMPIRE LIFE INSURANCE COMPANY
THE EMPIRE LIFE INSURANCE COMPANY EMPIRE CLASS SEGREGATED FUNDS INFORMATION FOLDER AND POLICY PROVISIONS This document contains the information folder and the contract provisions for the Empire Class Segregated
More informationApplication for your Structured Settlement Annuity
Application for your Structured Settlement Annuity How to Complete the Application Form* This form is used to apply for a Structured Settlement Annuity. Please answer all questions clearly and completely.
More informationInformation folder October 2015 CANADA LIFE GENERATIONS TM. The Canada Life Assurance Company
Information folder October 2015 The Canada Life Assurance Company is the sole issuer of the individual variable annuity policy described in this information folder. This document is not an insurance contract.
More informationApplication for Disability and/or Professional Overhead Expense Insurance
Please PRINT clearly in ink. 1 Member information Application for Disability and/or Professional Overhead Expense Insurance In this application you and your refer to the person applying for insurance.
More informationEVIDENCE OF INSURABILITY COVERAGE DETAIL
EVIDENCE OF INSURABILITY COVERAGE DETAIL This application consists of two parts: The Evidence of Insurability Coverage Detail form and Medical & Lifestyle Questionnaire. INSTRUCTIONS Plan Administrator:
More informationBENEFIT DISTRIBUTION REQUEST FORM (For Distributions due to Termination, Death, Disability, and Retirement) Date: EIN: 16-6184130 TIN: 611256314
BENEFIT DISTRIBUTION REQUEST FORM (For Distributions due to Termination, Death, Disability, and Retirement) : EIN: 16-6184130 TIN: 611256314 Plan Name: UFCW LOCAL ONE 401(K) SAVINGS PLAN Participant Data
More informationAPPLICATION TO RECEIVE A LUMP SUM PAYMENT FROM THE SHEET METAL WORKERS LOCAL 30 PENSION PLAN Registration Number 345850
APPLICATION TO RECEIVE A LUMP SUM PAYMENT FROM THE SHEET METAL WORKERS LOCAL 30 PENSION PLAN Registration Number 345850 Administrator's Office: Union Office: Employee Benefit Plan Services Limited Sheet
More informationMaking the Best Choice for Your Future Survivor Pension Options
Making the Best Choice for Your Future Survivor Pension Options How does the death of my pension partner affect my pension benefits? What options do I have? And what action must I take next in order to
More informationFor advisor use only Advisor Guide
For advisor use only Advisor Guide RBC Payout Annuities 2 RBC Payout Annuities: Advisor guide What you and your clients need to know about payout annuities In an uncertain financial world where guarantees
More informationADDENDUM TO THE RETIREMENT SAVINGS PLAN DECLARATION OF TRUST ESTABLISHING A LOCKED-IN RETIREMENT ACCOUNT. New Brunswick (LIRA)
ADDENDUM TO THE RETIREMENT SAVINGS PLAN DECLARATION OF TRUST ESTABLISHING A LOCKED-IN RETIREMENT ACCOUNT New Brunswick (LIRA) 1. What the Words Mean: Please remember that in this Addendum, I, me and my
More informationInformation Folder for the Investors Group Guaranteed Investment Funds
Information Folder for the Investors Group Guaranteed Investment Funds Individual Variable Annuity Policy June 2015 Issued by The guaranteed investment funds described in this Information Folder invest
More informationnvestmen UARANTEE GUIDE Investments ADVISOR GUARANTEED Life s brighter under the sun
un UARANTEE Sun GUARANTEED Investments nvestmen GUIDE ADVISOR WHAT S INSIDE Superflex/Income Master (Insurance GIC) Sun GIC Max non-redeemable (Trust GIC) SLF Trust GIC redeemable (Trust GIC) Life s brighter
More informationEMPIRE LIFE GUARANTEED INVESTMENT FUNDS 75/75 AND GUARANTEED INVESTMENT FUNDS 75/100 INFORMATION FOLDER AND CONTRACT PROVISIONS
THE EMPIRE LIFE INSURANCE COMPANY EMPIRE LIFE GUARANTEED INVESTMENT FUNDS 75/75 AND GUARANTEED INVESTMENT FUNDS 75/100 INFORMATION FOLDER AND CONTRACT PROVISIONS This document contains the information
More informationYour Payout Annuity policy
64075528 Your Payout Annuity policy In this document, "you" and "your" means the owner of this policy, or the policyholder. "We", "our", "us" and the "Company" means Sun Life Assurance Company of Canada.
More informationGROUP RETIREMENT SAVINGS PLAN
GROUP RETIREMENT SAVINGS PLAN (the "Group Plan") The individual Retirement Savings Plans (the "Plans") established under the Group Plan will be issued by Sun Life Assurance Company of Canada ("Sun Life")
More informationInformation folder. Including preferred series 1. June 2015. This document is not an insurance contract.
CANADA LIFE SEGREGATED FUNDS Information folder Including preferred series 1 June 2015 The Canada Life Assurance Company is the sole issuer of the individual variable annuity policy described in this information
More informationFinancial Services Commission of Ontario Commission des services financiers de l Ontario
Financial Services Commission of Ontario Commission des services financiers de l Ontario SECTION: Life Income Fund/Locked-In Retirement Account INDEX NO.: L050-500 TITLE: LIF Explanation and Tables for
More informationTerm Life Insurance Plan
Term Life Insurance Plan Your association is pleased to endorse Term Life Insurance available to you and your spouse. You can choose the coverage amount to fit your needs. Term Life is an affordable way
More informationTax-Free Savings Account
Tax-Free Savings Account Office Use Only Plan ID Advisor (Last KYC Review Date) Account Holder Information First Name Last Name Address (P.O. Box and General Delivery not acceptable) City Province Postal
More information5. ACCOUNT OPTIONS WHICH THE HOLDER MAY CHOOSE:
Submit In order to proceed with your application, please read the CIBC Tax-Free Savings Account Agreement and check the box at the bottom of the page to indicate that you agree to open a TFSA or contribute
More informationINFORMATION FOLDER October 2015
GREAT-WEST LIFE SEGREGATED FUND POLICIES PREFERRED SERIES 2 INFORMATION FOLDER October 2015 The Great-West Life Assurance Company is the sole issuer of the individual variable annuity policy described
More informationGroup Retirement Savings Plan for the Province of New Brunswick
All Members Group Retirement Savings Plan for the Province of New Brunswick Dear plan member, To help you* achieve financial security during your retirement years, the Province of New Brunswick has established
More informationInformation Folder and Annuity Policy Client Document Package M.V.P. - RIF. insured by Sun Life Assurance Company of Canada
Information Folder and Annuity Policy Client Document Package Sun Life Assurance Company of Canada M.V.P. - RIF managed by CI Investments Inc. insured by Sun Life Assurance Company of Canada Important
More informationSign up online for a chance to win an ipad!
(a) Since your statements will be available online, do you still wish to receive a paper copy? o Yes o No (b) o I request that my deferred annuity contract and other pertinent documents be posted on my
More informationRetirement Income Options
Retirement Income Options How will you spend your retirement? Table of Contents Introduction...4 Retirement Considerations...5 Other Considerations...8 Entering Retirement...9 Retirement Income Options...10
More informationSingle Premium Immediate Annuity A periodic guaranteed income benefit plan
Single Premium Immediate Annuity A periodic guaranteed income benefit plan Personal Data Province: Annuitant: Sex: Ontario Primary Annuitant Male Date of Birth: 16 Jul 1953 Age at purchase: 60 Single Premium
More informationTHE EMPIRE LIFE INSURANCE COMPANY LIFE INCOME FUND ENDORSEMENT QUÉBEC SUPPLEMENTAL PENSION PLANS ACT AND REGULATIONS
Policy Number: THE EMPIRE LIFE INSURANCE COMPANY LIFE INCOME FUND ENDORSEMENT QUÉBEC SUPPLEMENTAL PENSION PLANS ACT AND REGULATIONS Owner/Annuitant: The Policy Number indicated above is amended as described
More informationHow To Get Life Insurance In Canada
Distributed by: Complete this application if applying for PERMANENT WHOLE LIFE insurance Application for n-medical Life Insurance: Acceptance Life, Deferred Life, Simplified Life And Simplified Life Plus
More informationPEPP Talk... on Variable Pension Benefit
PEPP Talk... on Variable Pension Benefit This PEPP Talk provides members with information about PEPP s Variable Pension Benefit (VPB). When you are retired and ready to begin receiving income, you must
More informationJUNE 2016. Great-West Life investment plans Information folder. Program MANAGED-MONEY. This document is not an insurance contract.
JUNE 2016 Great-West Life investment plans Information folder Program MANAGED-MONEY This document is not an insurance contract. This information folder is not an insurance contract. The information in
More informationVERSATILE PORTFOLIOS NAVIGATOR KEY FACTS
information folder This information folder is not an insurance contract. Versatile Portfolios Navigator Individual Variable Insurance Contracts are issued by Co-operators Life Insurance Company. VERSATILE
More informationCANADIAN MERCHANT SERVICE GUILD
2006 CANADIAN MERCHANT SERVICE GUILD WESTERN BRANCH PENSION PLAN (Towboats) This statement has been prepared for: 2006 CANADIAN MERCHANT SERVICE GUILD WESTERN BRANCH PENSION PLAN (Towboats) Printed March
More informationNational Electrical Annuity Plan Lump Sum Benefit Application
National Electrical Annuity Plan Lump Sum Benefit Application To avoid delays in the processing and payment of your benefit, please follow these instructions carefully and completely. 1. Print all information
More informationREQUEST FOR THE ONTARIO MEDICAL ASSOCIATION GROUP FLEX-TERM LIFE INSURANCE PLAN
NEW YORK LIFE INSURANCE COMPANY REQUEST FOR THE ONTARIO MEDICAL ASSOCIATION GROUP FLEX-TERM LIFE INSURANCE PLAN I wish to apply for: Flex-10 Policy G-29700 Flex-20 Policy G-29800 SECTION A: MEMBER INFORMATION
More informationCOMMON SENSE FUNDS LOCKED-IN ADDENDUM
PRIMERICA LIFE INSURANCE COMPANY OF CANADA COMMON SENSE FUNDS LOCKED-IN ADDENDUM ONTARIO LIRA Your Locked-In Addendum Enclosed is the Locked-In Addendum for your registered retirement product, which, together
More informationApplication Instructions
Application Instructions 1. Print and fill out entire (PHSA) Application. 2. Write a $20.00 check payable to New York Community Bank for your PHSA set up fee. 3. Mail application and check to: NYCB Plaza
More informationHow To Get Life And Dd Insurance In New York
NEW YORK LIFE INSURANCE COMPANY REQUEST FOR THE ONTARIO MEDICAL ASSOCIATION GROUP TERM LIFE PLUS 75 INSURANCE PLAN SECTION A: MEMBER INFORMATION I wish coverage for (Check One) Myself Myself and Eligible
More informationPlanning Retirement. Information for BCGEU Pension Plan Members
Planning Retirement Information for BCGEU Pension Plan Members January 2012 PAGE ONE PAGE TWO PAGE THREE PAGE FOUR PAGE FIVE PAGE SIX PAGE SEVEN PAGE EIGHT PAGE NINE PAGE TWELVE TABLE OF CONTENTS Preparing
More informationMulti-Platform Open Annuity
Multi-Platform Open Annuity Application Form Powered by the London & Colonial... Upgradable, Capable, Flexible www.londoncolonial.com Multi-Platform Open Annuity Form To London & Colonial Assurance PLC:
More informationBeneficiary Change and Predetermined Payout Election Form
Beneficiary Change and Predetermined Payout Election Form Variable Annuities are issued by Pruco Life Insurance Company, in New York, by Pruco Life Insurance Company of New Jersey and The Prudential Insurance
More informationGROUP LIFE / ACCIDENTAL DEATH NOTICE OF CLAIM
GROUP LIFE / ACCIDENTAL DEATH NOTICE OF CLAIM EMPLOYER INSTRUCTIONS Send the Claimant s Statement to the beneficiary for completion and have it returned to you. Complete the Employer s Statement. These
More informationEFFECTIVE OCTOBER 2015. ivari TM Guaranteed Investment Funds INFORMATION FOLDER. This Information Folder is not complete without the Fund Facts.
EFFECTIVE OCTOBER 2015 ivari TM Guaranteed Investment Funds INFORMATION FOLDER This Information Folder is not complete without the Fund Facts. Effective October 2015 ivari TM ivari Guaranteed Investment
More informationINDIVIDUAL SINGLE PREMIUM DEFERRED ANNUITY CONTRACT
GENWORTH LIFE INSURANCE COMPANY Administrative Office 3100 Albert Lankford Drive Lynchburg, VA 24501 4948 INDIVIDUAL SINGLE PREMIUM DEFERRED ANNUITY CONTRACT This annuity is a legal contract between you
More informationLAKEHEAD UNIVERSITY EMPLOYEE PENSION PLAN MEMBER BOOKLET
LAKEHEAD UNIVERSITY EMPLOYEE PENSION PLAN MEMBER BOOKLET 2011 1 TABLE OF CONTENTS Introduction... 3 Eligibility... 4 Contributions... 5 Individual Account... 8 Short Term Account... 8 Retirement Dates...
More informationMETLIFE EXCEPTED GROUP LIFE POLICY TECHNICAL GUIDE
METLIFE EXCEPTED GROUP LIFE POLICY TECHNICAL GUIDE This document is a guide to the features, benefits, risks and limitations of the MetLife Excepted Group Life policy, including how the policy works and
More informationGGAI TAX-FREE SAVINGS ACCOUNT
Global Growth Assets Inc. (GGAI) GGAI TAX-FREE SAVINGS ACCOUNT application form www.globalgrowth.ca GGAI TAX-FREE SAVINGS ACCOUNT APPLICATION FORM 1. MANAGER GLOBAL PROSPERATA FUNDS INC. Account Number
More informationMinimum Premium: Qualified [$5,000] Non-Qualified [$10,000] Maximum Premium: [$250,000]
2721 North Central Avenue, Phoenix, Arizona 85004-1172 (866) 641-9999 Oxford Life Insurance Company Single Premium Multi-Year Guarantee Annuity With Market Value Adjustment Feature Benefit Summary and
More informationCREDENTIAL SECURITIES INC. SELF-DIRECTED LOCKED-IN RETIREMENT ACCOUNT AGREEMENT. THIS ADDENDUM dated the day of, 20.
CREDENTIAL SECURITIES INC. SELF-DIRECTED LOCKED-IN RETIREMENT ACCOUNT AGREEMENT THIS ADDENDUM dated the day of, 20. Contract (the Contract ) for the establishment of a Locked-In Retirement Account (the
More information(CLICK ON JURISDICTION FOR ADDENDUM) FEDERAL LIRA ALBERTA LIRA BRITISH COLUMBIA LRRSP MANITOBA LIRA NEWFOUNDLAND AND LABRADOR LIRA NOVA SCOTIA LIRA
Addendum To CANADIAN SHAREOWNER INVESTMENTS INC. Retirement Savings Plan Declaration of Trust for Locked-In Pension Transfers to a Locked-In Registered Retirement Savings Plan or a Locked-In Registered
More informationINDIVIDUAL LIFE INSURANCE
POLICIES AND PROCEDURES GUIDE INDIVIDUAL LIFE INSURANCE REQUIRED SIGNATURES... 5 TRANSACTION FEES... 7 CLIENT TITLE CHANGES (Non-Financial)... 8 Address... 8 Assignment for Collateral... 9 Beneficiary...
More information625 St-Amable Street Québec (Québec) G1R 2G5 ALBERTA LIFE INCOME FUND (LIF-RIDER)
625 St-Amable Street Québec (Québec) G1R 2G5 ALBERTA LIFE INCOME FUND (LIF-RIDER) Nature of the rider This rider (hereinafter also referred to as the addendum ) applies only to the Contractholder whose
More informationReview of Alberta and British Columbia Legislative Changes Regarding Annuities, Life and Living Benefits Insurance
September 2012 Advocis 390 Queens Quay West, Suite 209 Toronto, ON M5V 3A2 T 416.444.5251 1.800.563.5822 F 416.444.8031 www.advocis.ca Review of Alberta and British Columbia Legislative Changes Regarding
More informationADDENDUM TO THE RETIREMENT INCOME FUND DECLARATION OF TRUST ESTABLISHING A LIFE INCOME FUND. Nova Scotia (LIF)
ADDENDUM TO THE RETIREMENT INCOME FUND DECLARATION OF TRUST ESTABLISHING A LIFE INCOME FUND Nova Scotia (LIF) 1. What the Words Mean: Please remember that in this Addendum, I, me and my mean the individual
More informationGetting Close.Retirement Income Options
Getting Close.Retirement Income Options Today s meeting How much do I need to retire? Sources of retirement income Retirement planning tools Countdown to retirement How much do I need to retire? How much
More informationFranklin Templeton Retirement Plan Beneficiary Distribution Request
Franklin Templeton Retirement Plan Beneficiary Distribution Request For assistance, please call your financial advisor or Franklin Templeton Retirement Services at 1-800/527-2020. 1 PARTICIPANT (DECEDENT)
More informationUnlocking Pension Money
An information bulletin regarding the unlocking of pensions pursuant to The Pension Benefits Act, 1992. fcaa.gov.sk.ca Page 2 [This page was left blank intentionally] Introduction Section 29 of The Pension
More informationTD Mutual Funds Life Income Fund TD Mutual Funds Locked-In Retirement Income Fund
Open Your TD Mutual Funds Account # Retirement Fund (RIF) Life Fund* (LIF); attach applicable addendum Locked-In Retirement Fund* (LRIF); attach applicable addendum Make changes to your personal information
More informationApplication/Instructions Form. Non-registered Savings Annuity. (To be used only for companies)
Application/Instructions Form Non-registered Savings Annuity (To be used only for companies) 1. BASIC INFORMATION Application/Instructions Non-registered Savings Annuity (To be used only for companies)
More informationCannon SuperDogs Investment Application
Cannon SuperDogs Investment Application 1. Notes and Requirements 1.1. Requirements on submission of this investment application, without which it will not be processed: 1.1.1. Verification of the identity
More informationShort Term Disability Income Benefit. Employee s Guide
Short Term Disability Income Benefit Employee s Guide Short Term Disability Income Benefits This guide contains the forms you need to apply for disability benefits and some important information about
More informationBanner Life Insurance Company. 3275 Bennett Creek Avenue. Frederick, Maryland 21704. 800-638-8428. [Jane Doe], or subsequently changed by the Owner
RENEWABLE AND CONVERTIBLE TERM LIFE INSURANCE. Banner Life Insurance Company. 3275 Bennett Creek Avenue. Frederick, Maryland 21704. 800-638-8428 Insured - [John Doe] Face Amount - [$1,000,000] Policy Number
More informationLife Insurance Application
Life Insurance Application (for use with telephone interview) IMPORTANT GUIDELINES This application is for Term 10, Term 20, Term 100 and Universal Life Insurance, and available benefits and riders. DO
More informationTransfer of ownership and appointment of contingent owner
Transfer of ownership and appointment of contingent owner The following administrative guidelines explain the procedures to transfer ownership rights and/or to appoint a Contingent Owner under the following
More informationTax Free Savings Account Application
Tax Free Savings Account Application THIS APPLICATION FORM CAN BE USED FOR: TFSA (TAX FREE SAVINGS ACCOUNT) Section 1: Plan Type Value Partners Investments Inc. - Tax Free Savings Account Application 400-305
More informationSUPPLEMENTARY TERMS FOR LOCKED-IN RETIREMENT ACCOUNT (LIRA) BMO INVESTORLINE RETIREMENT SAVINGS PLAN
SUPPLEMENTARY TERMS FOR LOCKED-IN RETIREMENT ACCOUNT (LIRA) Pursuant to the Pension Benefits Standards Act (British Columbia) BMO INVESTORLINE RETIREMENT SAVINGS PLAN Plan Issuer BMO Trust Company 100
More informationSingle Premium Immediate Annuities (SPIA)
Transamerica LIFE CANaDA Single Premium Immediate Annuities (SPIA) For Advisor Use only One of the biggest fears your clients can face is outliving their retirement savings. Unlike banks and trust companies
More informationissued by Sun Life Assurance Company of Canada
Sun Life Assurance Company of Canada Electronic Signature Form - May 2009 - Updated with CPA requirements Only to be used in conjunction with the Sun Life Financial Electronic Application Including SunWise
More informationLong-Term Disability Income Benefit. Employee s Statement
Long-Term Disability Income Benefit Employee s Statement Employee s Statement Long Term Disability Income Benefits This guide explains how to apply for Long Term Disability benefits. It contains the form
More informationissued by Sun Life Assurance Company of Canada
Sun Life Assurance Company of Canada Tax-Free Savings Account Rapid Application Form - May 2009 Only to be used by Nominee/Intermediaries establishing self-directed accounts via FundSERV Including SunWise
More informationPersonal Health Insurance application form
Personal Health Insurance application form Please PRINT clearly ID number In this application, you and your refer to the proposed insured and the applicant. We, us, our and the company refer to Sun Life
More informationFinancial Services Commission of Ontario Commission des services financiers de l Ontario. Life Income Fund/Locked-In Retirement Account
Financial Services Commission of Ontario Commission des services financiers de l Ontario SECTION: Life Income Fund/Locked-In Retirement Account INDEX NO.: L050-100 TITLE: APPROVED BY: Requirements of the
More informationPreparing for Retirement. A Guide for Employees. Human Resources
Preparing for Retirement A Guide for Employees 010 Human Resources Contents Introduction... 3 Canada Pension Plan Retirement Benefits... 4 Old Age Security... 6 Employment Insurance Benefits at Retirement...
More informationOctober 2015. The Canada Life Assurance Company Information folder ESTATE PROTECTION
The Canada Life Assurance Company Information folder October 2015 The Canada Life Assurance Company is the sole issuer of the individual variable annuity policy described in this information folder. This
More informationPart-time Employee Retirement Plan Designation of Beneficiary
Part-time Employee Retirement Plan Designation of Human Resources To the Trustee (s) or Custodian (as applicable) of the Austin Community College Money Purchase Plan Printed Name of Participant I hereby
More information