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FORM 73442 (02/2009) -Bank Copy (Forward to MFRP)-
Royal Bank of CanadaDisability Savings Plan Application
HOLDER’S INFORMATION (This information is provided by the Holder).
BENEFICIARY INFORMATION - Mandatory (This information is provided by the Holder.)
PRIMARY CAREGIVER INFORMATION - This section is Mandatory if the beneficiary is under the age of 18(This information is provided by the person or public department who is the Beneficiary’s Primary Caregiver.)
PRIMARY CAREGIVER CERTIFICATION (To be completed if there is a Primary Caregiver who is not a Holder.)
I, Primary Caregiver:
acknowledge1. that the information contained in this Application will be shared with the Canada Revenue Agency and Human Resources and Skills Development Canada (the federal government responsible for the Canada Disability Savings Grant program) any other provincial governments or departments as applicable, for purposes of validating Beneficiary information, including residency and status as a DTC-Eligible Individual, and that such validation will be shared with Royal Bank.
acknowledge2. that the information collected and under control of the Canada Revenue Agency and Human Resources and Skills Development Canada will be administered in accordance with all applicable laws including the Canada Disability Savings Act, the Privacy Act (Canada), the Income Tax Act (Canada) and the Department of Skills Development Act, as amended or replaced from time to time.
certify3. that the information provided by me in this Application is, to the best of my knowledge, correct and complete.
DATE PRIMARY CAREGIVER SIGNATURE
FORM 73442 (02/2009)
ACCOUNT NUMBER
APPLICATION DATE
LANGUAGE PREFERENCE❑ ENGLISH❑ FRENCH
PLEASE INDICATE WHETHER YOU ARE:❑ A BENEFICIARY.❑ A LEGAL PARENT OF BENEFICIARY.❑ A GUARDIAN, TUTOR, CURATOR OR OTHER INDIVIDUAL LEGALLY AUTHORIZED TO ACT ON BEHALF OF THE BENEFICIARY.❑ PUBLIC DEPARTMENT, AGENCY, OR INSTITUTION LEGALLY AUTHORIZED TO ACT ON BEHALF OF THE BENEFICIARY.
SUBMITTING BRANCH DOMICILE
FIRST NAME(S) \ AGENCY OR PUBLIC DEPARTMENT
FIRST NAME(S)
FIRST NAME(S)
DATE OF BIRTH
DATE OF BIRTH
DATE OF BIRTH
SIN/BUSINESS #
SIN
SIN/BUSINESS#
FAMILY NAME
FAMILY NAME
FAMILY NAME
NAME OF PUBLIC DEPARTMENT AGENCY, or INSTITUTION LEGALLY AUTHORIZED TO ACT ON BEHALF OF THE BENEFICIARY (if applicable)
GENDER
GENDER
GENDER
SRF NUMBER
HOME TELEPHONE #
HOME TELEPHONE #
STREET NUMBER & NAME (APR. #)
STREET NUMBER & NAME (APR. #)
STREET NUMBER & NAME (APR. #)
CITY/TOWN
CITY/TOWN
CITY/TOWN
OCCUPATION
BUSINESS TELEPHONE #
BUSINESS TELEPHONE #
PROVINCE/TERRITORY
PROVINCE/TERRITORY
PROVINCE/TERRITORY
POSTAL CODE
POSTAL CODE
POSTAL CODE
HOME TELEPHONE # BUSINESS TELEPHONE #
BUSINESS CONTACT
TRANSIT NO.
ROYAL BANK OF CANADADISABILITY SAVINGS PLAN APPLICATION
-Bank Copy (Forward to MFRP)-
FORM 73442 (02/2009)
APPENDIX TO THE REGISTERED DISABILITY SAVINGS PLAN APPLICATION
SCHEDULE OF FEES
You may charge the following Services Fees:A $25.00 service fee for the transfer of property from the Plan to another financial institution, except a member of the Royal •Bank Financial Group, and A $25.00 service fee for the termination of the Plan during the first twelve months of operation, and•A $5.00 service fee for each duplicate RDSP statement request.•
Note: This schedule of fees is subject to change. “You” means Royal Bank of Canada, in its capacity as agent and administrator of the Plan.
Fund Code
Fund Code
GIC Code GIC Name Issued By Interest Rate Investment AmountMaturity DateDD/MM/YR
Total
Total
$
$
$
$
$
$
Fund Name
Fund Name Investment Amount(Lump Sum)
Investment AmountContribution Amount
(Complete PAC Info Below)
DEPOSIT/MUTUAL FUNDS
ACCOUNT HOLDER SIGNATURE
ATTACH VOID CHEQUE TO APPLICATION
DEPOSIT/MUTUAL FUNDS/PRE-AUTHORIZED CONTRIBUTION SET-UP
GUARANTEED INVESTMENT CERTIFICATE (GIC)
GRANT PAYMENT INVESTMENT INSTRUCTIONS
INVESTMENT INSTRUCTIONS
PRE-AUTHORIZED CONTRIBUTION (PAC)START DATE ______________________
STOP DATE _______________________(if applicable)
BANKING INFORMATION TRANSIT # INSTITUTION # ACCOUNT #
ACCOUNT NAME _____________________________ _________ _______________ ________________
NAME OF FINANCIAL INSTITUTION _______________________________________________________________
ADDRESS OF FINANCIAL INSTITUTION ___________________________________________________________
Note: If banking information is for another financial institution, a void cheque must be attached.
GUARANTEED INVESTMENT CERTIFICATES
Non-Redeemable – Annual Compound Interest OptionInterest rates quoted are per annum, with interest calculated and added to principal on each 12-month anniversary date, and at maturity.Market-LinkedRate of return is based on the performance of various stock indices and payable at maturity. Please refer to the Special Terms & Conditions for more details.Issued by
1. Royal Bank of Canada2. The Royal Trust Company3. Royal Trust Corporation of Canada (not available in Quebec)
SAVINGS DEPOSITSInterest rates quoted are per annum, with interest calculated on the daily closing balance and added to principal at the end of June and December. Interest rates are subject to change.MUTUAL FUNDSRBC Funds are offered by RBC Asset Management Inc., and distributed through Royal Mutual Funds Inc. (RMFI), a member of the RBC Financial Group. RMFI and Royal Bank of Canada are separate corporate entities, which are affiliated. RMFI is licensed as a financial services firm in the province of Quebec. Mutual Funds are not insured by the Canada Deposit Insurance Corporation, the Régie de l’assurance-dépôts du Québec or any other deposits insurer nor guaranteed by Royal Bank or Royal Trust. Unit values and investment returns will fluctuate. For the money market funds, yields will fluctuate and there is no assurance the funds can maintain a fixed net asset value. Royal Mutual Funds Inc. reserves the right to accept or reject a subscription, in whole or in part. The decision to accept or reject a subscription will be exercised promptly and in any event within two days of receipt thereof. In the case of the rejection of a subscription in whole or in part, the corresponding portion of the monies received with the subscription will be returned to the applicant immediately.
DATE HOLDER’S SIGNATURE
DATE REGISTERED MUTUAL FUND SALESPERSON SIGNATURE
DATE BRANCH COMPLIANCE OFFICER SIGNATURE
FREQUENCY: ❑ Weekly ❑ Bi-Weekly ❑ Monthly ❑ Semi-Monthly ❑ Quarterly ❑ Semi-Annually ❑ Annually
I hereby authorized the Funds indicated above to draw on my account set out in Banking Information below
-Bank Copy (Forward to MFRP)-
FORM 73442 (02/2009)
HOLDER REQUESTS, ACKNOWLEDGMENTS, CERTIFICATIONS AND UNDERTAKINGS
I(we), Holder(s), hereby apply for a disability savings plan (the “Plan”) with Royal Bank of Canada (Royal Bank) and request that Royal Bank submit the Royal Bank plan to the Government of Canada as a Registered Disability Savings Plan under any other applicable laws of the province of Canada indicated in the Beneficiary’s address.
I(we each) acknowledge that:
1. in order to have the Plan registered as a disability savings plan, the Beneficiary must have been issued a Social Insurance Number and must be DTC-Eligible Individual and a Canadian resident.
2. it is my responsibility to ensure that contributions to the Plan do not exceed those allowable under the applicable laws, and (to the extent that I am then a Holder) that the contributions end no later than the Beneficiary’s 60th year.
3. no other person may contribute to the Plan except with my (and any other Holder’s) written consent.4. the Beneficiary may direct the Royal Bank to make Disability Assistance Payments only if the Beneficiary has
attained the age of 27 years but not the age of 59 years, and I (and any other Holder) have notified the Royal Bank in writing that the Beneficiary may so direct and confirmed that the Beneficiary is not an Incapable Person.
5. I, any other Holder and the Beneficiary (or the Beneficiary’s estate) are jointly liable for taxes arising in connection with the deregistration of the Plan due to failure to comply with the applicable laws.
6. the information contained in this Application will be shared with the Canada Revenue Agency and Human Resources and Skills Development Canada (the federal government responsible for the Canada Disability Savings Grant and Bond program) any other provincial governments or departments as applicable, for purposes of (i) administering the registered disability savings plan program, (ii) validating Holder information, and (iii) validating Beneficiary information, including residency and status as a DTC-Eligible Individual.
7. the validation of the Beneficiary information, including residency and status as a DTC-Eligible Individual will be shared with Royal Bank.
8. the information collected and under control of the Canada Revenue Agency and Human Resources and Skills Development Canada will be administered in accordance with all applicable laws including the Canada Disability Savings Act, the Privacy Act (Canada), the Income Tax Act (Canada) and the Department of Skills Development Act, as amended or replaced from time to time.
9. the information contained in this Application may also be shared with the legal parent, guardian, tutor, curator, public department, agency, institution or other person legally authorized to act on behalf of the Beneficiary.
10. receipt of the Plan and Trust Agreement, Schedule of Fees and Collection and Use of Personal Information provisions, and agree to everything written there and on this Application.
I (we each) certify that:
1. the information provided by me in this Application is, to the best of my knowledge, correct and complete.2. the Beneficiary is a DTC-Eligible Individual and a Canadian resident, and agree that Royal Bank will is and is
authorized to rely on this confirmation.3. this account will not be used by or on behalf of a third party.
I(we each) undertake:
1. to advise Royal Bank if the Beneficiary is no longer a DTC-Eligible Individual or Canadian resident.2. not to resign while a Qualifying Person unless there is another Holder at that time.3. if I am a Legal Parent of the Beneficiary, to take steps to determine whether the Beneficiary could be found to be
an Incapable Person upon attaining the age of majority and, if it appears that the Beneficiary:a. could be so found, to ensure that a person who would qualify as a Qualifying Person is appointed prior
to the Beneficiary attaining the Age of Majority.b. could not be so found, to ensure that the Beneficiary, not less than six (6) months prior to attaining the
Age of Majority, shall provide any information to the Royal Bank and complete any document provided by the Royal Bank, expressing his or her agreement to be a Holder, or
4. if I am a Legal Parent of the Beneficiary, and the steps set out above are not taken, to have another Qualifying Person be appointed as a Holder prior to the Beneficiary attaining the Age of Majority.
I (we each) hereby request that:
1. Royal Bank forward on my behalf all completed and signed government grant applications for contributions made to this Plan.
2. any applicable government grant and bond proceeds received be invested per my (and any other Holder’s) instructions.
____________________________________ ________________________________________________DATE HOLDER SIGNATUREAccepted by Royal Bank of Canada as Agent for The Royal Trust Company
____________________________________ ________________________________________________DATE SALES REPRESENTATIVE SIGNATURE® Registered trademark of Royal Bank of Canada.
-Bank Copy (Forward to MFRP)-
FORM 73442 (02/2009)DEFINITIONS
For purposes of this Application:
Age of Majority 1. is the age at which the Beneficiary is deemed to be capable of managing property pursuant to the laws of the Beneficiary’s province or territory of residence.
A 2. DTC-Eligible Individual is an individual in respect of whom an amount is deductible under section 118.3 of the Income Tax Act (Canada), or would be deductible if the Income Tax Act (Canada) were read without reference to paragraph 118.3(1)(c), in computing a taxpayer’s tax payable under Part I of the Income Tax Act (Canada).
An 3. Incapable Person is someone in respect of whom:the Public Guardian and Trustee or another person has been appointed as committee of the estate or guardian of property, a. statutory or otherwise, of such person, in any manner and for any reason, orletters of opinion have been given by two physicians duly qualified to practise in the jurisdiction where that person resides that such b. person is incapable of managing property due to physical or mental disability.
A 4. Legal Parent is a person who is identified on the Beneficiary’s birth certificate as the Beneficiary’s parent, whose paternity in respect of the Beneficiary has been recognized by a court of competent jurisdiction, or who is an adoptive parent of the Beneficiary pursuant to an act of a court of competent jurisdiction, and who has not lost his or her parental rights in respect of the Beneficiary in accordance with applicable law.
A 5. Primary Caregiver is either an individual who is eligible to receive the Canada Child Tax Benefit or an entity that is eligible to receipt of a special allowance payable under the Children’s Special Allowances Act (Canada) in respect of the Beneficiary at the time this Application is completed.
A 6. Qualifying Person is:if the Beneficiary has not attained the age of majority, a (i) person who is a Legal Parent, a guardian, tutor, curator or other a. individual, or (ii) public department, an agency or any institution, and is legally authorized to act on behalf of the Beneficiary, andif the Beneficiary, at that time, has attained the age of majority but is an Incapable Person, an entity that is a public department, an b. agency or any institution and legally authorized to act on behalf of the Beneficiary.
-Bank Copy (Forward to MFRP)-
FORM 73442 (02/2009)COLLECTION AND USE OF PERSONAL INFORMATION
Collecting your personal information
We (Royal Bank) may from time to time collect financial and other information about you such as:
information establishing your identity (for example, name, address, phone number, date of birth, etc.) and your personal background;•information related to transactions arising from your relationship with and through us, and from other financial institutions;•information you provide on an application for any of our products and services;•information for the provision of products and services; and•information about financial behaviour such as your payment history and credit worthiness.•
We may collect and confirm this information during the course of our relationship. We may obtain this information from a variety of sources, including from you, from service arrangements you make with or through us, from credit reporting agencies and financial institutions, from registries, from references you provide to us and from other sources, as is necessary for the provision of our products and services.
You acknowledge receipt of notice that from time to time reports about you may be obtained by us from credit reporting agencies.
Using your personal information
This information may be used from time to time for the following purposes:
to verify your identity and investigate your personal background; •to open and operate your account(s) and provide you with products and services you may request; •to better understand your financial situation;•to determine your eligibility for products and services we offer; •to help us better understand the current and future needs of our clients;•to communicate to you any benefit, feature and other information about products and services you have with us;•to help us better manage our business and your relationship with us;•to maintain the accuracy and integrity of information held by a credit reporting agency; and•as required or permitted by law.•
For these purposes, we may:
make this information available to our employees, our agents and service providers, who are required to maintain the confidentiality of this •information;
share this information with other financial institutions; and•give credit, financial and other related information to credit reporting agencies who may share it with others. •
In the event our service provider is located outside of Canada, the service provider is bound by, and the information may be disclosed in accordance with, the laws of the jurisdiction in which the service provider is located.
Upon your request, we may give this information to other persons.
We may also use this information and share it with RBC companies (i) to manage our risks and operations and those of RBC companies, (ii) to comply with valid requests for information about you from regulators, government agencies, public bodies or other entities who have a right to issue such requests, and (iii) to let RBC companies know your choices under “Other uses of your personal information” for the sole purpose of honouring your choices.
If we have your social insurance number, we may use it for tax related purposes if you hold a product generating income and share it with the appropriate government agencies, and we may also share it with credit reporting agencies as an aid to identify you.
Other uses of your personal information
We may use this information to promote our products and services, and promote products and services of third parties we select, which may •be of interest to you. We may communicate with you through various channels, including telephone, computer or mail, using the contact information you have provided.
We may also, where not prohibited by law, share this information with RBC companies for the purpose of referring you to them or promoting •to you products and services which may be of interest to you. We and RBC companies may communicate with you through various channels, including telephone, computer or mail, using the contact information you have provided. You acknowledge that as a result of such sharing they may advise us of those products or services provided.
If you also deal with RBC companies, we may, where not prohibited by law, consolidate this information with information they have about you •to allow us and any of them to manage your relationship with RBC companies and our business.
You understand that we and RBC companies are separate, affiliated corporations. RBC companies include our affiliates which are engaged in the business of providing any one or more of the following services to the public: deposits, loans and other personal financial services; credit, charge and payment card services; trust and custodial services; securities and brokerage services; and insurance services.
You may choose not to have this information shared or used for any of these “Other uses” by contacting us as set out below, and in this event, you will not be refused credit or other services just for that reason. We will respect your choices and, as mentioned above, we may share your choices with RBC companies for the sole purpose of honouring your choices regarding “Other uses of your personal information”.
Your right to access your personal information
You may obtain access to the information we hold about you at any time and review its content and accuracy, and have it amended as appropriate; however, access may be restricted as permitted or required by law. To request access to such information, to ask questions about our privacy policies or to request that the information not be used for any or all of the purposes outlined in “Other uses of your personal information” you may do so now or at any time in the future by:
contacting your branch; or•calling us toll free at 1-800 Royal®1-1 (1-800-769-2511).•
Our privacy policies
You may obtain more information about our privacy policies by asking for a copy of our “Straight Talk®” brochure about privacy, by calling us at the toll free number shown above or by visiting our web site at www.rbc.com/privacy
-Bank Copy (Forward to MFRP)-
FORM 73442 (02/2009) -Client Copy-
Royal Bank of CanadaDisability Savings Plan Application
HOLDER’S INFORMATION (This information is provided by the Holder).
BENEFICIARY INFORMATION - Mandatory (This information is provided by the Holder.)
PRIMARY CAREGIVER INFORMATION - This section is Mandatory if the beneficiary is under the age of 18(This information is provided by the person or public department who is the Beneficiary’s Primary Caregiver.)
PRIMARY CAREGIVER CERTIFICATION (To be completed if there is a Primary Caregiver who is not a Holder.)
I, Primary Caregiver:
acknowledge1. that the information contained in this Application will be shared with the Canada Revenue Agency and Human Resources and Skills Development Canada (the federal government responsible for the Canada Disability Savings Grant program) any other provincial governments or departments as applicable, for purposes of validating Beneficiary information, including residency and status as a DTC-Eligible Individual, and that such validation will be shared with Royal Bank.
acknowledge2. that the information collected and under control of the Canada Revenue Agency and Human Resources and Skills Development Canada will be administered in accordance with all applicable laws including the Canada Disability Savings Act, the Privacy Act (Canada), the Income Tax Act (Canada) and the Department of Skills Development Act, as amended or replaced from time to time.
certify3. that the information provided by me in this Application is, to the best of my knowledge, correct and complete.
DATE PRIMARY CAREGIVER SIGNATURE
FORM 73442 (02/2009)
ACCOUNT NUMBER
APPLICATION DATE
LANGUAGE PREFERENCE❑ ENGLISH❑ FRENCH
PLEASE INDICATE WHETHER YOU ARE:❑ A BENEFICIARY.❑ A LEGAL PARENT OF BENEFICIARY.❑ A GUARDIAN, TUTOR, CURATOR OR OTHER INDIVIDUAL LEGALLY AUTHORIZED TO ACT ON BEHALF OF THE BENEFICIARY.❑ PUBLIC DEPARTMENT, AGENCY, OR INSTITUTION LEGALLY AUTHORIZED TO ACT ON BEHALF OF THE BENEFICIARY.
SUBMITTING BRANCH DOMICILE
FIRST NAME(S) \ AGENCY OR PUBLIC DEPARTMENT
FIRST NAME(S)
FIRST NAME(S)
DATE OF BIRTH
DATE OF BIRTH
DATE OF BIRTH
SIN/BUSINESS #
SIN
SIN/BUSINESS#
FAMILY NAME
FAMILY NAME
FAMILY NAME
NAME OF PUBLIC DEPARTMENT AGENCY, or INSTITUTION LEGALLY AUTHORIZED TO ACT ON BEHALF OF THE BENEFICIARY (if applicable)
GENDER
GENDER
GENDER
SRF NUMBER
HOME TELEPHONE #
HOME TELEPHONE #
STREET NUMBER & NAME (APR. #)
STREET NUMBER & NAME (APR. #)
STREET NUMBER & NAME (APR. #)
CITY/TOWN
CITY/TOWN
CITY/TOWN
OCCUPATION
BUSINESS TELEPHONE #
BUSINESS TELEPHONE #
PROVINCE/TERRITORY
PROVINCE/TERRITORY
PROVINCE/TERRITORY
POSTAL CODE
POSTAL CODE
POSTAL CODE
HOME TELEPHONE # BUSINESS TELEPHONE #
BUSINESS CONTACT
TRANSIT NO.
ROYAL BANK OF CANADADISABILITY SAVINGS PLAN APPLICATION
-Client Copy-
FORM 73442 (02/2009)
APPENDIX TO THE REGISTERED DISABILITY SAVINGS PLAN APPLICATION
SCHEDULE OF FEES
You may charge the following Services Fees:A $25.00 service fee for the transfer of property from the Plan to another financial institution, except a member of the Royal •Bank Financial Group, and A $25.00 service fee for the termination of the Plan during the first twelve months of operation, and•A $5.00 service fee for each duplicate RDSP statement request.•
Note: This schedule of fees is subject to change. “You” means Royal Bank of Canada, in its capacity as agent and administrator of the Plan.
Fund Code
Fund Code
GIC Code GIC Name Issued By Interest Rate Investment AmountMaturity DateDD/MM/YR
Total
Total
$
$
$
$
$
$
Fund Name
Fund Name Investment Amount(Lump Sum)
Investment AmountContribution Amount
(Complete PAC Info Below)
DEPOSIT/MUTUAL FUNDS
ACCOUNT HOLDER SIGNATURE
ATTACH VOID CHEQUE TO APPLICATION
DEPOSIT/MUTUAL FUNDS/PRE-AUTHORIZED CONTRIBUTION SET-UP
GUARANTEED INVESTMENT CERTIFICATE (GIC)
GRANT PAYMENT INVESTMENT INSTRUCTIONS
INVESTMENT INSTRUCTIONS
PRE-AUTHORIZED CONTRIBUTION (PAC)START DATE ______________________
STOP DATE _______________________(if applicable)
BANKING INFORMATION TRANSIT # INSTITUTION # ACCOUNT #
ACCOUNT NAME _____________________________ _________ _______________ ________________
NAME OF FINANCIAL INSTITUTION _______________________________________________________________
ADDRESS OF FINANCIAL INSTITUTION ___________________________________________________________
Note: If banking information is for another financial institution, a void cheque must be attached.
GUARANTEED INVESTMENT CERTIFICATES
Non-Redeemable – Annual Compound Interest OptionInterest rates quoted are per annum, with interest calculated and added to principal on each 12-month anniversary date, and at maturity.Market-LinkedRate of return is based on the performance of various stock indices and payable at maturity. Please refer to the Special Terms & Conditions for more details.Issued by
1. Royal Bank of Canada2. The Royal Trust Company3. Royal Trust Corporation of Canada (not available in Quebec)
SAVINGS DEPOSITSInterest rates quoted are per annum, with interest calculated on the daily closing balance and added to principal at the end of June and December. Interest rates are subject to change.MUTUAL FUNDSRBC Funds are offered by RBC Asset Management Inc., and distributed through Royal Mutual Funds Inc. (RMFI), a member of the RBC Financial Group. RMFI and Royal Bank of Canada are separate corporate entities, which are affiliated. RMFI is licensed as a financial services firm in the province of Quebec. Mutual Funds are not insured by the Canada Deposit Insurance Corporation, the Régie de l’assurance-dépôts du Québec or any other deposits insurer nor guaranteed by Royal Bank or Royal Trust. Unit values and investment returns will fluctuate. For the money market funds, yields will fluctuate and there is no assurance the funds can maintain a fixed net asset value. Royal Mutual Funds Inc. reserves the right to accept or reject a subscription, in whole or in part. The decision to accept or reject a subscription will be exercised promptly and in any event within two days of receipt thereof. In the case of the rejection of a subscription in whole or in part, the corresponding portion of the monies received with the subscription will be returned to the applicant immediately.
DATE HOLDER’S SIGNATURE
DATE REGISTERED MUTUAL FUND SALESPERSON SIGNATURE
DATE BRANCH COMPLIANCE OFFICER SIGNATURE
FREQUENCY: ❑ Weekly ❑ Bi-Weekly ❑ Monthly ❑ Semi-Monthly ❑ Quarterly ❑ Semi-Annually ❑ Annually
I hereby authorized the Funds indicated above to draw on my account set out in Banking Information below
-Client Copy-
FORM 73442 (02/2009)
HOLDER REQUESTS, ACKNOWLEDGMENTS, CERTIFICATIONS AND UNDERTAKINGS
I(we), Holder(s), hereby apply for a disability savings plan (the “Plan”) with Royal Bank of Canada (Royal Bank) and request that Royal Bank submit the Royal Bank plan to the Government of Canada as a Registered Disability Savings Plan under any other applicable laws of the province of Canada indicated in the Beneficiary’s address.
I(we each) acknowledge that:
1. in order to have the Plan registered as a disability savings plan, the Beneficiary must have been issued a Social Insurance Number and must be DTC-Eligible Individual and a Canadian resident.
2. it is my responsibility to ensure that contributions to the Plan do not exceed those allowable under the applicable laws, and (to the extent that I am then a Holder) that the contributions end no later than the Beneficiary’s 60th year.
3. no other person may contribute to the Plan except with my (and any other Holder’s) written consent.4. the Beneficiary may direct the Royal Bank to make Disability Assistance Payments only if the Beneficiary has
attained the age of 27 years but not the age of 59 years, and I (and any other Holder) have notified the Royal Bank in writing that the Beneficiary may so direct and confirmed that the Beneficiary is not an Incapable Person.
5. I, any other Holder and the Beneficiary (or the Beneficiary’s estate) are jointly liable for taxes arising in connection with the deregistration of the Plan due to failure to comply with the applicable laws.
6. the information contained in this Application will be shared with the Canada Revenue Agency and Human Resources and Skills Development Canada (the federal government responsible for the Canada Disability Savings Grant and Bond program) any other provincial governments or departments as applicable, for purposes of (i) administering the registered disability savings plan program, (ii) validating Holder information, and (iii) validating Beneficiary information, including residency and status as a DTC-Eligible Individual.
7. the validation of the Beneficiary information, including residency and status as a DTC-Eligible Individual will be shared with Royal Bank.
8. the information collected and under control of the Canada Revenue Agency and Human Resources and Skills Development Canada will be administered in accordance with all applicable laws including the Canada Disability Savings Act, the Privacy Act (Canada), the Income Tax Act (Canada) and the Department of Skills Development Act, as amended or replaced from time to time.
9. the information contained in this Application may also be shared with the legal parent, guardian, tutor, curator, public department, agency, institution or other person legally authorized to act on behalf of the Beneficiary.
10. receipt of the Plan and Trust Agreement, Schedule of Fees and Collection and Use of Personal Information provisions, and agree to everything written there and on this Application.
I (we each) certify that:
1. the information provided by me in this Application is, to the best of my knowledge, correct and complete.2. the Beneficiary is a DTC-Eligible Individual and a Canadian resident, and agree that Royal Bank will is and is
authorized to rely on this confirmation.3. this account will not be used by or on behalf of a third party.
I(we each) undertake:
1. to advise Royal Bank if the Beneficiary is no longer a DTC-Eligible Individual or Canadian resident.2. not to resign while a Qualifying Person unless there is another Holder at that time.3. if I am a Legal Parent of the Beneficiary, to take steps to determine whether the Beneficiary could be found to be
an Incapable Person upon attaining the age of majority and, if it appears that the Beneficiary:a. could be so found, to ensure that a person who would qualify as a Qualifying Person is appointed prior
to the Beneficiary attaining the Age of Majority.b. could not be so found, to ensure that the Beneficiary, not less than six (6) months prior to attaining the
Age of Majority, shall provide any information to the Royal Bank and complete any document provided by the Royal Bank, expressing his or her agreement to be a Holder, or
4. if I am a Legal Parent of the Beneficiary, and the steps set out above are not taken, to have another Qualifying Person be appointed as a Holder prior to the Beneficiary attaining the Age of Majority.
I (we each) hereby request that:
1. Royal Bank forward on my behalf all completed and signed government grant applications for contributions made to this Plan.
2. any applicable government grant and bond proceeds received be invested per my (and any other Holder’s) instructions.
____________________________________ ________________________________________________DATE HOLDER SIGNATUREAccepted by Royal Bank of Canada as Agent for The Royal Trust Company
____________________________________ ________________________________________________DATE SALES REPRESENTATIVE SIGNATURE® Registered trademark of Royal Bank of Canada.
-Client Copy-
FORM 73442 (02/2009)DEFINITIONS
For purposes of this Application:
Age of Majority 1. is the age at which the Beneficiary is deemed to be capable of managing property pursuant to the laws of the Beneficiary’s province or territory of residence.
A 2. DTC-Eligible Individual is an individual in respect of whom an amount is deductible under section 118.3 of the Income Tax Act (Canada), or would be deductible if the Income Tax Act (Canada) were read without reference to paragraph 118.3(1)(c), in computing a taxpayer’s tax payable under Part I of the Income Tax Act (Canada).
An 3. Incapable Person is someone in respect of whom:the Public Guardian and Trustee or another person has been appointed as committee of the estate or guardian of property, a. statutory or otherwise, of such person, in any manner and for any reason, orletters of opinion have been given by two physicians duly qualified to practise in the jurisdiction where that person resides that such b. person is incapable of managing property due to physical or mental disability.
A 4. Legal Parent is a person who is identified on the Beneficiary’s birth certificate as the Beneficiary’s parent, whose paternity in respect of the Beneficiary has been recognized by a court of competent jurisdiction, or who is an adoptive parent of the Beneficiary pursuant to an act of a court of competent jurisdiction, and who has not lost his or her parental rights in respect of the Beneficiary in accordance with applicable law.
A 5. Primary Caregiver is either an individual who is eligible to receive the Canada Child Tax Benefit or an entity that is eligible to receipt of a special allowance payable under the Children’s Special Allowances Act (Canada) in respect of the Beneficiary at the time this Application is completed.
A 6. Qualifying Person is:if the Beneficiary has not attained the age of majority, a (i) person who is a Legal Parent, a guardian, tutor, curator or other a. individual, or (ii) public department, an agency or any institution, and is legally authorized to act on behalf of the Beneficiary, andif the Beneficiary, at that time, has attained the age of majority but is an Incapable Person, an entity that is a public department, an b. agency or any institution and legally authorized to act on behalf of the Beneficiary.
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FORM 73442 (02/2009)COLLECTION AND USE OF PERSONAL INFORMATION
Collecting your personal information
We (Royal Bank) may from time to time collect financial and other information about you such as:
information establishing your identity (for example, name, address, phone number, date of birth, etc.) and your personal background;•information related to transactions arising from your relationship with and through us, and from other financial institutions;•information you provide on an application for any of our products and services;•information for the provision of products and services; and•information about financial behaviour such as your payment history and credit worthiness.•
We may collect and confirm this information during the course of our relationship. We may obtain this information from a variety of sources, including from you, from service arrangements you make with or through us, from credit reporting agencies and financial institutions, from registries, from references you provide to us and from other sources, as is necessary for the provision of our products and services.
You acknowledge receipt of notice that from time to time reports about you may be obtained by us from credit reporting agencies.
Using your personal information
This information may be used from time to time for the following purposes:
to verify your identity and investigate your personal background; •to open and operate your account(s) and provide you with products and services you may request; •to better understand your financial situation;•to determine your eligibility for products and services we offer; •to help us better understand the current and future needs of our clients;•to communicate to you any benefit, feature and other information about products and services you have with us;•to help us better manage our business and your relationship with us;•to maintain the accuracy and integrity of information held by a credit reporting agency; and•as required or permitted by law.•
For these purposes, we may:
make this information available to our employees, our agents and service providers, who are required to maintain the confidentiality of this •information;
share this information with other financial institutions; and•give credit, financial and other related information to credit reporting agencies who may share it with others. •
In the event our service provider is located outside of Canada, the service provider is bound by, and the information may be disclosed in accordance with, the laws of the jurisdiction in which the service provider is located.
Upon your request, we may give this information to other persons.
We may also use this information and share it with RBC companies (i) to manage our risks and operations and those of RBC companies, (ii) to comply with valid requests for information about you from regulators, government agencies, public bodies or other entities who have a right to issue such requests, and (iii) to let RBC companies know your choices under “Other uses of your personal information” for the sole purpose of honouring your choices.
If we have your social insurance number, we may use it for tax related purposes if you hold a product generating income and share it with the appropriate government agencies, and we may also share it with credit reporting agencies as an aid to identify you.
Other uses of your personal information
We may use this information to promote our products and services, and promote products and services of third parties we select, which may •be of interest to you. We may communicate with you through various channels, including telephone, computer or mail, using the contact information you have provided.
We may also, where not prohibited by law, share this information with RBC companies for the purpose of referring you to them or promoting •to you products and services which may be of interest to you. We and RBC companies may communicate with you through various channels, including telephone, computer or mail, using the contact information you have provided. You acknowledge that as a result of such sharing they may advise us of those products or services provided.
If you also deal with RBC companies, we may, where not prohibited by law, consolidate this information with information they have about you •to allow us and any of them to manage your relationship with RBC companies and our business.
You understand that we and RBC companies are separate, affiliated corporations. RBC companies include our affiliates which are engaged in the business of providing any one or more of the following services to the public: deposits, loans and other personal financial services; credit, charge and payment card services; trust and custodial services; securities and brokerage services; and insurance services.
You may choose not to have this information shared or used for any of these “Other uses” by contacting us as set out below, and in this event, you will not be refused credit or other services just for that reason. We will respect your choices and, as mentioned above, we may share your choices with RBC companies for the sole purpose of honouring your choices regarding “Other uses of your personal information”.
Your right to access your personal information
You may obtain access to the information we hold about you at any time and review its content and accuracy, and have it amended as appropriate; however, access may be restricted as permitted or required by law. To request access to such information, to ask questions about our privacy policies or to request that the information not be used for any or all of the purposes outlined in “Other uses of your personal information” you may do so now or at any time in the future by:
contacting your branch; or•calling us toll free at 1-800 Royal®1-1 (1-800-769-2511).•
Our privacy policies
You may obtain more information about our privacy policies by asking for a copy of our “Straight Talk®” brochure about privacy, by calling us at the toll free number shown above or by visiting our web site at www.rbc.com/privacy
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