817-03-215E (11/18/2013)
199 Bay Street, Suite 600 PO Box 279 STN Commerce Court
Toronto ON M5L 0A2
Toll free 1.800.263.8349 Fax 1.866.941.7711
Should there be any discrepancy with this information, please advise us so that we can modify our records accordingly.
We hereby confirm that the following Assignment in favour of B2B Bank has been recorded in our books as follows:
Confirmation of Assignment
DATE:
TO: B2B Bank
FROM: Industrial Alliance Insurance and Financial Services Inc.
Industrial Alliance Insurance and Financial Services Inc.
Signed:
We refer to the Segregated Funds Loan Program Distribution Agreement among B2B Bank and Industrial Alliance Insurance
and Financial Services Inc dated January 27, 2011 (the “Agreement”). Unless otherwise defined herein, the words and
expressions defined in the Agreement have the same respective meanings when used herein.
We hereby also confirm that:
- the Contract/policy has not been previously assigned or hypothecated in favour of any Person, other than B2B Bank;
- we will not register or acquiesce to an assignment or hypothecation of the Policy in favour of any Person, other than
B2B Bank or enter into any “control agreement” with any Person other than B2B Bank or otherwise give “control” to
any Person other than B2B Bank (within the meaning given to such terms in the Act respecting the transfer of
securities and the establishment of security entitlements (Quebec)) and/or the Securities Transfer Act (Ontario) and
any equivalent legislation in other jurisdictions), in relation to the Policy; and
- we will promptly inform you in the event any Person (other than B2B Bank) purports to be the assignee or hypothecary
creditor of, or requests information regarding the assignability or hypothecation of, the Contract/Policy.
Contract / Policy Information
Contract/Policy Number:
Date of purchase of Contract/Policy:
Annuitant of Contract/Policy:
Beneficiary of Contract/Policy:
Date of Assignment / Hypothecation:
Revocable Irrevocable
