Fillable Registered Education Savings Plan (RESP) Request for change (iA Clarington)

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Registered Education Savings Plan (RESP) Request for change (iA Clarington)

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The Registered Education Savings Plan (RESP) Request for change (iA Clarington) form is 3 pages long and contains:

  • 4 signatures
  • 60 check-boxes
  • 110 other fields

Country of origin: US
File type: PDF

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Plan Type
❑ Individual plan ❑ Family plan
Date (DD/MM/YYYY)
/
Representative name Dealer name Dealer/rep number
Subscriber name Joint subscriber name RESP contract number
Pre-authorized Contribution Plan (PAC)
Please remember it is the subscriber’s responsibility to track his/her yearly contribution limits.
❑ Start plan ❑ Modify existing plan ❑ Stop existing plan
❑ Change banking information ❑ Change withdrawal/deposit date Effective date (DD/MM/YYYY):
Frequency (please choose one): ❑ Weekly ❑ Bi-weekly ❑ Twice monthly ❑ Monthly ❑ Every 2 months ❑ Quarterly ❑ Semi-annually ❑ Annually
Contribution amount $ Please process the payment from my bank account on the
day(s) of the month,
or ❑ end of each month.
❑ Increase from $ to $ . ❑Decrease from $ to $ .
I, the holder of the account, have read and acknowledge the pre-authorized debit agreement.
X
Signature
Pre-authorized Debit Agreement (PAD)
Each account owner is referred to as “I” in this PAD Agreement section and makes the following statements in respect of himself or herself.
I authorize IA Clarington Investments Inc. (the “Company”) and the financial institution designated (or any other financial institution I may authorize
at any time) to begin deductions as per my instructions for regular recurring payments and/or a one-time payment from time to time, for payment
of all premiums, deposits, installments and charges arising from the contract hereunder mentioned. Regular payments will be debited from my
specified account based on the date and/or frequency I have chosen, whereas a one-time payment from time to time can be debited from my
account on any other date.
I agree that, for the purpose of this PAD Agreement, all PADs from my account will be treated either as Personal or Business* depending on the
choice I’ve made.
I waive the right to receive pre-notification of an increase or a decrease in the amount to be debited or a change in the date and/or
frequency of these payments.
I agree that the Company is not required to provide me with written notice of a change in a PAD amount that is made as a result of my request.
If a PAD is dishonoured for any reason such as, but not limited to, insufficient funds (“NSF”), a stop payment or a closed account, the Company
is authorized to re-submit the payment. Any charges incurred by the Company as a result of the dishonoured PAD will be added to the
subsequent PAD.
I may cancel or modify this PAD Agreement at any time, subject to providing the Company with thirty (30) days notice in writing. To obtain a sample
cancellation form or for more information on my right to cancel the PAD Agreement, I may contact my financial institution or visit www.cdnpay.ca.
Any cancellation of this PAD Agreement will not affect my contract(s) for financial services, so long as payment is provided by an alternate method.
The Company will not assign this PAD Agreement without providing me with written notice of the assignment, any time prior to the
next PAD.
I have certain recourse rights if any PAD does not comply with this PAD Agreement. For example, I have the right to receive reimbursement for
any PAD that is not authorized or is not consistent with this PAD Agreement. To obtain more information on my recourse rights, I should contact
my financial institution or visit www.cdnpay.ca.
*Business PAD means a PAD for the payment of goods or services related to a business or commercial activity of the payor.
Registered Education Savings Plan (RESP) – Request for change
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Banking information
Please attach a VOID CHEQUE with pre-printed bank account owner information or direct deposit pre-printed form from your bank.
❑ CDN$ ❑ US$ (Domestic bank accounts only)
Investment Instructions
Investment Grant allocation Contribution amount PAC RESP contribution
Fund number Fund name Amount %
Sales
charge
% DSC
Low
load
Amount $
or %
Sales
charge
% DSC
Low
load
Wire
Order
Number(s)
Amount $
or %
Sales
charge
% DSC
Low
load
❑ ❑ ❑ ❑ ❑ ❑
❑ ❑ ❑ ❑ ❑ ❑
❑ ❑ ❑ ❑ ❑ ❑
❑ ❑ ❑ ❑ ❑ ❑
❑ ❑ ❑ ❑ ❑ ❑
Total:
Dividend/distribution options
Please choose one option. If no option is chosen IA Clarington Investments Inc. will reinvest the dividends/distributions.
❑ Reinvest dividends and distributions from all funds. ❑ Redirect to fund number:
Addition of Beneficiaries
The beneficiary’s information must appear exactly as it does on the Social Insurance Number Card. I designate the following individual(s) as the person(s) entitled
to receive payments from the plan to further his/her post-secondary education. For additional beneficiaries please use a separate form and check here ❑.
Family plan
1st additional beneficiary
Gender of beneficiary: ❑ Male ❑ Female Relationship to subscriber:
❑ Same address as subscriber
Last name First name Initial
Address City Province S.I.N. (MANDATORY)
Postal code Residence phone Other phone Ext. Date of birth (DD/MM/YYYY)
2nd additional beneficiary
Gender of beneficiary: ❑ Male ❑ Female Relationship to subscriber:
❑ Same address as subscriber
Last name First name Initial
Address City Province S.I.N. (MANDATORY)
Postal code Residence phone Other phone Ext. Date of birth (DD/MM/YYYY)
Contribution allocation
❑ Equally, or, beneficiary 1 % and beneficiary 2 %
Custodial parent/legal guardian – Where multiple custodial parents or legal guardians exist, please identify the custodial parent or legal guardian
related to the beneficiary. Please use a separate form for additional custodial parents or legal guardians.
❑ Same as subscriber ❑ Same as joint subscriber ❑ Primary caregiver ❑ Other - enter information below.
Last name First name Initial S.I.N. / B.I.N. (MANDATORY)
Address City Province Date of birth (DD/MM/YYYY)
Postal code Residence phone Business phone Ext.
Signatures
X
Subscriber signature Date (DD/MM/YYYY)
X
Joint subscriber signature Date (DD/MM/YYYY)
X
Representative signature Date (DD/MM/YYYY)
Trademarks displayed herein that are not owned by Industrial Alliance Insurance and Financial Services Inc. are the property of and trademarked
by the corresponding company and are used for illustrative purposes only. The iA Clarington Funds are managed by IA Clarington Investments Inc.
iA Clarington and the iA Clarington logo are trademarks of Industrial Alliance Insurance and Financial Services Inc. and are used under license.
iaclarington.com
INVESTED IN YOU.
(20-0037) 02/20-010132-05
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Registered Education Savings Plan (RESP) Request for change (iA Clarington)

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Completed 26 December 2020

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