modification form – kyc update - Desjardins Financial Security

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modification form – kyc update - Desjardins Financial Security
1150, rue de Claire-Fontaine
Québec (Québec) G1R 5G4
PLAN no
4. PLAN INVESTMENT OBJECTIVES – Each plan must be fully completed to update the client’s information.
client id
plan kyc with changes account number
RESET
non-registered
modification form –
kyc update
1. ACCOUNT REGISTRATION TYPE
DEALER CODE
9697
OWNER FIRST NAME
initial
JOINT OWNER FIRST NAME
initial
INCOME
RISK TOLERANCE LOW
initial
%
GROWTH
MEDIUM LOW
0 - 3 years
non-registered
plan kyc without changes account number
SPOUSAL RRSP
%
Intended use of account
RRIF
%
SPOUSAL RRIF
SPECULATIVE
%
MEDIUM
4 - 5 years
%
%
Retirement
LIRA
resp
tfsa
OTHER
= 100%
MEDIUM HIGH
6 - 9 years
Personal savings
LIF
%
HIGH
%
RISK TOLERANCE LOW
Other
BRANCH CODE
plan kyc with changes account number
OWNER LAST NAME
non-registered
JOINT OWNER LAST NAME
IN TRUST FOR – LAST NAME
rRSP
OBJECTIVES
INCOME
RISK TOLERANCE LOW
%
%
MEDIUM LOW
0 - 3 years
Intended use of account
GROWTH
RRIF
%
SPOUSAL RRIF
SPECULATIVE
%
MEDIUM
4 - 5 years
%
%
Retirement
LIRA
resp
tfsa
OTHER
= 100%
%
HIGH
INCOME
RISK TOLERANCE LOW
%
= 100%
non-registered
EMPLOYER INFORMATION
EMPLOYER
BUSINESS TYPE
OCCUPATION
OBJECTIVES
INCOME
RISK TOLERANCE LOW
TIME HORIZON
address
CITY
PROVINCE
POSTAL CODE
PHONE NUMBER
rRSP
%
%
MEDIUM LOW
0 - 3 years
Intended use of account
GROWTH
RRIF
%
SPOUSAL RRIF
SPECULATIVE
%
MEDIUM
4 - 5 years
%
%
Retirement
LIF
plan kyc with changes account number
NUMBER OF DEPENDENTS
non-registered
INVESTMENT CHARACTERISTICS – Refer to the end of this form for definitions.
INVESTMENT KNOWLEDGE
GROSS ANNUAL INCOME
NOVICE
less than $50,000
less than $50,000
FAIR
$50,000 TO $99,999
$50,000 TO $99,999
GOOD
$100,000 TO $149,999
$100,000 TO $249,999
SOPHISTICATED
$150,000 AND over
$250,000 TO $999,999
OBJECTIVES
INCOME
RISK TOLERANCE LOW
TIME HORIZON
NET WORTH
Check the box if the assets and liabilities include the spouse’s.
rRSP
resp
tfsa
OTHER
= 100%
OBJECTIVES
INCOME
RISK TOLERANCE LOW
TIME HORIZON
%
HIGH
%
= 100%
non-registered
INCOME
RISK TOLERANCE LOW
MEDIUM
4 - 5 years
%
%
%
GROWTH
MEDIUM LOW
0 - 3 years
LIF
resp
tfsa
OTHER
= 100%
%
HIGH
%
PHONE NUMBER
non-registered
INCOME
%
SPOUSAL RRIF
SPECULATIVE
%
MEDIUM
4 - 5 years
%
%
Retirement
LIF
DEPENDENTS
RISK TOLERANCE LOW
NUMBER OF DEPENDENTS
TIME HORIZON
%
MEDIUM LOW
0 - 3 years
Intended use of account
GROWTH
GROSS ANNUAL INCOME
resp
tfsa
OTHER
NOVICE
less than $50,000
less than $50,000
FAIR
$50,000 TO $99,999
$50,000 TO $99,999
GOOD
$100,000 TO $149,999
$100,000 TO $249,999
SOPHISTICATED
$150,000 AND over
$250,000 TO $999,999
non-registered
%
HIGH
%
INCOME
RRIF
%
10 years and over
SPOUSAL RRIF
SPECULATIVE
%
MEDIUM
4 - 5 years
%
%
Other
Retirement
LIF
LIRA
resp
tfsa
OTHER
= 100%
MEDIUM HIGH
6 - 9 years
%
HIGH
%
= 100%
10 years and over
Children’s education
RISK TOLERANCE LOW
TIME HORIZON
0 - 3 years
Intended use of account
$1,000,000 AND OVER
%
GROWTH
MEDIUM LOW
4 - 5 years
Personal savings
= 100%
Children’s education
Other
SPOUSAL RRIF
SPECULATIVE
%
MEDIUM
4 - 5 years
%
%
LIF
resp
tfsa
OTHER
= 100%
MEDIUM HIGH
6 - 9 years
Retirement
LIRA
%
HIGH
%
= 100%
10 years and over
Children’s education
Other
plan kyc without changes account number
%
GROWTH
MEDIUM LOW
RRIF
%
SPOUSAL RRIF
SPECULATIVE
%
MEDIUM
4 - 5 years
%
%
LIF
Retirement
resp
tfsa
OTHER
= 100%
MEDIUM HIGH
6 - 9 years
Personal savings
LIRA
%
HIGH
%
= 100%
10 years and over
Children’s education
Other
RISK TOLERANCE LOW
plan kyc without changes account number
SPOUSAL RRSP
%
%
0 - 3 years
GROWTH
MEDIUM LOW
RRIF
%
SPOUSAL RRIF
SPECULATIVE
%
MEDIUM
4 - 5 years
Personal savings
%
%
LIF
MEDIUM HIGH
6 - 9 years
Retirement
LIRA
resp
tfsa
OTHER
= 100%
%
HIGH
%
= 100%
10 years and over
Children’s education
Other
Other
OWNER SIGNATURE
plan kyc without changes account number
SPOUSAL RRSP
%
%
Desjardins Financial Security Investments Inc. (DFS Investments) Self-directed accounts only: I hereby authorize DFS Investments to accept purchases, switches within
the same fund family, and redemptions for me in accordance with my specific instructions for each transaction. The authorization also applies to new premiums, fund
switches and redemptions for deposit into my bank account in relation to individual variable insurance contracts (Segregated funds) and to other products distributed
through DFS Investments. I confirm that DFS Investments is authorized to accept my verbal instructions with respect to investment in and renewal of guaranteed
investment certificates, subject to applicable policies. This limited trading authorization does not constitute discretionary trading authorization. I acknowledge that
I will pay any applicable fees, commissions or charges payable to DFS Investments as a result of these transactions. I further acknowledge that in proving instructions to
DFS Investments pursuant to this limited trading authorization, I have the same rights and obligation as I would, had I provided DFS Investments with written instructions.
I understand that, unless otherwise specifically provided, this limited trading authorization is not intended to supersede or replace any other power of attorney granted by
me or anyone other than DFS Investments. I also understand that this limited trading authorization is valid only for authorized DFS Investments advisors. This limited trading
authorization is valid until I revoke it in writing addressed to DFS Investments. It expires upon my death. It is also valid only if DFS Investments authorizes my advisor to use it.
I hereby declare that no changes have been made regarding the persons having trading authorization in this account since the account was created or last updated. If this
is not the case, I will complete the “Identity Verification Supplementary Form” to update the information.
Corporate, trust or partnership accounts authorization: I hereby declare that no changes have been made regarding the administrators or owners. If this is not the case,
I will complete the “Identity Verification Supplementary Form” to update the information.
Joint accounts: I authorize DFS Investments to accept transaction orders from either the owner or a joint owner.
= 100%
plan kyc without changes account number
Personal savings
rRSP
OBJECTIVES
HIGH
6. trading AUTHORIZATION, agreements and signatures
= 100%
Children’s education
plan kyc with changes account number
NET WORTH
Check the box if the assets and liabilities include the spouse’s.
%
10 years and over
5. SPECIAL INSTRUCTIONS
INVESTMENT CHARACTERISTICS – Refer to the end of this form for definitions.
INVESTMENT KNOWLEDGE
OTHER
Other
LIRA
MEDIUM HIGH
6 - 9 years
SPOUSAL RRSP
%
tfsa
plan kyc without changes account number
RRIF
Personal savings
rRSP
OBJECTIVES
%
SPOUSAL RRSP
rRSP
INCOME
Intended use of account
= 100%
10 years and over
Children’s education
plan kyc with changes account number
POSTAL CODE
resp
plan kyc without changes account number
RRIF
Personal savings
0 - 3 years
OBJECTIVES
TIME HORIZON
OCCUPATION
PROVINCE
Retirement
LIRA
MEDIUM HIGH
6 - 9 years
plan kyc with changes account number
Other
LIRA
MEDIUM HIGH
6 - 9 years
Retirement
SPOUSAL RRSP
%
Intended use of account
CITY
SPOUSAL RRIF
SPECULATIVE
%
Personal savings
rRSP
OBJECTIVES
TIME HORIZON
EMPLOYER INFORMATION
address
%
%
LIF
= 100%
10 years and over
Children’s education
plan kyc with changes account number
3. JOINT owner’S PERSONAL AND FINANCIAL INFORMATION
BUSINESS TYPE
GROWTH
MEDIUM LOW
0 - 3 years
Intended use of account
$1,000,000 AND OVER
EMPLOYER
%
%
RRIF
GROWTH
MEDIUM LOW
%
Intended use of account
plan kyc without changes account number
SPOUSAL RRSP
%
rRSP
non-registered
DEPENDENTS
MEDIUM
%
plan kyc with changes account number
Other
LIRA
MEDIUM HIGH
6 - 9 years
Personal savings
%
SPOUSAL RRSP
%
Intended use of account
plan kyc without changes account number
SPOUSAL RRSP
SPOUSAL RRIF
SPECULATIVE
4 - 5 years
Personal savings
0 - 3 years
non-registered
2. owner’S PERSONAL AND FINANCIAL INFORMATION
RRIF
%
10 years and over
Children’s education
plan kyc with changes account number
MEDIUM LOW
rRSP
OBJECTIVES
TIME HORIZON
MEDIUM HIGH
6 - 9 years
Personal savings
LIF
%
GROWTH
plan kyc with changes account number
plan kyc without changes account number
SPOUSAL RRSP
plan kyc without changes account number
SPOUSAL RRSP
%
0 - 3 years
Intended use of account
10 years and over
Children’s education
INCOME
TIME HORIZON
= 100%
rRSP
OBJECTIVES
non-registered
TIME HORIZON
IN TRUST FOR – FIRST NAME
rRSP
OBJECTIVES
TIME HORIZON
advisor CODE
plan kyc with changes account number
Refer to the end of this form for definitions.
RRIF
%
SPOUSAL RRIF
SPECULATIVE
%
MEDIUM
%
%
6 - 9 years
Retirement
LIF
LIRA
resp
tfsa
%
HIGH
%
DATE (DD/MM/YYYY)
OTHER
= 100%
MEDIUM HIGH
JOINT OWNER SIGNATURE (if applicable)
Advisor declaration: I confirm that a copy of this fully completed form has been provided to the client.
= 100%
ADVISOR NAME (IN PRINTED CHARACTERS)
advisor SIGNATURE
DATE (DD/MM/YYYY)
BRANCH MANAGER/SUPERVISING OFFICER NAME
BRANCH MANAGER/SUPERVISING OFFICER SIGNATURE
DATE (DD/MM/YYYY)
10 years and over
Children’s education
Other
(IN PRINTED CHARACTERS)
Mutual funds and guaranteed investment certificates are distributed through Desjardins Financial Security Investments Inc. Desjardins Financial Security Investments Inc. may act
as an administrative service provider for segregated funds, which are primarily distributed under the applicable Insurance Acts or non securities-related regulation.
07073E (13-06)
copy: BRANCH, CLIENT AND ADVISOR
Page 1 of 4
07073E (13-06)
copy: BRANCH, CLIENT AND ADVISOR
Page 2 of 4
07073E (13-06)
copy: BRANCH, CLIENT AND ADVISOR
Page 3 of 4
1150, rue de Claire-Fontaine
Québec (Québec) G1R 5G4
PLAN no
4. PLAN INVESTMENT OBJECTIVES – Each plan must be fully completed to update the client’s information.
client id
plan kyc with changes account number
non-registered
modification form –
kyc update
1. ACCOUNT REGISTRATION TYPE
DEALER CODE
9697
OWNER FIRST NAME
initial
JOINT OWNER FIRST NAME
initial
INCOME
RISK TOLERANCE LOW
initial
%
GROWTH
MEDIUM LOW
0 - 3 years
non-registered
plan kyc without changes account number
SPOUSAL RRSP
%
Intended use of account
RRIF
%
SPOUSAL RRIF
SPECULATIVE
%
MEDIUM
4 - 5 years
%
%
Retirement
LIRA
resp
tfsa
OTHER
= 100%
MEDIUM HIGH
6 - 9 years
Personal savings
LIF
%
HIGH
%
RISK TOLERANCE LOW
Other
BRANCH CODE
plan kyc with changes account number
OWNER LAST NAME
non-registered
JOINT OWNER LAST NAME
IN TRUST FOR – LAST NAME
rRSP
OBJECTIVES
INCOME
RISK TOLERANCE LOW
%
%
MEDIUM LOW
0 - 3 years
Intended use of account
GROWTH
RRIF
%
SPOUSAL RRIF
SPECULATIVE
%
MEDIUM
4 - 5 years
%
%
Retirement
LIRA
resp
tfsa
OTHER
= 100%
%
HIGH
INCOME
RISK TOLERANCE LOW
%
= 100%
non-registered
EMPLOYER INFORMATION
EMPLOYER
BUSINESS TYPE
OCCUPATION
OBJECTIVES
INCOME
RISK TOLERANCE LOW
TIME HORIZON
address
CITY
PROVINCE
POSTAL CODE
PHONE NUMBER
rRSP
%
%
MEDIUM LOW
0 - 3 years
Intended use of account
GROWTH
RRIF
%
SPOUSAL RRIF
SPECULATIVE
%
MEDIUM
4 - 5 years
%
%
Retirement
LIF
plan kyc with changes account number
NUMBER OF DEPENDENTS
non-registered
INVESTMENT CHARACTERISTICS – Refer to the end of this form for definitions.
INVESTMENT KNOWLEDGE
GROSS ANNUAL INCOME
NOVICE
less than $50,000
less than $50,000
FAIR
$50,000 TO $99,999
$50,000 TO $99,999
GOOD
$100,000 TO $149,999
$100,000 TO $249,999
SOPHISTICATED
$150,000 AND over
$250,000 TO $999,999
OBJECTIVES
INCOME
RISK TOLERANCE LOW
TIME HORIZON
NET WORTH
Check the box if the assets and liabilities include the spouse’s.
rRSP
resp
tfsa
OTHER
= 100%
OBJECTIVES
INCOME
RISK TOLERANCE LOW
TIME HORIZON
%
HIGH
%
= 100%
non-registered
INCOME
RISK TOLERANCE LOW
MEDIUM
4 - 5 years
%
%
%
GROWTH
MEDIUM LOW
0 - 3 years
LIF
resp
tfsa
OTHER
= 100%
%
HIGH
%
PHONE NUMBER
non-registered
INCOME
%
SPOUSAL RRIF
SPECULATIVE
%
MEDIUM
4 - 5 years
%
%
Retirement
LIF
DEPENDENTS
RISK TOLERANCE LOW
NUMBER OF DEPENDENTS
TIME HORIZON
%
MEDIUM LOW
0 - 3 years
Intended use of account
GROWTH
GROSS ANNUAL INCOME
resp
tfsa
OTHER
NOVICE
less than $50,000
less than $50,000
FAIR
$50,000 TO $99,999
$50,000 TO $99,999
GOOD
$100,000 TO $149,999
$100,000 TO $249,999
SOPHISTICATED
$150,000 AND over
$250,000 TO $999,999
non-registered
%
HIGH
%
INCOME
RRIF
%
10 years and over
SPOUSAL RRIF
SPECULATIVE
%
MEDIUM
4 - 5 years
%
%
Other
Retirement
LIF
LIRA
resp
tfsa
OTHER
= 100%
MEDIUM HIGH
6 - 9 years
%
HIGH
%
= 100%
10 years and over
Children’s education
RISK TOLERANCE LOW
TIME HORIZON
0 - 3 years
Intended use of account
$1,000,000 AND OVER
%
GROWTH
MEDIUM LOW
4 - 5 years
Personal savings
= 100%
Children’s education
Other
SPOUSAL RRIF
SPECULATIVE
%
MEDIUM
4 - 5 years
%
%
LIF
resp
tfsa
OTHER
= 100%
MEDIUM HIGH
6 - 9 years
Retirement
LIRA
%
HIGH
%
= 100%
10 years and over
Children’s education
Other
plan kyc without changes account number
%
GROWTH
MEDIUM LOW
RRIF
%
SPOUSAL RRIF
SPECULATIVE
%
MEDIUM
4 - 5 years
%
%
LIF
Retirement
resp
tfsa
OTHER
= 100%
MEDIUM HIGH
6 - 9 years
Personal savings
LIRA
%
HIGH
%
= 100%
10 years and over
Children’s education
Other
RISK TOLERANCE LOW
plan kyc without changes account number
SPOUSAL RRSP
%
%
0 - 3 years
GROWTH
MEDIUM LOW
RRIF
%
SPOUSAL RRIF
SPECULATIVE
%
MEDIUM
4 - 5 years
Personal savings
%
%
LIF
MEDIUM HIGH
6 - 9 years
Retirement
LIRA
resp
tfsa
OTHER
= 100%
%
HIGH
%
= 100%
10 years and over
Children’s education
Other
Other
OWNER SIGNATURE
plan kyc without changes account number
SPOUSAL RRSP
%
%
Desjardins Financial Security Investments Inc. (DFS Investments) Self-directed accounts only: I hereby authorize DFS Investments to accept purchases, switches within
the same fund family, and redemptions for me in accordance with my specific instructions for each transaction. The authorization also applies to new premiums, fund
switches and redemptions for deposit into my bank account in relation to individual variable insurance contracts (Segregated funds) and to other products distributed
through DFS Investments. I confirm that DFS Investments is authorized to accept my verbal instructions with respect to investment in and renewal of guaranteed
investment certificates, subject to applicable policies. This limited trading authorization does not constitute discretionary trading authorization. I acknowledge that
I will pay any applicable fees, commissions or charges payable to DFS Investments as a result of these transactions. I further acknowledge that in proving instructions to
DFS Investments pursuant to this limited trading authorization, I have the same rights and obligation as I would, had I provided DFS Investments with written instructions.
I understand that, unless otherwise specifically provided, this limited trading authorization is not intended to supersede or replace any other power of attorney granted by
me or anyone other than DFS Investments. I also understand that this limited trading authorization is valid only for authorized DFS Investments advisors. This limited trading
authorization is valid until I revoke it in writing addressed to DFS Investments. It expires upon my death. It is also valid only if DFS Investments authorizes my advisor to use it.
I hereby declare that no changes have been made regarding the persons having trading authorization in this account since the account was created or last updated. If this
is not the case, I will complete the “Identity Verification Supplementary Form” to update the information.
Corporate, trust or partnership accounts authorization: I hereby declare that no changes have been made regarding the administrators or owners. If this is not the case,
I will complete the “Identity Verification Supplementary Form” to update the information.
Joint accounts: I authorize DFS Investments to accept transaction orders from either the owner or a joint owner.
= 100%
plan kyc without changes account number
Personal savings
rRSP
OBJECTIVES
HIGH
6. trading AUTHORIZATION, agreements and signatures
= 100%
Children’s education
plan kyc with changes account number
NET WORTH
Check the box if the assets and liabilities include the spouse’s.
%
10 years and over
5. SPECIAL INSTRUCTIONS
INVESTMENT CHARACTERISTICS – Refer to the end of this form for definitions.
INVESTMENT KNOWLEDGE
OTHER
Other
LIRA
MEDIUM HIGH
6 - 9 years
SPOUSAL RRSP
%
tfsa
plan kyc without changes account number
RRIF
Personal savings
rRSP
OBJECTIVES
%
SPOUSAL RRSP
rRSP
INCOME
Intended use of account
= 100%
10 years and over
Children’s education
plan kyc with changes account number
POSTAL CODE
resp
plan kyc without changes account number
RRIF
Personal savings
0 - 3 years
OBJECTIVES
TIME HORIZON
OCCUPATION
PROVINCE
Retirement
LIRA
MEDIUM HIGH
6 - 9 years
plan kyc with changes account number
Other
LIRA
MEDIUM HIGH
6 - 9 years
Retirement
SPOUSAL RRSP
%
Intended use of account
CITY
SPOUSAL RRIF
SPECULATIVE
%
Personal savings
rRSP
OBJECTIVES
TIME HORIZON
EMPLOYER INFORMATION
address
%
%
LIF
= 100%
10 years and over
Children’s education
plan kyc with changes account number
3. JOINT owner’S PERSONAL AND FINANCIAL INFORMATION
BUSINESS TYPE
GROWTH
MEDIUM LOW
0 - 3 years
Intended use of account
$1,000,000 AND OVER
EMPLOYER
%
%
RRIF
GROWTH
MEDIUM LOW
%
Intended use of account
plan kyc without changes account number
SPOUSAL RRSP
%
rRSP
non-registered
DEPENDENTS
MEDIUM
%
plan kyc with changes account number
Other
LIRA
MEDIUM HIGH
6 - 9 years
Personal savings
%
SPOUSAL RRSP
%
Intended use of account
plan kyc without changes account number
SPOUSAL RRSP
SPOUSAL RRIF
SPECULATIVE
4 - 5 years
Personal savings
0 - 3 years
non-registered
2. owner’S PERSONAL AND FINANCIAL INFORMATION
RRIF
%
10 years and over
Children’s education
plan kyc with changes account number
MEDIUM LOW
rRSP
OBJECTIVES
TIME HORIZON
MEDIUM HIGH
6 - 9 years
Personal savings
LIF
%
GROWTH
plan kyc with changes account number
plan kyc without changes account number
SPOUSAL RRSP
plan kyc without changes account number
SPOUSAL RRSP
%
0 - 3 years
Intended use of account
10 years and over
Children’s education
INCOME
TIME HORIZON
= 100%
rRSP
OBJECTIVES
non-registered
TIME HORIZON
IN TRUST FOR – FIRST NAME
rRSP
OBJECTIVES
TIME HORIZON
advisor CODE
plan kyc with changes account number
Refer to the end of this form for definitions.
RRIF
%
SPOUSAL RRIF
SPECULATIVE
%
MEDIUM
%
%
6 - 9 years
Retirement
LIF
LIRA
resp
tfsa
%
HIGH
%
DATE (DD/MM/YYYY)
OTHER
= 100%
MEDIUM HIGH
JOINT OWNER SIGNATURE (if applicable)
Advisor declaration: I confirm that a copy of this fully completed form has been provided to the client.
= 100%
ADVISOR NAME (IN PRINTED CHARACTERS)
advisor SIGNATURE
DATE (DD/MM/YYYY)
BRANCH MANAGER/SUPERVISING OFFICER NAME
BRANCH MANAGER/SUPERVISING OFFICER SIGNATURE
DATE (DD/MM/YYYY)
10 years and over
Children’s education
Other
(IN PRINTED CHARACTERS)
Mutual funds and guaranteed investment certificates are distributed through Desjardins Financial Security Investments Inc. Desjardins Financial Security Investments Inc. may act
as an administrative service provider for segregated funds, which are primarily distributed under the applicable Insurance Acts or non securities-related regulation.
07073E (13-06)
copy: BRANCH, CLIENT AND ADVISOR
Page 1 of 4
07073E (13-06)
copy: BRANCH, CLIENT AND ADVISOR
Page 2 of 4
07073E (13-06)
copy: BRANCH, CLIENT AND ADVISOR
Page 3 of 4
1150, rue de Claire-Fontaine
Québec (Québec) G1R 5G4
PLAN NO
4. PLAN INVESTMENT OBJECTIVES – Each plan must be fully completed to update the client’s information.
CLIENT ID
PLAN KYC WITH CHANGES ACCOUNT NUMBER
NON-REGISTERED
MODIFICATION FORM –
KYC UPDATE
1. ACCOUNT REGISTRATION TYPE
DEALER CODE
9697
OWNER FIRST NAME
INITIAL
JOINT OWNER FIRST NAME
INITIAL
INCOME
RISK TOLERANCE LOW
INITIAL
%
GROWTH
MEDIUM LOW
0 - 3 YEARS
NON-REGISTERED
PLAN KYC WITHOUT CHANGES ACCOUNT NUMBER
SPOUSAL RRSP
%
INTENDED USE OF ACCOUNT
RRIF
%
SPOUSAL RRIF
SPECULATIVE
%
MEDIUM
4 - 5 YEARS
%
%
RETIREMENT
LIRA
RESP
TFSA
OTHER
= 100%
MEDIUM HIGH
6 - 9 YEARS
PERSONAL SAVINGS
LIF
%
HIGH
%
RISK TOLERANCE LOW
OTHER
BRANCH CODE
PLAN KYC WITH CHANGES ACCOUNT NUMBER
OWNER LAST NAME
NON-REGISTERED
JOINT OWNER LAST NAME
IN TRUST FOR – LAST NAME
RRSP
OBJECTIVES
INCOME
RISK TOLERANCE LOW
%
%
MEDIUM LOW
0 - 3 YEARS
INTENDED USE OF ACCOUNT
GROWTH
RRIF
%
SPOUSAL RRIF
SPECULATIVE
%
MEDIUM
4 - 5 YEARS
%
%
RETIREMENT
LIRA
RESP
TFSA
OTHER
= 100%
%
HIGH
INCOME
RISK TOLERANCE LOW
%
= 100%
NON-REGISTERED
EMPLOYER INFORMATION
EMPLOYER
BUSINESS TYPE
OCCUPATION
OBJECTIVES
INCOME
RISK TOLERANCE LOW
TIME HORIZON
ADDRESS
CITY
PROVINCE
POSTAL CODE
PHONE NUMBER
RRSP
%
%
MEDIUM LOW
0 - 3 YEARS
INTENDED USE OF ACCOUNT
GROWTH
RRIF
%
SPOUSAL RRIF
SPECULATIVE
%
MEDIUM
4 - 5 YEARS
%
%
RETIREMENT
LIF
PLAN KYC WITH CHANGES ACCOUNT NUMBER
NUMBER OF DEPENDENTS
NON-REGISTERED
INVESTMENT CHARACTERISTICS – Refer to the end of this form for definitions.
INVESTMENT KNOWLEDGE
GROSS ANNUAL INCOME
NOVICE
LESS THAN $50,000
LESS THAN $50,000
FAIR
$50,000 TO $99,999
$50,000 TO $99,999
GOOD
$100,000 TO $149,999
$100,000 TO $249,999
SOPHISTICATED
$150,000 AND OVER
$250,000 TO $999,999
OBJECTIVES
INCOME
RISK TOLERANCE LOW
TIME HORIZON
NET WORTH
Check the box if the assets and liabilities include the spouse’s.
RRSP
RESP
TFSA
OTHER
= 100%
OBJECTIVES
INCOME
RISK TOLERANCE LOW
TIME HORIZON
%
HIGH
%
= 100%
NON-REGISTERED
INCOME
RISK TOLERANCE LOW
MEDIUM
4 - 5 YEARS
%
%
%
GROWTH
MEDIUM LOW
0 - 3 YEARS
LIF
RESP
TFSA
OTHER
= 100%
%
HIGH
%
PHONE NUMBER
NON-REGISTERED
INCOME
%
SPOUSAL RRIF
SPECULATIVE
%
MEDIUM
4 - 5 YEARS
%
%
RETIREMENT
LIF
DEPENDENTS
RISK TOLERANCE LOW
NUMBER OF DEPENDENTS
TIME HORIZON
%
MEDIUM LOW
0 - 3 YEARS
INTENDED USE OF ACCOUNT
GROWTH
GROSS ANNUAL INCOME
RESP
TFSA
OTHER
NOVICE
LESS THAN $50,000
LESS THAN $50,000
FAIR
$50,000 TO $99,999
$50,000 TO $99,999
GOOD
$100,000 TO $149,999
$100,000 TO $249,999
SOPHISTICATED
$150,000 AND OVER
$250,000 TO $999,999
NON-REGISTERED
%
HIGH
%
INCOME
RRIF
%
10 YEARS AND OVER
SPOUSAL RRIF
SPECULATIVE
%
MEDIUM
4 - 5 YEARS
%
%
OTHER
RETIREMENT
LIF
LIRA
RESP
TFSA
OTHER
= 100%
MEDIUM HIGH
6 - 9 YEARS
%
HIGH
%
= 100%
10 YEARS AND OVER
CHILDREN’S EDUCATION
RISK TOLERANCE LOW
TIME HORIZON
0 - 3 YEARS
INTENDED USE OF ACCOUNT
$1,000,000 AND OVER
%
GROWTH
MEDIUM LOW
4 - 5 YEARS
PERSONAL SAVINGS
= 100%
CHILDREN’S EDUCATION
OTHER
SPOUSAL RRIF
SPECULATIVE
%
MEDIUM
4 - 5 YEARS
%
%
LIF
RESP
TFSA
OTHER
= 100%
MEDIUM HIGH
6 - 9 YEARS
RETIREMENT
LIRA
%
HIGH
%
= 100%
10 YEARS AND OVER
CHILDREN’S EDUCATION
OTHER
PLAN KYC WITHOUT CHANGES ACCOUNT NUMBER
%
GROWTH
MEDIUM LOW
RRIF
%
SPOUSAL RRIF
SPECULATIVE
%
MEDIUM
4 - 5 YEARS
%
%
LIF
RETIREMENT
RESP
TFSA
OTHER
= 100%
MEDIUM HIGH
6 - 9 YEARS
PERSONAL SAVINGS
LIRA
%
HIGH
%
= 100%
10 YEARS AND OVER
CHILDREN’S EDUCATION
OTHER
RISK TOLERANCE LOW
PLAN KYC WITHOUT CHANGES ACCOUNT NUMBER
SPOUSAL RRSP
%
%
0 - 3 YEARS
GROWTH
MEDIUM LOW
RRIF
%
SPOUSAL RRIF
SPECULATIVE
%
MEDIUM
4 - 5 YEARS
PERSONAL SAVINGS
%
%
LIF
MEDIUM HIGH
6 - 9 YEARS
RETIREMENT
LIRA
RESP
TFSA
OTHER
= 100%
%
HIGH
%
= 100%
10 YEARS AND OVER
CHILDREN’S EDUCATION
OTHER
OTHER
OWNER SIGNATURE
PLAN KYC WITHOUT CHANGES ACCOUNT NUMBER
SPOUSAL RRSP
%
%
Desjardins Financial Security Investments Inc. (DFS Investments) Self-directed accounts only: I hereby authorize DFS Investments to accept purchases, switches within
the same fund family, and redemptions for me in accordance with my specific instructions for each transaction. The authorization also applies to new premiums, fund
switches and redemptions for deposit into my bank account in relation to individual variable insurance contracts (Segregated funds) and to other products distributed
through DFS Investments. I confirm that DFS Investments is authorized to accept my verbal instructions with respect to investment in and renewal of guaranteed
investment certificates, subject to applicable policies. This limited trading authorization does not constitute discretionary trading authorization. I acknowledge that
I will pay any applicable fees, commissions or charges payable to DFS Investments as a result of these transactions. I further acknowledge that in providing instructions to
DFS Investments pursuant to this limited trading authorization, I have the same rights and obligation as I would, had I provided DFS Investments with written instructions.
I understand that, unless otherwise specifically provided, this limited trading authorization is not intended to supersede or replace any other power of attorney granted by
me or anyone other than DFS Investments. I also understand that this limited trading authorization is valid only for authorized DFS Investments advisors. This limited trading
authorization is valid until I revoke it in writing addressed to DFS Investments. It expires upon my death. It is also valid only if DFS Investments authorizes my advisor to use it.
I hereby declare that no changes have been made regarding the persons having trading authorization in this account since the account was created or last updated. If this
is not the case, I will complete the “Identity Verification Supplementary Form” to update the information.
Corporate, trust or partnership accounts authorization: I hereby declare that no changes have been made regarding the administrators or owners. If this is not the case,
I will complete the “Identity Verification Supplementary Form” to update the information.
Joint accounts: I authorize DFS Investments to accept transaction orders from either the owner or a joint owner.
= 100%
PLAN KYC WITHOUT CHANGES ACCOUNT NUMBER
PERSONAL SAVINGS
RRSP
OBJECTIVES
HIGH
6. TRADING AUTHORIZATION, AGREEMENTS AND SIGNATURES
= 100%
CHILDREN’S EDUCATION
PLAN KYC WITH CHANGES ACCOUNT NUMBER
NET WORTH
Check the box if the assets and liabilities include the spouse’s.
%
10 YEARS AND OVER
5. SPECIAL INSTRUCTIONS
INVESTMENT CHARACTERISTICS – Refer to the end of this form for definitions.
INVESTMENT KNOWLEDGE
OTHER
OTHER
LIRA
MEDIUM HIGH
6 - 9 YEARS
SPOUSAL RRSP
%
TFSA
PLAN KYC WITHOUT CHANGES ACCOUNT NUMBER
RRIF
PERSONAL SAVINGS
RRSP
OBJECTIVES
%
SPOUSAL RRSP
RRSP
INCOME
INTENDED USE OF ACCOUNT
= 100%
10 YEARS AND OVER
CHILDREN’S EDUCATION
PLAN KYC WITH CHANGES ACCOUNT NUMBER
POSTAL CODE
RESP
PLAN KYC WITHOUT CHANGES ACCOUNT NUMBER
RRIF
PERSONAL SAVINGS
0 - 3 YEARS
OBJECTIVES
TIME HORIZON
OCCUPATION
PROVINCE
RETIREMENT
LIRA
MEDIUM HIGH
6 - 9 YEARS
PLAN KYC WITH CHANGES ACCOUNT NUMBER
OTHER
LIRA
MEDIUM HIGH
6 - 9 YEARS
RETIREMENT
SPOUSAL RRSP
%
INTENDED USE OF ACCOUNT
CITY
SPOUSAL RRIF
SPECULATIVE
%
PERSONAL SAVINGS
RRSP
OBJECTIVES
TIME HORIZON
EMPLOYER INFORMATION
ADDRESS
%
%
LIF
= 100%
10 YEARS AND OVER
CHILDREN’S EDUCATION
PLAN KYC WITH CHANGES ACCOUNT NUMBER
3. JOINT OWNER’S PERSONAL AND FINANCIAL INFORMATION
BUSINESS TYPE
GROWTH
MEDIUM LOW
0 - 3 YEARS
INTENDED USE OF ACCOUNT
$1,000,000 AND OVER
EMPLOYER
%
%
RRIF
GROWTH
MEDIUM LOW
%
INTENDED USE OF ACCOUNT
PLAN KYC WITHOUT CHANGES ACCOUNT NUMBER
SPOUSAL RRSP
%
RRSP
NON-REGISTERED
DEPENDENTS
MEDIUM
%
PLAN KYC WITH CHANGES ACCOUNT NUMBER
OTHER
LIRA
MEDIUM HIGH
6 - 9 YEARS
PERSONAL SAVINGS
%
SPOUSAL RRSP
%
INTENDED USE OF ACCOUNT
PLAN KYC WITHOUT CHANGES ACCOUNT NUMBER
SPOUSAL RRSP
SPOUSAL RRIF
SPECULATIVE
4 - 5 YEARS
PERSONAL SAVINGS
0 - 3 YEARS
NON-REGISTERED
2. OWNER’S PERSONAL AND FINANCIAL INFORMATION
RRIF
%
10 YEARS AND OVER
CHILDREN’S EDUCATION
PLAN KYC WITH CHANGES ACCOUNT NUMBER
MEDIUM LOW
RRSP
OBJECTIVES
TIME HORIZON
MEDIUM HIGH
6 - 9 YEARS
PERSONAL SAVINGS
LIF
%
GROWTH
PLAN KYC WITH CHANGES ACCOUNT NUMBER
PLAN KYC WITHOUT CHANGES ACCOUNT NUMBER
SPOUSAL RRSP
PLAN KYC WITHOUT CHANGES ACCOUNT NUMBER
SPOUSAL RRSP
%
0 - 3 YEARS
INTENDED USE OF ACCOUNT
10 YEARS AND OVER
CHILDREN’S EDUCATION
INCOME
TIME HORIZON
= 100%
RRSP
OBJECTIVES
NON-REGISTERED
TIME HORIZON
IN TRUST FOR – FIRST NAME
RRSP
OBJECTIVES
TIME HORIZON
ADVISOR CODE
PLAN KYC WITH CHANGES ACCOUNT NUMBER
Refer to the end of this form for definitions.
RRIF
%
SPOUSAL RRIF
SPECULATIVE
%
MEDIUM
%
%
6 - 9 YEARS
RETIREMENT
LIF
LIRA
RESP
TFSA
%
HIGH
%
DATE (DD/MM/YYYY)
OTHER
= 100%
MEDIUM HIGH
JOINT OWNER SIGNATURE (if applicable)
Advisor declaration: I confirm that a copy of this fully completed form has been provided to the client.
= 100%
ADVISOR NAME (IN PRINTED CHARACTERS)
ADVISOR SIGNATURE
DATE (DD/MM/YYYY)
BRANCH MANAGER/SUPERVISING OFFICER NAME
BRANCH MANAGER/SUPERVISING OFFICER SIGNATURE
DATE (DD/MM/YYYY)
10 YEARS AND OVER
CHILDREN’S EDUCATION
OTHER
(IN PRINTED CHARACTERS)
Mutual funds and guaranteed investment certificates are distributed through Desjardins Financial Security Investments Inc. Desjardins Financial Security Investments Inc. may act
as an administrative service provider for segregated funds, which are primarily distributed under the applicable Insurance Acts or non securities-related regulation.
07073E (13-06)
COPY: BRANCH, CLIENT AND ADVISOR
Page 1 of 4
07073E (13-06)
COPY: BRANCH, CLIENT AND ADVISOR
Page 2 of 4
07073E (13-06)
COPY: BRANCH, CLIENT AND ADVISOR
Page 3 of 4
DEFINITIONS
Investment knowledge describes your knowledge of the investment industry and/or experience of investment products’
characteristics and inherent risks.
• Novice: You understand there are different things you can invest in but do not know the differences between each type. This
might be your first investment.
• Fair: You know different types of investments and their level of risk. You own different investments.
• Good: You are familiar with mutual funds, bonds and equities. You understand the interaction between the risk level, the
returns and the fluctuation in time of different investment types.
modification form
KYC update
• Sophisticated: You have in-depth knowledge of the financial market, its movement and its effect on your investments.
Annual income indicates your gross annual incomes that come from your salary, rental, business and investment incomes.
Net worth = liquid assets + non-liquid assets + fixed assets - liabilities
• Liquid assets: Assets such as cash, bank accounts and investments that are not subject to restrictions and are readily converted
into cash without penalties (including taxes owing).
• Non-liquid assets: Investments that cannot qualify as liquid assets. Assets held in locked-in plans (e.g. pension plans) or
registered plans are examples of non-liquid assets.
• Fixed assets: Real estate, motor vehicles, furniture and equipment are examples of fixed assets.
• Liabilities are deducted from your gross worth to obtain your net worth. Examples of liabilities include mortgages, car loans
and lines of credit.
Objectives
• Income: Your primary goal is to generate income from your investments starting today or in the near future. Your focus is on
capital preservation; you are less concerned with capital appreciation. Appropriate holdings would include some bond, money
market, dividend and income funds.
• Growth: Your focus is on capital appreciation; current income from investments is not a primary goal.
• Speculative: Your objective is pure capital appreciation; current income from investments is not a requirement. This may lead
you to hold a relatively high portion of funds engaging in speculative trading strategies or to hold high risk funds for lower
time horizons. This objective increases the chances of substantial gains as well as substantial or total losses; therefore, only
money you can afford to lose should be invested in such an account. High risk tolerance is required to identify a speculative
objective for an account.
Risk tolerance – This section identifies your willingness and your ability to assume risk. Please refer to the prospectus to determine
the risk level of a mutual fund.
• Low: You seek to minimize price fluctuations, and will accept modest returns. Low-risk mutual funds generally exhibit the least
amount of price fluctuations and offer the lowest return potential.
• Medium Low: You seek a potential for returns generally greater than those as described in low risk and price fluctuations
which generally exhibit characteristics that are in-between those described for the low and medium risk tolerance.
• Medium: You seek to enhance your returns, and will accept some market value fluctuations in the pursuit of this goal. If held
for a number of years, medium-risk mutual funds offer a greater return potential when compared to low risk investments, but
they generally exhibit greater short to medium term price fluctuations.
• Medium High: You seek a potential for returns generally greater than those as described in medium risk and price fluctuations
which generally exhibit characteristics that are in-between those described for the medium and high risk tolerance.
• High: You seek the highest possible returns, and can tolerate large losses in the pursuit of this goal. High-risk mutual funds
generally offer the greatest return potential when compared to medium risk investments, but they generally exhibit large price
fluctuations. Examples of high risk investments may include labour-sponsored venture capital funds.
07073E (13-06)
Time horizon indicates the period between now and when you will need to redeem a significant portion of the money you
invested in this account.
07073E (13-06)
copy: BRANCH, CLIENT AND ADVISOR
Page 4 of 4

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