"*" indicates required fields ADVISOR INFORMATIONName*Company*TelephoneEmail* SPONSORING COMPANY INFORMATIONName of Sponsoring Company*Date of Incorporation Submitted as DD/MM/YYYY.Corporate Year EndSubmitted as DD/MM.PLAN MEMBERPlan Member Name*Plan Member Gender* Male Female Plan Member Date of Birth* Submitted as DD/MM/YYYYPlan Member Date of Hire* Submitted as DD/MM/YYYYPlan Member Province of Residence*OntarioAlbertaBritish ColumbiaQuebecManitobaSaskatchewanNova ScotiaNew BrunswickNewfoundland and LabradorPrince Edward IslandNorthwest TerritoriesNunavutYukonBEST THREE YEARS T4/T4PS EARNINGS(DO NOT INCLUDE DIVIDENDS OR OTHER INCOME)Year 1Year 1 T4Year 2Year 2 T4Year 3Year 3 T4You have not entered any earningsIs the RCA Established pursuant to a Severance* YES NO Expected Age or Date of Retirement for ParticipantSubmitted as either an age (e.g. 65) or a date (e.g. Dec 31, 2021).Please fill out either your expected age or date of your retirement. Do not respond to both questions.Has the member ever been a participant of any other pension plan or, deferred profit sharing plan?* YES NO If YES, type of plan:Date of Entry into Plan Submitted as DD/MM/YYYY.Will your spouse participate in the plan?* Yes No PLAN MEMBER SPOUSE(IF EMPLOYED BY THE COMPANY)Plan Member Spouse NamePlan Member Spouse Gender Male Female Plan Member Spouse Date of Birth Submitted as DD/MM/YYYY.Plan Member Spouse Date of Hire Submitted as DD/MM/YYYY.Plan Member Spouse Province of Residence*OntarioAlbertaBritish ColumbiaQuebecManitobaSaskatchewanNova ScotiaNew BrunswickNewfoundland and LabradorPrince Edward IslandNorthwest TerritoriesNunavutYukonBEST THREE YEARS T4/T4PS EARNINGS (SPOUSE)(DO NOT INCLUDE DIVIDENDS OR OTHER INCOME)Year 1Year 1 T4 (spouse)Year 2Year 2 T4 (spouse)Year 3Year 3 T4 (spouse)You have not entered any earningsThis site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
"*" indicates required fields
