Transfer-in Authorization Form For Registered & Non ... - SEI
Transfer-in Authorization Form For Registered & Non ... - SEI
Transfer-in Authorization Form For Registered & Non ... - SEI
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<strong>SEI</strong> Account Number:<br />
<strong>Transfer</strong>-<strong>in</strong> <strong>Authorization</strong> <strong><strong>For</strong>m</strong><br />
<strong>For</strong> <strong>Registered</strong> & <strong>Non</strong>-<strong>Registered</strong> Investments<br />
Instructions:<br />
Complete this <strong>Transfer</strong>-<strong>in</strong> <strong>Authorization</strong> form for liquidat<strong>in</strong>g<br />
assets from your Account at another Institution (Bank, Broker,<br />
Investment Firm or Mutual Fund Company) and transferr<strong>in</strong>g<br />
the assets to your <strong>SEI</strong> Investments Canada Company<br />
Account.<br />
It is recommended that you confirm with the previous<br />
Institution to see if additional paperwork is required to liquidate<br />
or transfer funds. This step will help avoid delays <strong>in</strong> receiv<strong>in</strong>g<br />
your transfer. If multiple Accounts and/or Institutions are<br />
<strong>in</strong>volved, a form for each Account or Institution is required.<br />
<strong>For</strong>ward all completed forms directly to the RELINQUISHING<br />
INSTITUTION:<br />
Copies should be mailed or couriered to:<br />
International F<strong>in</strong>ancial Data Services (IFDS)<br />
Attention: <strong>SEI</strong> Client Service<br />
30 Adelaide Street East<br />
Toronto, ON M5C 3G9<br />
Receiv<strong>in</strong>g Institution Information<br />
<strong>SEI</strong> Investments Canada Company<br />
Receiv<strong>in</strong>g Institution Name<br />
30 Adelaide Street East, Suite 1<br />
Address<br />
Client Service<br />
Contact Name<br />
Toronto ON M5C 3G9<br />
City Prov<strong>in</strong>ce Postal Code<br />
(866) 734-1114 (866) 733-9555<br />
Telephone Number<br />
Specimen Plan Number<br />
Fax Number<br />
A. Dealer Information (<strong>For</strong> use by Mutual Fund<br />
Brokers/Dealers only)<br />
Investment Advisor/Representative Name<br />
Dealer Code/Rep Code<br />
OR By Fax: 1-866-733-9555<br />
Dealer Firm Name<br />
Client Information<br />
Dealer Telephone Number<br />
Dealer Fax Number<br />
Mr. Mrs. Miss Ms. Dr. Other<br />
Dealer Account Number<br />
Account Policy Holder Last Name<br />
First Name & Initial<br />
Account Type (select one)<br />
RRSP<br />
RRIF<br />
Street Address<br />
Spousal RRSP<br />
Spousal RRIF<br />
City<br />
Prov<strong>in</strong>ce, Postal Code<br />
LIRA<br />
LRSP<br />
LRIF<br />
LIF<br />
Social Insurance Number<br />
<strong>Non</strong>-<strong>Registered</strong><br />
Telephone Number<br />
Bus<strong>in</strong>ess Telephone Number<br />
<strong><strong>For</strong>m</strong> # A9-01/06-E<br />
Cont<strong>in</strong>ued
<strong>Transfer</strong>-<strong>in</strong> <strong>Authorization</strong> <strong><strong>For</strong>m</strong> <strong>For</strong> <strong>Registered</strong> & <strong>Non</strong>-<strong>Registered</strong> Investments<br />
Page 2<br />
<strong>SEI</strong> Account Number:<br />
Client Direction to Rel<strong>in</strong>quish<strong>in</strong>g Institution<br />
<strong>For</strong> Use By Rel<strong>in</strong>quish<strong>in</strong>g Institution Only<br />
A. Account Type (please check applicable box)<br />
Rel<strong>in</strong>quish<strong>in</strong>g Institution Name<br />
Contact Name<br />
Address<br />
RRSP<br />
LIRA<br />
LRSP<br />
RRIF<br />
Qualified<br />
<strong>Non</strong>-Qualified<br />
LRIF<br />
LIF<br />
<strong>Non</strong>-<strong>Registered</strong><br />
City Prov<strong>in</strong>ce Postal Code<br />
B. Spousal Plan: No Yes (if yes, complete the follow<strong>in</strong>g)<br />
Telephone Number<br />
Fax Number<br />
Group Plan Number (if applicable)<br />
Last Name<br />
First Name & Initial<br />
Client Account/Policy Number<br />
Social Insurance Number<br />
*Please refer to statement <strong>in</strong> bold <strong>in</strong> section 6<br />
All <strong>in</strong> cash<br />
Partial <strong>in</strong> cash (as listed below)<br />
$ (or) %<br />
Investment Amount<br />
% of Investment<br />
All <strong>in</strong>-k<strong>in</strong>d<br />
Partial <strong>in</strong>-k<strong>in</strong>d (as listed below)<br />
Locked In: No Yes<br />
$<br />
Locked-In Funds<br />
Contact Name<br />
Govern<strong>in</strong>g Legislation<br />
Investment Description<br />
Investment Code<br />
Telephone Number<br />
Fax Number<br />
$ (or) %<br />
Investment Amount<br />
% of Investment<br />
Authorized Signature<br />
Date<br />
Investment Description<br />
Investment Code<br />
$ (or) %<br />
Investment Amount<br />
% of Investment<br />
Investment Description<br />
Investment Code<br />
Please attach additional <strong>in</strong>structions if <strong>in</strong>sufficient space<br />
Signature Guaranteed Stamp<br />
(Required for non-registered <strong>in</strong>vestments only)<br />
Client <strong>Authorization</strong><br />
I hereby request the transfer of my account as described<br />
above.<br />
*I AUTHORIZE THE LIQUIDATION OF MY INVESTMENTS AS IDENTIFIED IN<br />
4 AND AGREE TO PAY ANY APPLICABLE FEES, CHARGES OR<br />
ADJUSTMENTS.<br />
Signature of Account Holder<br />
Date<br />
<strong><strong>For</strong>m</strong> # A9-01/06-E<br />
End of <strong><strong>For</strong>m</strong>