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To: Concentra Trust - Trustee
I hereby apply for participation in the Trustee's Retirement Savings Plan (Plan) in accordance with the Declaration of Trust supplied to me.
I request that the Trustee apply for registration of my Plan as a retirement savings plan with the proper authorities pursuant to the provisions of the Income Tax Act(Canada).
I request that this contribution, and any subsequent contributions, be deposited or invested In the Credit Union above named by the Trustee and I acknowledge that the terms and conditions of such deposits or investments have been and will be agreed upon between myself and the Credit Union and that such deposits or investments will be held in trust by the Trustee.
I hereby acknowledge that I am solely responsible for determining the amount of contribution to the Plan which I may claim as a deduction under applicable tax legislation.
I hereby acknowledge that any payments received by me under the Plan must be included in my income for the taxation year of receipt and will be subject to tax under the applicable tax legislation.
I confirm that the information provided to Concentra Financial Services Association, its agents or affiliates (collectively "Concentra Financial") is complete and accurate. I hereby agree and consent to, and accept this as notice of, the terms of the Concentra Financial Confidentiality and Privacy Statement (located at https://www.concentrafinancial.ca/pages/ConfidentialityPrivacy.aspx ). I further agree and consent to Concentra Financial obtaining and retaining my personal information in order to ascertain my identity as required by the Proceeds of Crime (Money Laundering) and Terrorist Financing Actand as required by law.
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