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Get AFBS F20 2014

Ca Please complete all information requested below sign and return to SECTION 1 Member Information please print Reset Form I hereby provide authorization to Actra Fraternal Benefit Society to withdraw funds from my RRSP or TFSA account for the next available withdrawal distribution date. Please refer to request deadline and distribution dates and additional information on-line www. afbs. Please refer to request deadline and distribution dates and additional information on-line www. afbs. ca. Date of Birth Member Name Last First Middle Initial Telephone Number ACTRA/WGC Number Your Account Number SIN No. Street Address Province City Postal Code Please ensure your current address is on file at AFBS. This information is required for verification and identification purposes. SECTION 2 RRSP or TFSA Withdrawal Request IMPORTANT - For income tax purposes Non-Resident Note Citizenship does not necessarily determine residence. FORM 20 AFBS 1000 Yonge Street Toronto ON M4W 2K2 PHONE 416-967-6600 1-800-387-8897 FAX 416-967-4744 1-888-804-8929 E-MAIL benefits afbs. ca Request for RRSP or TFSA Withdrawal AFBS WEST 320 -1155 Pender Street West Vancouver BC V6E 2P4 PHONE 604-801-6550 1-866-801-6550 FAX 604-801-6580 E-MAIL afbswest afbs. ca Please complete all information requested below sign and return to SECTION 1 Member Information please print Reset Form I hereby provide authorization to Actra Fraternal Benefit Society to withdraw funds from my RRSP or TFSA account for the next available withdrawal distribution date. Please refer to request deadline and distribution dates and additional information on-line www. afbs. ca* Date of Birth Member Name Last First Middle Initial Telephone Number ACTRA/WGC Number Your Account Number SIN No* Street Address Province City Postal Code Please ensure your current address is on file at AFBS* This information is required for verification and identification purposes. SECTION 2 RRSP or TFSA Withdrawal Request IMPORTANT - For income tax purposes Non-Resident Note Citizenship does not necessarily determine residence. Canadian Resident RRSP withdrawal in the amount of Gross Net Gross is the amount prior to fee and tax deductions. Net is the amount of the cheque after fee and tax deductions. See Section 5 for tax details. Withdrawal of excess or unused RRSP contributions in the amount of For proper tax reporting please verify this amount with your financial advisor. For ongoing over-contributions please refer to afbs. ca for contribution limit information* TFSA withdrawal in the amount of There are no tax deductions on TFSA withdrawals. See Section 5 for administration fee details. SECTION 3 Mail or Pick Up Cheque Toronto Office Vancouver Office Do you wish to pick up cheque at If this section is not completed your cheque will be mailed to the address provided* SECTION 4 Address for Mailing the Cheque if different than above SECTION 5 Authorization for Withdrawal I acknowledge deduction of the administration fee 10 of the withdrawal amount to a maximum of 100 on both RRSP and TFSA withdrawals and the following withholding tax as required by the Canada Revenue Agency on RRSP withdrawals only. .

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