Hedge Fund Subscription Procedure (Page 20 of 23) in pdf

SCHEDULE “D”

ENTITY TAX SELF-CERTIFICATION FORM

Instructions

You may complete a U.S. Internal Revenue Service (IRS) W8 or W9 tax form as an alternative to this Entity Tax Self-Certification

form. To obtain the latest IRS W tax form, please visit the IRS website:

Please use this form for an account held by an entity such as a corporation, partnership, any formal trusts or any other corporate

forms/organizations (for both account opening or updating the tax status of an entity of an existing account).

Please use the Individual Tax Self-Certification form for an account held by a natural person or sole proprietor.

For joint accounts, please complete a Tax Self-Certification form for each joint account holder.

Please send completed form to AGF Investments Inc. at TD Bank Tower, 66 Wellington Street West, 31

Floor, Toronto, ON

M5K 1E9.

Under Section 265(2) of the Income Tax Act (Canada), it is required for a Canadian financial institution to collect information to determine

whether entities opening an account are a specified U.S. person, a financial institution or a non-financial foreign entity. For further information,

please visit the Canada Revenue Agency (CRA) website at or the IRS website at

Legal name of the entity:

_________________________

Account number(s): ______________

A. Speciﬁed U.S. person

Yes

No

1) a) In the case of a corporation or partnership, is it incorporated or organized in Canada?

b) If not incorporated or organized in Canada, please indicate whether the entity is a specified U.S. person. Yes

No

If “yes”, please also provide the entity’s U.S. TIN

__ __ - __ __ __ __ __ __ __

2) In the case of a trust, please indicate whether it is a specified U.S. person. Yes

No

If “yes”, please provide the trust’s U.S. TIN

__ __ - __ __ __ __ __ __ __

B. Financial institution

Yes

No

1) Is the entity a financial institution?

If the entity is a financial institution, please also provide its status:



Financial institution with valid GIIN – GIIN#: _________________________________



A partner jurisdiction financial institution that does not yet have a GIIN



Nonparticipating financial institution (NPFI)



Other – provide status: ___________________________________________________

C. Entity type

Complete this section only if the entity account holder is not a specified U.S. person or a financial institution.

1) Check any that apply to the entity:

 An Active Non-Financial Foreign Entity (Active NFFE) The category of an Active NFFE includes, but is not limited to:



active trade or business – less than 50% of the entity’s gross income is passive income and less than 50% of its assets produce passive

income;



a registered charity, or a club, association or arrangement in Canada operated exclusively for cultural, athletic or educational purposes;



a corporation with shares that regularly trade on an established securities market; or



a government or international organization (or agency thereof).

 A Passive Non-Financial Foreign Entity (Passive NFFE)

A Passive NFFE is any entity that is neither a specified U.S. person, a financial institution, nor an Active NFFE. If an entity is a Passive

NFFE, please complete the following Question 2 on the next page.

C. Entity type (continued)

2) Please complete this question only if the entity is identified as a Passive NFFE above.

Hedge Fund Subscription Procedure Page 20

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