Account Application (Personal Accounts Only) - 2014 printable pdf download

Account ApplicAtion

Choice

( Personal Accounts Only )

Customer Number(s)

Account Number

14th Floor – 888 Dunsmuir Street

e - S a v i n g s A c c o u n t

Vancouver, BC V6C 3K4

Phone: 604-683-2881 Fax: 604-683-5110

( For Office Use Only )

Toll Free: 1-800-663-0324

Purpose of Doing Business with Peoples Trust:

Application Was Completed:

Account Type:

Opening an Investment Account

In Person

Individual

Joint

Other ______________

Other_____________________________

By Mail or Electronic Means

New Customer

Existing Customer

Applicant:

(If more than 2 applicants, complete an additional Application Form)

Name

Phone #

S.I.N.

D.O.B.

(incl. area code)

(DD/MM/YY)

Address

City

Province

Postal Code

Applicant Email

Occupation*

Employer

Co-Applicant:

Name

Phone #

S.I.N.

D.O.B.

(incl. area code)

(DD/MM/YY)

Address

City

Province

Postal Code

Applicant Email

Occupation*

Employer

U.S. Citizenship or Residency:

Do you hold U.S. Citizenship or are you a resident of the U.S.?

YES

Registration Details for More Than One Owner:

Signing Authority:

Joint Tenants with Right of Survivorship

ANY one to sign or provide instructions

Tenants in Common

ALL must sign and provide instructions

Third Party Declaration:

Will this Account be used on behalf of anyone not disclosed on this application?

YES

(If yes, please provide details on a separate Third Party Information Form)

Politically Exposed Person (PEP)

Have the applicant(s) or any close relative of the applicant(s) ever held a senior position in government, political party, military, tribunal or government-owned

corporation?

(If yes, please provide the specific details on a separate PEP Form)

YES

Intended Use of Account:

Saving/Investment

Vacation

Retirement

Education

Other

(Please specify) ______________________________________________

Initial Deposit

Personal Cheque enclosed for $ _________________________

Acknowledgement Section:

By signing this application I/we acknowledge that: I/we have received, read and understand the Terms & Conditions. I/we consent to the collection, use and

disclosure of my/our personal information as outlined in the Terms & Conditions. I/we consent to an indentification check to confirm my/our identity. I/we hereby

apply to be the Registered Holder(s) of the account as set out above.

Applicant Signature ______________________________________ Co-Applicant Signature _____________________________________ Date ________________

After completing this application form, send it together with your pre-printed personal cheque payable to yourself to:

Peoples Trust Company

1400 – 888 Dunsmuir Street, Vancouver, BC V6C 3K4

If you are opening a joint account, we require a pre-printed personal cheque for each registered owner – either one cheque with both names endorsed by both

parties, or a separate cheque endorsed by each owner.

* If self-employed, state the nature of employment. If retired, please state your occupation before retirement.

Peoples Trust e-Savings Account Application April 2014