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Change of Address Account Raymond James Ltd. is a Member of CIPF IIROC IA Branch Account Number s Name s TYPE OF CHANGE Mailing Address Only Temporary Residence Change1 Permanent Address Change2 Tick if this is a request to set up DUPLICATE confirms and statements Move Date2 mm/dd/yy If RESP account s included update beneficiaries address as well NEW OLD ADDRESS INCLUDING PHONE AND EMAIL Note If the new address is a PO Box number or General Delivery address then also include the client s physical location civic address legal land description or rural route address New Address Old Address Please provide new identification if you have moved to a new country or provide a signed W8Ben for each account holder. In the case of a permanent move to the United States a signed W9 is required* Client Signature s Print Name s Date Signed mm/dd/yyyy This document and all related documents including all notices are available in the French language. The Client has expressly requested that these documents be in the English language. Ce document et tous les documents qui s y rattachent y compris tous les avis sont disponibles en version fran aise. Le client a express ment demand que ces documents soient en langue anglaise. 0035-09302011 RESET SAVE PRINT 1. A country to country temporary residence change takes place when you do not cease residency for tax purposes. This means you will continue to file resident tax returns in your former country of residence. The current withholding tax rate will continue to apply to your account. country for tax purposes. You have declared or will declare a departure/entry date on your emigrant/immigrant tax returns. Please indicate this date as the move date above. If you hold registered and non-registered accounts at Raymond James we will open new accounts to ensure proper withholding taxes are applied to your non-registered account. Note you will be subject to non-resident withholding tax on Canadian income after your departure from Canada* 3. A Duplicate address will only receive statements and/or confirms. It will not receive duplicate tax slips or 3rd party mailings from issuers. Tax slips and 3rd party mailings will only go to the Primary address on the account Account Profile update completed by Date Is the IA licensed in the new province/jurisdiction where the client is moving Yes No For clients with country to country moves Un-RAP completed New Client Number for Non-Registered NRT code for Registered NRT code for Non-Registered 0 Canadian 1 Treaty 2 RRSP only 3 Non-Treaty Residence Code IRS Panel Code US Person Blanked or If Yes Input New Identification Input W9 or Input back-up withholding YES For clients leaving Canada Back tax required If yes Owns Canadian Mutual Funds Owns Canadian Partnerships Owns RESP On DRIP Program Completed T5 NR4 split required Advised client re inability to purchase Advised implications Taken off DRIP. In the case of a permanent move to the United States a signed W9 is required* Client Signature s Print Name s Date Signed mm/dd/yyyy This document and all related documents including all notices are available in the French language. The Client has expressly requested that these documents be in the English language. Ce document et tous les documents qui s y rattachent y compris tous les avis sont disponibles en version fran aise.