Fillable Printable Enduring Power of Attorney - Manitoba
Fillable Printable Enduring Power of Attorney - Manitoba
Enduring Power of Attorney - Manitoba
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Enduring Power of Attorney
1. IMPORTANT INSTRUCTIONS:
ACCOUNT HOLDER — PLEASE READ BEFORE
EXECUTING THIS ENDURING POWER OF ATTORNEY
You should only use this power of attorney if you want to give another
person full authority to make decisions about, and give instructions in
connection with, your accounts with Phillips, Hager & North Investment
Funds Ltd. (“PH&NIF”). PH&NIF is not advising you to appoint an agent
to make decisions for you. This is a decision that only you can make. The
effect of this document is to authorize the person you have named as your
agent to act on your behalf with respect to your property and financial
affairs, including your accounts at PH&NIF. By completing this power of
attorney, except as restricted below, the agent will have very wide powers
to deal with your property on your behalf, including all of your assets and
accounts in your name at PH&NIF. The agent will also be able to use your
property to provide support for and benefit your spouse and dependent
children. You should consider very carefully whether or not you wish to
impose any restrictions on the powers of the agent and if so, you should
consult a lawyer (in Quebec, a lawyer or notary) to prepare a power of
attorney to suit your specific needs. Your agent should be someone you
know and trust completely and who is very capable of handling financial
matters. Your agent could seriously deplete your financial assets. This
power of attorney is an “enduring” or “continuing” power of attorney, which
means that it will continue during your lifetime and it will not come to an
end or terminate if you become mentally incapable of managing your own
affairs unless you have revoked it before that time. At that point, the agent
will have a duty to manage your affairs, as described above, and may not
be able to resign without first obtaining permission from the court. This
power of attorney takes effect as soon as it is signed and witnessed. If you
do not want the agent to be able to act on your behalf until after you become
mentally incapable of managing your own affairs, you should say so in this
document and consult a lawyer (in Quebec, a lawyer or notary) to prepare
a power of attorney to suit your specific needs. You may cancel, terminate
or revoke this power of attorney at any time in the manner described below
under the heading “Ending this Power of Attorney,” as long as you are
mentally capable of understanding what you are doing.
2. DEFINITIONS
In this power of attorney, “you” “yourself” or “ account holder” means
the account holder set out in Section A below, “PH&NIF” means Phillips,
Hager & North Investment Funds Ltd., “agent” refers to the individual
identified in Section C below as your agent and attorney, and the “accounts”
means the account or accounts with PH&NIF identified in Section A below
and all other accounts that you hold with PH&NIF.
3. SCOPE OF POWER AND AUTHORITY GRANTED
You hereby appoint the agent as your agent and attorney in fact and for
property with full power and authority over the accounts, (subject to the
limitations set out herein). This power of attorney does not apply to any
property other than the assets in the accounts. When this power of attorney
is signed and properly witnessed, the agent will have full power and
authority to carry out all actions with respect to the accounts as if you were
giving PH&NIF the instructions directly (subject to the limitations set out
herein). This power and authority includes, but is not limited to, the power
and authority to:
• buy,sell(redeem)andtransferunits;
• receivepaymentsfromothers;
• receivetransactionstatements,andapproveandconfirmthem;
• receiveallnoticesanddemandsofanykindaddressedtoorintendedfor
youregardingtransactionsinorfortheaccounts;
• sign any agreements with PH&NIF on your behalf necessary for
transactionsorfortheaccounts;
• instruct PH&NIF to act on investment objectives different than those
establishedbyyou;and
• actonyourbehalfinanyothermatterregardingtheaccounts,
in all cases subject to compliance with any applicable policies, procedures
and other requirements that we establish from time to time with respect to
these matters. Notwithstanding the foregoing, the agent will NOT have the
power or authority to direct PH&NIF to make payments to the agent or to
any person other than the account holder.
You acknowledge and confirm that PH&NIF is NOT required to notify
you before or after acting on the agent’s instructions or to send you any
statements, notices or demands with respect to these or any other actions
carried out by the agent with respect to the accounts. By signing this power
of attorney, you are approving all of the agent’s actions with respect to the
accounts. You agree that PH&NIF is not required to oversee, control or
supervise the decisions made by the agent. You acknowledge that PH&NIF
will follow the agent’s instructions unless you instruct PH&NIF in writing
to do otherwise.
4. DURATION OF THIS POWER OF ATTORNEY
The power and authority granted by this power of attorney will continue
until this power of attorney is terminated in the manner described below
under the heading “Ending this Power of Attorney.” In particular, you
authorize this power of attorney, and the power and authority of the agent
granted under this power of attorney, to continue if you subsequently
become mentally infirm or incapable, or legally incapacitated. This power
of attorney is a continuing power of attorney binding on you and your heirs,
executors, liquidators, administrators, successors and assigns. If you are
signing this power of attorney while you are in or a resident of Quebec, the
agent may cease to have authority to act upon your mental incapacity.
You do not intend to, and this power of attorney shall not, revoke any
other current power of attorney that you have granted. If you have a current
power of attorney, you intend to have multiple powers of attorney. This
power of attorney will not be revoked by your subsequent execution of any
other power of attorney. If you execute a subsequent power of attorney, you
intend to have multiple powers of attorney. The agent’s authority will be
concurrent with that of all other agents for property that you currently or
subsequently appoint.
5. CONFLICTING INSTRUCTIONS
PH&NIF will accept and act on instructions from the agent unless you
instruct us otherwise in writing. If at any time PH&NIF receives conflicting
instructions from persons other than yourself who each appear to have the
right to make decisions on your behalf, PH&NIF is entitled to refuse to act
on such instructions.
6. LIABILITY
You hereby direct PH&NIF to accept this power of attorney and act on the
agent’s instructions until this power of attorney is terminated in the manner
described below under the heading “Ending this Power of Attorney.”
In consideration of PH&NIF agreeing to accept this power of attorney
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and act on the instructions of the agent, you agree that PH&NIF is entitled
to rely on the authority granted to the agent in this power of attorney and
the representations, warranties and certificates contained herein and is
not responsible for any actions taken by the agent regarding the accounts.
You hereby indemnify PH&NIF and agree to hold PH&NIF harmless
completely from and against any liability (including costs of defending
itself) arising from any action taken by the agent in relation to the accounts,
including without limitation, actions taken by the agent if this power of
attorney is found to be invalid or if the agent ceases to have authority to act
under this power of attorney for any reason. This indemnity will survive the
termination of this power of attorney. You will, on PH&NIF’s request, take
all reasonable steps required to ratify any action of the agent.
7. ENDING THIS POWER OF ATTORNEY
This power of attorney will remain effective and PH&NIF is entitled to
continue to accept the agent’s instructions until (a) PH&NIF receives a signed
written notice of revocation of this power of attorney, (b) PH&NIF receives
proof of your death (for example, a certified copy of a death certificate),
(c) PH&NIF receives proof of the agent’s death (for example, a certified
copy of the agent’s death certificate), (d) PH&NIF receives a copy of the
agent’s resignation or renunciation, or (e) PH&NIF receives a court order
terminating this power of attorney or other proof satisfactory to PH&NIF
that this power of attorney has terminated by operation of law, including in
some jurisdictions the bankruptcy of either the agent or the account holder
or the mental incapacity of the agent. This power of attorney comes to an
end if you die or your attorney dies.
A | To Be Completed By The Account Holder
The account holder’s signature must be signed in the presence of one or two witnesses (depending on the laws of the jurisdiction in which this power of
attorney is executed) who must comply with the applicable requirements set out in Section B below. You must have reached the age of majority in the
province or territory of your residence and in which this power of attorney is executed in order to give this power of attorney. You must ensure that your
agent is aware of this power of attorney and has agreed to be appointed as agent by having your agent complete Section C below. You may not appoint as
your agent a person who is under the age of majority in the province or territory of the agent’s residence or in which this power of attorney is executed,
is mentally incapacitated, is an undischarged bankrupt, has been convicted of a criminal offence in the past ten years, or whose occupation or business
involves providing personal care or health care services to you.
Account holder’s name (please print) PH&NIF account holder’s signature Date (yyyy/mm/dd
PH&NIF account number(s)
The agent should sign the acceptance in Section C of this document to indicate that he or she knows about this document and agrees to being appointed
as your attorney and that he or she is aware of his or her duties. Note that the agent must sign Section C and that signature must be witnessed by the
completion of Section D if the account holder is resident in British Columbia.
B | To Be Completed By Witness(es)
The account holder’s signature in Section A above was witnessed by the following witness or witnesses who comply with the applicable requirements set out
on the back of this form and signed this power of attorney in the presence of the account holder.
I,
1. Witness name
of
Residential address (number, street, apartment or suite number) City or town Province/Territory Postal code
and
I,
2. Witness name
of
Residential address (number, street, apartment or suite number) City or town Province/Territory Postal code
certify:
(a) that I witnessed the signing of the enduring power of attorney of dated
(b) that I am an adult with capacity and that I am not the account holder named in the above-mentioned enduring power of attorney and that I am not a
familymemberofeitherthegrantorortheattorney;
(c) that in my opinion was an adult who could understand the nature and effect of an enduring power of
attorney at the time that he or she signed the above-mentioned enduring power of attorney.
Name of account holder
(yyyy/mm/dd)
Name of account holder
1. Witness name (please print)* Witness signature Date (yyyy/mm/dd)
2. Witness name (please print)* Witness signature Date (yyyy/mm/dd)
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C | To Be Completed By The Agent
PH&NIF is not advising the agent to accept this appointment. An agent is subject to various legal duties and responsibilities to the account holder and others.
If the agent requires further information about an agent’s duties and responsibilities, the agent should consult a lawyer (in Quebec, a lawyer or notary).
By signing this power of attorney, the agent hereby accepts his or her appointment as agent and attorney of the account holder, confirms that he or she
has read and understood this power of attorney and understands and acknowledges his or her responsibilities, obligations and liabilities of acting as agent
and attorney, agrees to take on these responsibilities, obligations and liabilities, and represents and warrants to PH&NIF that he or she is familiar with the
investment objectives of the account holder.
The agent hereby certifies that he or she is not under the age of majority in the province or territory of the agent’s residence or in which this power of attorney
is executed, is not an undischarged bankrupt and has not been convicted of a criminal offence in the past ten years, and that his or her occupation or business
does not involve providing personal care or health care services to the account holder.
For agent of an account holder where this power of attorney was executed in Quebec or the account holder is resident in Quebec: The agent
understands that upon the mental incapacity of the account holder, the agent may cease to have authority to act under this power of attorney. The agent may
continue acting under this power of attorney if this power of attorney is confirmed by a court.
Agent’s name Agent’s signature Date (yyyy/mm/dd)
Personal Information of Agent:
Residential Address (number, street, apartment or suite number) City or town Province/Territory
Postal code Business telephone number Home telephone number Fax number Email address
Nature of relationship with account holder (describe):
D | To Be Completed By Witness(es)
The agent’s signature in Section C above was witnessed by the following witness or witnesses who comply with the applicable requirements set out on the
back of this form and signed this power of attorney in the presence of the agent.
To be Completed by Witness(es). This section applicable to British Columbia account holder
residents only.
1. Witness name (please print)
Of
Residential address (number, street, apartment or suite number) City or town Province/Territory Postal code
Witness signature Date (yyyy/mm/dd)
2. Witness name
Of
Residential address (number, street, apartment or suite number) City or town Province/Territory Postal code
Witness signature Date (yyyy/mm/dd)
General requirements for witnesses:
A person may NOT be a witness if he or she is (i) the account holder, (ii) the agent, (iii) a spouse, partner, adult interdependent partner, common law or
same-sex spouse, (iv) parent, (v) child (or a person whom the account holder has demonstrated a settled intention to treat as his or her child) or (vi) other
family member of the account holder or the agent, (vii) an employee of the agent (other than an employee who is a lawyer, a notary in the jurisdiction, a public
trustee or a financial institution authorized to carry on trust business in the jurisdiction), (viii) a person whose property is under guardianship or regime of
protective supervision or who has a guardian, (ix) a person who is under the age of majority in the province or territory in which the person resides and in
the province or territory where this power of attorney is executed or (x) a person who does not understand the means of communication of the account holder
(unless interpretive assistance is provided to understand the communication).
*Specific requirements for witnesses (by province or territory):
• ForanaccountholderresidentinOntarioorQuebec,twowitnessesarerequiredforanenduringpowerofattorney.
• ForanaccountholderresidentinAlberta,NewBrunswick,NovaScotia,Newfoundland,PrinceEdwardIsland,NorthwestTerritoriesandNunavut,one
witness is required for an enduring power of attorney.
• ForanaccountholderresidentinManitoba,onewitnessisrequiredforanenduringpowerofattorneyandthatwitnessmustbe:anindividualregistered,
orqualifiedtoberegistered,undersection3ofTheMarriageAct(Manitoba)tosolemnizemarriages;ajudgeofasuperiorcourtofManitoba;ajustice
ofthepeace,magistrateorprovincialjudge;adulyqualifiedmedicalpractitioner;anotarypublicappointedforManitoba;alawyerentitledtopracticein
Manitoba;amemberoftheRoyalCanadianMountedPolice;oramemberofamunicipalpoliceforceinManitobawhoexercisesthepowersofapeace
officer.ThewitnessmustincludehisorhertitleafterhisorhernameinSection1ofthewitnesscertificate(e.g.MarySmith,JusticeofthePeaceinthe
ProvinceofManitoba).
• ForanaccountholderresidentinBritishColumbia,thesigningofanenduringpowerofattorneybytheaccountholdermay be witnessed by a practicing
lawyer or notary public alone or it may be witnessed by two persons (non-lawyers) who complete and sign the certificate of (non-lawyer) witnesses
set out above. An enduring power of attorney must also be signed by an agent, and the agent’s signing must also be witnessed by two persons who
must then complete section D above.
• ForanaccountholderresidentinSaskatchewan,anenduringpowerofattorneymay be witnessed by a lawyer alone, provided that the lawyer provides
a certificate of legal advice and witness certificate or it may be witnessed by two persons (non-lawyers) who complete and sign the certificate of
(non-lawyer) witnesses set out above.
• ForanaccountholderresidentintheYukon,anenduringpowerofattorneymustbewitnessed by a lawyer and accompanied by a certificate of legal advice
from a lawyer who is not the agent or the agent’s spouse.
• AnaccountholderresidentintheNorthwestTerritoriesmaynamearecipienttoreceivereportsontheaccountholder’sfinancialaffairs,intheformofan
accounting from the agent. The recipient would then be able to review the reports to ensure that the agent is properly handling the account holder’s affairs.
Please return form to: PH&N Investment Services, 20
th
Floor, 200 Burrard Street, Vancouver, B.C., V6C 3N5
PH&N Investment Services
®
isatradenameusedbyPhillips,Hager&NorthInvestmentFundsLtd.,anindirect,wholly-ownedsubsidiaryofRoyalBankofCanada.
® /
TM
Trademark(s)ofRoyalBankofCanada.Usedunderlicence.
n Telephone: 1-800-661-6141 Facsimile: 1-800-666-9899 Email: info@phn.com Website: www.phn.com
EnduringPowerofAttorney11.4IF[ver9]March2014
1 | Information about the individual to be authorized on the account
2 | Identity Verification Options
The federal Proceeds of Crime (Money Laundering) and Terrorist Financing Act provides for a number of identity verification options. PH&N Investment
Services suggests that two of those options, which are provided below, are the most time and cost efficient to those who wish to open an investment account.
Please choose either option A or B:
Option A (please check if applicable)
I am personally an existing client of the Royal Bank of Canada (RBC). By signing this form where indicated, I authorize PH&N Investment Services to
contact RBC in order to confirm that the personal identification information that I have provided to PH&N Investment Services below is consistent with
the information that I provided to RBC.
Option B (please check if applicable)
By signing this form where indicated, I authorize PH&N Investment Services to obtain information about me from a credit bureau solely for the purpose
of PH&N Investment Services being able to verify my identity in compliance with the client identification requirements of the Proceeds of Crime (Money
Laundering) and Terrorist Financing Act. I understand that PH&N Investment Services will make no further use or disclosure of my personal identification
information and that it will protect my personal identification information in accordance with the terms of its privacy policy.
If you are an account holder and your initial purchase will be made by a method other than a personal cheque (e.g., by electronic funds transfer or transfer
from another account or institution) or an attorney appointed by an account holder under a power of attorney, you must ALSO include with this form a $1.00
personal (non-counter) cheque from a Canadian financial institution, made payable to RBC Global Asset Management Inc. The Proceeds of Crime (Money
Laundering) and Terrorist Financing Act requires PH&N Investment Services to use two methods to verify the identity of an account holder or the authorized
representative of an account holder if that person (a) wishes to establish his or her identity without a face to face meeting with a representative of PH&N
Investment Services and (b) does not have an account with a financial entity that is affiliated with PH&N Investment Services . The two identification
methods that PH&N Investment Services has chosen are a credit check and a cleared personal cheque.
Please provide your 16 digit RBC client card number:
Name (rst, middle, last) Date of Birth (yyyy/mm/dd) Social Insurance Number
Mailing Address (number, street, apartment or suite number City or town Province Postal Code
Principal business or occupation
List your country (ies) of residence for tax purposes (check all that apply) Tax Identication Number (TIN) of U.S. and/ or Other Country
Canada *United States Other:
* A U.S. citizen is considered a U.S. resident for tax purposes even if resident of another country. Please attach a completed IRS W-9 form.
_________________________
Please complete one form per account holder and/or authorized signatory.
Effective June 23, 2008, Phillips, Hager & North Investment Funds Ltd., which uses a trade name PH&N Investment Services, is required under the
federal Proceeds of Crime (Money Laundering) and Terrorist Financing Act to obtain certain information regarding the identity of each individual who
wishes to open an investment account at PH&N Investment Services or who is authorized to give instructions on the account. This information is in
addition to that which is sought under PH&N Investment Services’ standard account opening forms and must be obtained by PH&N Investment Services
before it will open a new account. Please note that PH&N Investment Services does not require the identification information requested below if you wish
to open a registered plan account (e.g. a locked-in retirement plan account, a registered retirement savings plan account and group registered retirement
savings plan accounts)
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Federal ID Requirements
Individuals – Online or Mailed Applications
Mr Mrs Ms Dr
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5 | Signature
4 | Use of Accounts by a Third Party
3 | Intended Use of the Account
PH&N Investment Services is a trade name used by Phillips, Hager & North Investment Funds Ltd., an indirect wholly-owned subsidiary of Royal Bank of Canada.
® /
TM
Trademark(s) of Royal Bank of Canada. Used under licence.
n Telephone: 1-800-661-6141 Facsimile: 1-800-666-9899 Email: info@phn.com Website: www.phn.com
Please return form to: PH&N Investment Services, 20
th
Floor, 200 Burrard Street, Vancouver, B.C., V6C 3N5
Federal ID Requirements 11.12 IF [ver 6] June 2014
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Federal ID Requirements
Individuals – Online or Mailed Applications
Proceeds from the sale of property
Estate proceeds
Business or employment income
Other (please describe)___________________________________
Please indicate the source of your funds and intended purpose below.
Saving for retirement
Saving for education
Saving for a house
Saving for a trip
Other (please descrbe)___________________________________
Purpose of Funds Source of Funds
a) Are you opening this account on behalf of another person?
b) Will any person other than the account holder or authorized representative of the account holder direct the activity in this account?
If you answered “yes” to either of these questions, please provide the following information about that third party:
Yes No
Yes No
Name of the third party Address of the third party
Date of birth of the third party (if he or she is an individual) Incorporation number and place of incorporation (if the third party is a corporation)
The principal business or the occupation of the third party The relationship that exists between the account holder and the third party
By signing below, I verify that all of the information that I have provided in this form is true.
Signature Date (yyyy/mm/dd)
