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Banking account - Direct Access

*All fields are mandatory except where indicated.

Regulatory information CRS/FATCA

Country of residence for tax purposes

Under Part XVIII and XIX of the Income Tax Act, Canadian financial institutions are required to collect the information you provide on this form to determine if they have to report your financial account to the Canadian Revenue Agency (CRA). CRA may share that information with the government of a foreign jurisdiction that you are resident for tax purposes, or to the U.S. government in you are a citizen of his country. You may ask your financial institution the nature of the information exchanged. Each account holder of a joint account has to fill out a CRS-FATCA Self-Certification form.

What are your countries of residence for tax purposes?

Please tick all the applicable options

Do you have a U.S. SSN or ITIN?

Please provide the reason amongst options

Reason A: I will or I have already requested it, but I have not yet received it. If I have not yet requested one, I have 90 days to apply for it and 15 days after I receive it to provide it to my financial institution.

Reason B: I am resident for tax purposes of a country that does NOT issue a TIN to its residents (excluding the United States).

Reason C: I have it, but not on hand. I will provide it within a 15-day period from the date hereof.

Reason D: I refuse to provide it, even though it is required by Part XVIII and/or XIX of the Income Tax Act and I could be subject to penalties by doing so.

If you ticked this box, provide your countries of residence for tax purposes and taxpayer identification numbers (TIN).

Do you have a Taxpayer identification number (TIN)?

Please provide the reason amongst options

Reason A:   I will or I have already requested it, but I have not yet received it. If I have not yet requested one, I have 90 days to apply for it and 15 days after I receive it to provide it to my financial institution.

Reason B:   I am resident for tax purposes of a country that does NOT issue a TIN to its residents (excluding the United States).

Reason C:   I have it, but not on hand. I will provide it within a 15-day period from the date hereof.

Reason D:   I refuse to provide it, even though it is required by Part XVIII and/or XIX of the Income Tax Act and I could be subject to penalties by doing so.

Do you have a Taxpayer identification number (TIN)?

Please provide the reason amongst options

Reason A:  I will or I have already requested it, but I have not yet received it. If I have not yet requested one, I have 90 days to apply for it and 15 days after I receive it to provide it to my financial institution.

Reason B:   I am resident for tax purposes of a country that does NOT issue a TIN to its residents (excluding the United States).

Reason C:   I have it, but not on hand. I will provide it within a 15-day period from the date hereof.

Reason D: I refuse to provide it, even though it is required by Part XVIII and/or XIX of the Income Tax Act and I could be subject to penalties by doing so.

Do you have a Taxpayer identification number (TIN)?

Please provide the reason amongst options

Reason A:  I will or I have already requested it, but I have not yet received it. If I have not yet requested one, I have 90 days to apply for it and 15 days after I receive it to provide it to my financial institution.

Reason B: I am resident for tax purposes of a country that does NOT issue a TIN to its residents (excluding the United States).

Reason C:   I have it, but not on hand. I will provide it within a 15-day period from the date hereof.

Reason D:   I refuse to provide it, even though it is required by Part XVIII and/or XIX of the Income Tax Act and I could be subject to penalties by doing so.

Important Notice: if the reason for not providing a SSN/ITIN/TIN is A, C or D as per Part XVIII and/or XIX of the Income Tax Act, I understand that my financial institution may have to declare my account based on any indicia that may indicate a foreign tax residence and that I may be subject to penalties from CRA as a result of my refusal or negligence to provide these information. I agree to assume any liability directly or indirectly related to this situation.

Banking account - Direct Access

*All fields are mandatory except where indicated.