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Divident Reinvestment Plans (DRIP) - Fax Sheet
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RBC Investor Services - DRIP Fax Instruction Form
Fax To:
From:
Fax No:
416 955 3031
Name:
To:
DRIP Department
Company:
Company:
RBC Investor Services
Phone No:
Date:
Fax No:
No. of Pages:
DRIP ENROLLMENT / TERMINATION FORM
Client Name:
Security Description:
ISIN / CUSIP No:
Record Date:
Pay Date:
Account Numbers:
Enrollment
Number of shares to be enrolled in the plan
(if this is a new enrollment)
:
Shares to be added to the plan
(if already enrolled in the plan)
:
Termination
Number of shares to be terminated
(and deposit to safekeeping account)
:
Full termination
(to receive cash in lieu of fractional shares)
:
Additional Information:
Signature
:
(please print name)
