Request for Quote

Retirement Compensation Funding

IPP and

PENSIONWrap™

(RRSPWrap™ / MPPPWrap™ / IPPWrap™)

Request for Illustration

Personal Information

Plan Member	Date of Birth		Non-Smoker	Male	US Citizen
Plan Member	Date of Birth	(DD/MM/YY)	Smoker	Female	Canadian
Spouse	Date of Birth		Non-Smoker	Male	US Citizen
Spouse	Date of Birth	(DD/MM/YY)	Smoker	Female	Canadian

Corporate Information

Company/Employer			Incorporated		Corporate Year End (DD/MM/YY)
			Non Incorporated

Address

City

Province

Postal Code


Shares Owned			Years of Service in Current Company
	% by Plan Member	% by Spouse

Entitlement Calculation

ANNUAL CLIENT COMPENSATION

INCLUDE IN CALCULATION

CURRENT PENSION BALANCES

Current Salary

Yes

RRSP $

Current Bonus

Yes

MPPP $

Normally, RCA entitlements are based on SALARY (which can be increased if desired). If BONUSES are included in the entitlement calculation, total T4'd earnings CANNOT be reduced in the subsequent year. RCA deposits must be in addition to the T4'd SALARY and BONUS

IPP Start Date

(DD/MM/YY)

Annual IPP Payout $

PAST EARNINGS

Year:		T4's Earnings: $			Plan member's expected retirement age (Please check one)
					69	65	60	55	Other:

					Salary Index Rate (Please check one)
					0%	2%	3%	5%	Other:

Supplementary IPP Questionnaire

Are you a connected Person*?

Yes

A connected person is a person who owns, either directly or indirectly, (ie: spouse, sibling, parent) at least 10% of the issued shares of a company or a corporation related to the company, or a person who receives a salary from his Employer 2.5 times higher than the maximum pensionable earnings.

Is the company controlled by a holding corporation?

Yes

How much have you contributed to an RRSP since the beginning of the year? $

Unused RRSP deduction limit at the end of the immediately preceding year? $

Has the company ever contributed to a DPSP (deferred profit sharing plan) on your behalf?

Yes, in which years:

Does or has the company contributed to a pension plan on your behalf?

Yes, in which years:

Does the company contribute to a pension plan for its non-executive employees?

Yes, since:

Your Contact Information

First Name		Last Name	Company / Organization
Address		City	Province
Postal Code		Phone		E-mail
Additional Comments
Preferred Language	English Français
	By submitting this request I consent to release this information to Retirement Compensation Funding Inc. (R^CF). R^CF will keep all personal information strictly confidential, and will not release this information to any 3rd party without my consent.