INDIVIDUAL PENSION PLAN (IPP)

DATA SHEET – YEAR 2011

 

Company Information

 

Full legal name:                                                                                                                                                    

Address (including postal code):                                                                                                                     

                                                                                                                                                                               

Telephone number:                                                                                                                                             

Fax number:                                                                                                                                                          

Name of contact:                                                                  Title:                                                                      

Date of incorporation (DD/MM/YYYY):                                                                                                         

Fiscal year-end:                                                                                                                                                   

Nature of Business:                                                                                                                                            

CRA Employer Remittance Account Number [1] :                                                                                        

 

 

Employee Information

 

Name:                                                      

Gender:                                Male/Female

Connected? [2]                   Yes/No 

S.I.N.:                                                     

Province of employment:                                                                

Birthdate (DD/MM/YYYY):                                             

Hire Date (DD/MM/YYYY):                                             

Address (incl. postal code):                                                                                                              

                                                                                                                                                               

                                                                                                                                                               

Phone:                                                   

Fax:                                                        

Email:                                                                                                     

 

 

Gross earnings reported on T4:

Year                            Amount

2011 (expected):                                   

2010:                                                      

2009:                                                      
2008:                                                      

2007:                                                      

2006:                                                      

2005:                                                      

2004:                                                      

2003:                                                      

2002:                                                      

2001:                                                      

2000:                                                      

1999:                                                      

1998:                                                      

1997:                                                      

1996:                                                      

1995:                                                      

1994:                                                      

1993:                                                      

1992:                                                      

1991:                                                      

1990*:                                                  

 

*    If 1990 earned income for RRSP purposes is different from T-4 earnings paid by Company,

      please indicate amount here _____________.

 

Unused RRSP Contribution Room (prior to Dec. 31, 2010):                                 

 

RRSP Balance (Market Value):                                                     

 

 

Accountant Information

 

Name:                                                                    

Company Name:                                                                                  

Address (incl. postal code):                                                                                                              

                                                                                                                                                               

                                                                                                                                                               

Phone:                                   

Fax:                                        

Email:                                                                                     

 

 

Financial Advisor Information

 

Name:                                                                    

Company Name:                                                                                  

Address (incl. postal code):                                                                                                              

                                                                                                                                                               

                                                                                                                                                               

Phone:                                   

Fax:                                        

Email:                                                                                     

 

 


 

[1]            Format is nine digits followed by the letters RP and then 4 digits (e.g. 12345-6789-RP0001).

[2]           directly or indirectly hold 10% or more of any class of shares of the Company, related to such person, or do not deal  at arm’s length with such person.