APPENDIX C: NON STANDARD PERSONAL RETIREMENT SAVINGS ACCOUNT 

DECLARATION

 

TO BE COMPLETED BY THE VENDOR (WHETHER PRODUCT PRODUCER OR INTERMEDIARY).

Name of Consumer to whom a non-Standard PRSA has been offered or recommended: (Print name in block capital letters)

Name of Non-Standard PRSA offered to the Consumer:

Name of Non-Standard PRSA Product Producer:

  1. I declare that I have explained to this consumer that there are differences between a Non-Standard PRSA and Standard PRSA, and focused on the fact that the charges may be higher and the investment risks are greater for this non-Standard PRSA.
  2. I declare that in my opinion it is in the best interest of the above named consumer to purchase this non-Standard PRSA.
  3. I declare that in my opinion the non-Standard PRSA I have offered/recommended to the above named consumer is the PRSA product most suited to this consumer from among all those I am able to provide.

 

Signature of Salesperson:

Name of Salesperson (in block capitals):

Position Held:

Name of Regulated Entity:                                              

Date of completion of the declaration: