RRSP & RRIF Non-Qualified Investment Information Return

2017V1 - updated 2016-10-27

<Return>
<RRSPOrRRIFNonQualifiedInvestment>
<RRSPOrRRIFNQISlip>
<Transaction>

<TransactionDate>

<NQITransactionDay></NQITransactionDay>
- Required 2 numeric
- Enter the 2 digits corresponding to the day for this transaction (ex.: 29)

<NQITransactionMonth></NQITransactionMonth>
- Required 2 numeric
- Enter the 2 digits corresponding to the month for this transaction (ex.: 12)

<NQITransactionYear></NQITransactionYear>
- Required 4 numeric
- Enter the 4 digits corresponding to the year for this transaction (ex.: 2011)

</TransactionDate>

<AcquiredNonQualifiedInvestmentFairMarketValueAmount>
</AcquiredNonQualifiedInvestmentFairMarketValueAmount>
- Required 11 numeric, enter dollars and cents
-- Fair market value when it became a non-qualified investment or was acquired as such
-- Do not report negative values.
-- Do not enter a dollar sign.

<DisposedNonQualifiedInvestmentFairMarketValueAmount>
</DisposedNonQualifiedInvestmentFairMarketValueAmount>
- Required 11 numeric, enter dollars and cents
-- Fair market value when it ceased to be a non-qualified investment or was disposed of
-- Do not report negative values.
-- Do not enter a dollar sign.

<NonQualifiedInvestmentDescription></NonQualifiedInvestmentDescription>
-Required 120 alphanumeric
-Enter the description of the investment, this may include the trade name of the company or investment, the stock exchange and the stock ticker of the investment. Ex. NASDAQ: (ENER) Energy conversion Devices, Inc.

</Transaction>

<SlipIdentification>

<AnnuitantName>
<FamilyName></FamilyName>
- Required 30 alphanumeric
- First 30 letters of the annuitant’s surname
- Omit titles such as Mr., Mrs., etc.
- Do not include the first name or initials

<GivenName></GivenName>
- Required 30 alphanumeric
- First 30 letters of the annuitant’s first given name
Note: If only initials are available, provide the annuitant’s first initial

<NameInitialText></NameInitialText>
- 1 alpha
- Initial of the annuitant’s second given name

</AnnuitantName>

<AnnuitantSocialInsuranceNumber></AnnuitantSocialInsuranceNumber>
- Required 9 numeric
- When the annuitant has failed to provide a SIN, enter zeroes in the entire field.
- Enter the annuitant’s SIN or temporary tax number

<AnnuitantAddress>

<AddressLine1Text></AddressLine1Text>
-30 alphanumeric
- First line of the annuitant’s address

<AddressLine2Text></AddressLine2Text>
- 30 alphanumeric
- Second line of the annuitant’s address

<CityName></CityName>
-28 alphanumeric
- City in which the annuitant is located

<ProvinceStateCode></ProvinceStateCode>
-2 alpha
- Canadian province or territory in which the annuitant is located or the state in the USA where the annuitant is located
- Use the abbreviations listed in the pdf document entitled "T619 - Electronic media transmittal" under section: Transmitter province or territory code.
- When the annuitant’s country code is neither CAN nor USA, enter ZZ in this field.

<CountryCode></CountryCode>
-3 alpha
- Country in which the annuitant is located
- Use the alphabetic country codes as outlined in the International Standard (ISO) 3166 Codes for the Representation of Names of Countries.
- Always use CAN for Canada, and USA for the United States of America.

<PostalZipCode></PostalZipCode>
-10 alphanumeric
- Annuitant’s Canadian postal code, format: alpha, numeric, alpha, numeric, alpha, numeric, example: A9A9A9
- or the annuitant’s USA zip code
- or where the annuitant’s country code is neither CAN nor USA, enter the foreign postal code.

</AnnuitantAddress>

<ContractID>

<RRSPOrRRIFNumber></RRSPOrRRIFNumber>
- Required 20 alphanumeric
- Registered Retirement Savings Plan or Registered Retirement Income Fund specimen plan/fund number that was issued by CRA.

< RRSPOrRRIFContractNumber></RRSPOrRRIFContractNumber>
- Required 30 alphanumeric
- Registered Retirement Savings Plan or Registered Retirement Income Fund contract number issued by the financial institution.

</ContractID>

<SlipReportTypeCode></SlipReportTypeCode>
- Required 1 alpha
- Original = O
- Amendment = A
- Cancel = C
Note: An original return cannot contain an amended or cancelled slip. An amended return cannot contain an original slip.

</SlipIdentification>

</RRSPOrRRIFNQISlip>

<RRSPOrRRIFNQISummary>

<FilerAccountNumber></FilerAccountNumber>
For original returns:
- Required 15 alphanumeric, 9 digits RZ 4 digits, example 000000000RZ0000
- Use the account number assigned to file the RRSP contribution receipt filing return with CRA.
- If you have not been notified of your number, or you are unsure of your number, contact our Business Enquiries line at 1-800-959-5525.
For amended returns:
- Required enter the same account number used in the original filed return.

<SummaryReportTypeCode></SummaryReportTypeCode>
- Required 1 alpha
- Original = O
- Amendment = A
Note: An original return cannot contain an amended or a canceled slip. An amended return cannot contain an original slip.

<TaxationYear></TaxationYear>
- Required 4 numeric
- Taxation year reported (e.g., 2011)

<TotalSlipCount></TotalSlipCount>
- Required 7 numeric
- Total number of slips filed with this summary

<FilerName>

<NameLine1Text ></NameLine1Text>
- Required 35 alphanumeric
- First line of filer/issuer’s name
- If "&" is used in the name area enter as "&amp;"

<NameLine2Text ></NameLine2Text>
- 35 alphanumeric
- Second line of filer/issuer’s name

<NameLine3Text ></NameLine3Text>
- 35 alphanumeric
- Use for "care of" or "attention"

</FilerName>

<FilerAddress>

<AddressLine1Text></AddressLine1Text>
-30 alphanumeric
- First line of the filer/issuer’s address

<AddressLine2Text></AddressLine2Text>
- 30 alphanumeric
- Second line of the filer/issuer’s address

<CityName></CityName>
-28 alphanumeric
- City in which the filer/issuer is located

<ProvinceStateCode></ProvinceStateCode>
-2 alpha
- Canadian province or territory in which the filer/issuer is located or the state in the USA where the filer/issuer is located
- Use the abbreviations listed in the pdf document entitled "T619 - Electronic media transmittal" under section: Transmitter province or territory code.
- When the filer/issuer's country code is neither CAN nor USA, enter ZZ in this field.

<CountryCode></CountryCode>
-3 alpha
- Country in which the filer/issuer is located
- Use the alphabetic country codes as outlined in the International Standard (ISO) 3166 Codes for the Representation of Names of Countries.
- Always use CAN for Canada, and USA for the United States of America.

<PostalZipCode></PostalZipCode>
- Required 10 alphanumeric
- Filer/issuer’s Canadian postal code, format: alpha, numeric, alpha, numeric, alpha, numeric, example: A9A9A9
- or the filer/issuer’s USA zip code
- or when the filer/issuer’s country code is neither CAN nor USA, enter the foreign postal code.

</FilerAddress>

<FilerContact>

<ContactFamilyName></ContactFamilyName>
- Required 30 alphanumeric
- Contact’s surname for this return
- Omit titles such as Mr., Mrs., etc.
- Do not include the first given name or initial.

<ContactGivenName></ContactGivenName>
-Required 30 alphanumeric
First 30 letters of the contacts first given name
Note: If only initials are available, provide contact’s first initial

<ContactAreaCode></ContactAreaCode>
- Required 3 numeric
- Area code of telephone number

<ContactPhoneNumber></ContactPhoneNumber>
- Required 3 numeric with a hyphen (-), followed by 4 numeric
- Telephone number of the contact

<ContactExtensionNumber></ContactExtensionNumber>
- 5 numeric
- Extension of the contact

<ContactEmailAddress></ContactEmailAddress>
Required 60 alphanumeric
- Contact’s email address

</FilerContact>

< T otalAcquiredNonQualifiedInvestmentFairMarketValueAmount>
</TotalAcquiredNonQualifiedInvestmentFairMarketValueAmount>
- Required 15 numeric characters, enter dollars and cents. Do not enter a dollar sign.
- Do not report negative values.
Total fair market value when they became non-qualified investments or were acquired as such.

< T otalDisposedNonQualifiedInvestmentFairMarketValueAmount>
</TotalDisposedNonQualifiedInvestmentFairMarketValueAmount>
- Required 15 numeric, enter dollars and cents. Do not enter a dollar sign.
- Do not report negative values.
Total fair market value when they ceased to be non-qualified investments or were disposed of as such.

</RRSPOrRRIFNQISummary>

</RRSPOrRRIFNonQualifiedInvestment>

</Return>

Date modified:

2016-10-27