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Simplii FinancialTM – RRSP Withdrawal Request

" Simplii FINANCIAL" and the Simplii FINANCIAL DESIGNS are trademarks of CIBC. " Simplii Financial" is a division of CIBC. Banking services are not available in Quebec. PO Box 603, STN Agincourt, Scarborough ON M1S 5K9 1-888-723-8881 7390 INT-2017/10 Page 1 of 2 Simplii FinancialTM RRSP Withdrawal RequestPlanholder Identification (please complete this section in full)SurnameFirst NameHome Telephone NumberBusiness Telephone NumberSocial Insurance NumberReason for Requesting Withdrawal (select one only)Regular WithdrawalLifelong Learning Plan (attach completed form RC96)Financial Hardship (not applicable under all pension legislation) (for non-redeemable GICs only)Home Buyers Plan (attach completed form T1036)Refund of Excess Contribution (attach completed form T3012A with part 3 completed by Canada Revenue Agency (CRA))Other (specify) Withdrawal Information1.

a) This RRSP withdrawal request is irrevocable, subject to the discretion of Canadian Imperial Bank of Commerce (CIBC); b) By making this RRSP withdrawal, I am responsible for determining the income tax consequences under any applicable tax laws;

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