Educational Assistance Payment (EAP) Withdrawal

1 Educational Assistance Payment (EAP) WithdrawalRESPP ersonal DetailSubscriber Name (surname first)Joint Subscriber Name (surname first)Contract # CodeBeneficiary's Name (surname first)SINSINSINName of Institution: Address: Postal Code: _____Program InformationCurrent Academic Year Start Date: Academic Year Length: Educational Program Length: Academic Program Year: Educational Program Type: 01 - University 03 - Private Trade, Vocational or Career College 02 - Community College or C GEP 04 - Other(number of continuous weeks enrolled)(Length of degree/diploma in years)(Year of current program of studies [ first, second, etc.])(mmm/dd/yyyy) Note: Letter verifying enrolment from Educational Institution must be Detail$$$EAP (grants*/income)PSE Withdrawal (contributions)Total Amount RequestedNote:1. The EAP portion of this request is taxable to the *Grants include Canada Education Savings Grant (CESG), Canada Learning Bond (CLB) and Provincial Grants, as If the beneficiary is a non-resident, he/she is not entitled to CESG, CLB or The EAP amount is taken from the income/grant holdings of all beneficiaries under this If there are insufficient income/grants to cover the EAP request, the balance will be processed as a PSE Withdrawal (Post-Secondary Education Withdrawal ).

2 6. The PSE Withdrawal amount is taken from the contribution holdings of all beneficiaries under this One Payment representing the Total Amount Requested (EAP plus PSE Withdrawal , as applicable) will be paid to the beneficiary OR the subscriber, as noted above. If not noted, Payment will be made to the Date (mmm/dd/yyyy)302-375 (06/18) Original - Subscriber File Copy - Concentra Copy - Subscriber Concentra Bank, 2018 Cash Withdrawal AuthorizationI/We hereby confirm that: I/We have taken the necessary steps to ensure that this Withdrawal request is in accordance with the applicable terms and conditions of the Income Tax Act and the agreement between me/us and the Promoter/Trustee and the amount listed as Grants/Income under the Payment Detail section is a qualified Educational expense. The beneficiary is a resident of Canada and enrolled at a post-secondary Educational institution in a: - Qualifying Educational Program - within Canada enrollment must be at least 3 consecutive weeks with not less than 10 hours per week on courses or work.

3 Outside of Canada 3 weeks for universities and 13 weeks for all other post-secondary institutions; or - Specified Educational Program - beneficiary is at least 16 years of age and enrolled for not less than 3 consecutive weeks duration, with not less than 12 hours per month on courses in the program. If I/we do not understand the applicable terms and conditions of the Income Tax Act, referred to above, I/we must read the Income Tax Act and seek professional understand that there are consequences when:1. Withdrawing contributions if the beneficiary is not eligible to receive an EAP (Grants clawed back and remaining beneficiaries may be ineligible for further CESG);2. Making an EAP if the expenses are not qualified Educational expenses (EAP could be treated as an Accumulated Income Payment (AIP) and taxed as income to me/us as provided for in the Income Tax Act and the RESP will be revoked).

4 3. The beneficiary receives more than $7,200 CESG in his/her lifetime (any portion in excess must be repaid). Signature of subscriberDate(Note: if joint subscribers, both must sign) Signature of joint subscriberEducational Institution Detail (information must be completed in its entirety by subscriber)(Coll ge d enseignement g n ral et professionel - in Quebec)Current Proof of Enrolment on File Paid to Beneficiary or Subscriber Plan to remain openPayment will be made by direct deposit only. Please attach a void cheque or complete the following:RouteTransitAccount #Beneficiary s Address Same as Subscriber address, or:Credit Union/Agent Name and BranchCU/Agent Contact Person (please print)CU/Agent #Branch #Fax #Phone #Concentra UseDate ReceivedEnteredBy: _____ApprovedBy: _____AuditedBy: _____Date Stamp(mmm/dd/yyyy) Verified no other plan for beneficiaryDiscuss with Subscriber if this Withdrawal will result in the beneficiary receiving CESG in excess of $7,200 (CESG withdrawals from all financial institutions).