GMWB Rider Election and Payment Direction Form

GMWB Rider Election and Payment Direction Form
(For Existing SunWise ® Elite Clients Only)
SunWise® Elite Plus
SunWise Elite is an individual variable annuity contract issued by Sun Life
Assurance Company of Canada, a member of the Sun Life Financial group
of companies.
managed by CI Investments Inc.
issued by Sun Life Assurance Company of Canada
SunWise Elite Plus
GMWB Rider Election and Payment Direction Form
(For Existing SunWise® Elite Clients Only)
issued by Sun Life Assurance Company of Canada
®
managed by CI Investments Inc.
Contract Owner Name
Joint Contract Owner Name
Social Insurance Number
Social Insurance Number
MANDATORY
Current SunWise Elite Contract Number
Current Dealer Account Number
New Dealer Account Number (for Head Office use only)
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1 GMWB Election
I (we) hereby elect the Guaranteed Minimum Withdrawal Benefit (GMWB) rider for my SunWise Elite Contract.
I (we) understand and acknowledge that:
• t his rider will only apply to premiums allocated to Class A (GWB), Class B (GWB) and Class C (GWB) units of my SunWise Elite Contract;
• t his rider may be elected only prior to the annuitant’s 80th birthday, or prior to the age limits defined in the contract;
• investment selection and minimum premium deposit restrictions apply; and
• I (we) have read the Guaranteed Minimum Withdrawal Benefit (GMWB) section of the SunWise Elite Information Folder and Individual Variable Annuity Contract and
agree to pay the applicable GWB Fees.
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2 GWB Payment Option Selection or Change Request
The GWB Payment Option selected will apply to all SunWise Elite Plus (GMWB) sub-accounts of your Contract.
Please select one:
qGWB Lifetime Option (LWA) – May be selected prior to Annuitant’s 65th birthday but the LWA is only calculated on December 31 of the year in which the Annuitant (the
LWA Annuitant for Joint Annuitants Contracts) turns 65. Guaranteed income under the GWB Lifetime Option ends upon the death of the LWA Annuitant or termination
of the contract. If a redemption is placed on or before December 31 of the year in which the Annuitant/LWA Annuitant turns 65, the payment will be deemed a GWB
Withdrawal Period Option payment (GWA).
qGWB Withdrawal Period Option (GWA) – Guaranteed income under the rider ends: when the Remaining GWB is reduced to nil; when the contract is terminated;
on the contract maturity date or upon the death of the last surviving annuitant.
LWA Annuitant* (to be completed for SunWise Elite Plus LWA Joint Annuitant Contracts only)
Y
LWA Annuitant’s Last Name First Name M
D
MANDATORY
Birth Date
Middle Initial *The LWA Annuitant is the person whose life the LWA payment entitlement is based upon and must be one of the Joint Annuitants named to the contract.
Existing SunWise Elite Plus (GMWB) Clients – Change of GWB Payment Option
By selecting the GWB Payment Option noted above, the GWB Payment Option previously selected for all existing sub-accounts of the Contract will be replaced with the
new GWB Payment Option selected (No fund direction is required).
For clients who hold SunWise Elite and SunWise Elite Plus (GWMB) contracts issued prior to March 24, 2008 - upon selection of the GWB Lifetime Option (LWA) for the
first time, you will forgo any benefits associated with the SunWise Elite Plus (GMWB) rider under SunWise Elite contracts issued prior to March 24, 2008 and will be
subject to the terms and conditions of the SunWise Elite Plus (GMWB) rider under SunWise Elite Including SunWise Elite Plus Information Folder and Individual Variable
Annuity Contract in force at the time this form is received by CI in good order .
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3 Fund Direction
T o elect the GMWB rider, you must select the SunWise Elite Plus fund codes. The SunWise Elite Plus units trade under the corresponding fund codes with the addition of a
P at the end of the code. Minimum initial deposit must be $25,000 for SunWise Elite Plus (GMWB) and $500,000 for SunWise Elite Plus (GMWB) PMA.
qSwitch all existing SunWise Elite units to SunWise Elite Plus (GMWB)
qSwitch funds listed below only qNew contributions to SunWise Elite Plus (GMWB).
PREMIUM AMOUNT ($ OR
% PLEASE CHECK ONE)
FUND NAME (FROM: IF SWITCH)
FUND CODE
FUND NAME (TO: IF SWITCH)
FUND CODE
q$ q%
q$ q%
q$ q%
q$ q%
q$ q%
Switch/Transfer
fee
% up to 2%
q Transfer existing PAC/AWD plan to the new fund q Continue existing PAC/AWD plan on the current fund q Stop PAC/AWD plan.
If no option is elected, CI will move the PAC/AWD to the new fund for full switches and continue PAC/AWD on the current fund for partial switches.
WIRE ORDER
NUMBER
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4 GMWB Payment Details
a) RRIF/LIF/LRIF/PRIF/RLIF PAYMENTS (The payment date may be between the 1st and the 25th of any month)
q The minimum annual payment (MAP) requirement
q The maximum annual gross amount (for LIF/LRIF/RLIF only)*
q The annual GWA/LWA payment entitlement
q An annual amount of $________________ qGross or
q Net of fees and withholding taxes*
If no date or payment amount is indicated, CI will pay the RRIF/LIF/LRIF/PRIF/RLIF minimum during the month of December, and will redeem units proportionately across all
Funds. For scheduled payments that are below the MAP requirement, CI will pay the balance of the RRIF/LIF/LRIF/PRIF/RLIF MAP during the month of December and will
redeem units proportionately across the Funds indicated in section 4c. If no Fund selection is indicated below, the MAP balance will be redeemed proportionally across
all Funds held in the contract.
Y
M
D
I elect the term of RRIF payments to be based on qMy age qAge of my spouse if younger (Please provide spouse’s date of birth) _____________________
b) NON-REGISTERED PLANS
q The annual GWA/LWA payment entitlement
q An annual amount of $________________ qGross or
q Net of fees*
*Withdrawals in excess of the annual GWA/LWA may have a negative impact on future guaranteed payments under the GMWB.
c) PAYMENT INSTRUCTIONS
Frequency (please choose only one): q Monthly
q Quarterly
q Semi-Annually
q Deposit directly to bank account (please attach void cheque) q Mail to Owner
Name
Address
City/Province
Postal Code
Y
D
q Mail to alternate address
SURRENDER
AMOUNT
FUND CODE
FUND NAME
M
q Annually: Start date _____________________
OR
PERCENT
$
%
$
%
$
%
$
%
$
%
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5 Client Authorization
I/We hereby authorize CI Investments to purchase or transfer units in accordance with the instructions set out above.
MANDATORY
MANDATORY
Contract Owner Name (please print)
Contract Owner Signature
MANDATORY
Joint Contract Owner Name (please print)
MANDATORY
Joint Contract Owner Signature
Y
M
D
MANDATORY
Irrevocable Beneficiary Signature
Date
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6 Representative Information (to be completed by the representative)
MANDATORY
Representative Name (please print)
MANDATORY
Dealer Number
MANDATORY
Representative Signature
MANDATORY
Representative Number
Telephone Number
When complete, please send the Head Office copy to: CI Investments, 15 York Street, Second Floor, Toronto, Ontario M5J 0A3 or at fax number 416-364-6299
Sun Life Assurance Company of Canada, a member of the Sun Life Financial group of companies, is the sole issuer of the individual variable annuity contract
providing for investment in SunWise Elite segregated funds. A description of the key features of the applicable individual variable annuity contract is
contained in the Information Folder. SUBJECT TO ANY APPLICABLE DEATH AND MATURITY GUARANTEES, ANY AMOUNT THAT IS ALLOCATED TO
A SEGREGATED FUND IS INVESTED AT THE RISK OF THE CONTRACT HOLDER AND MAY INCREASE OR DECREASE IN VALUE ACCORDING
TO FLUCTUATIONS IN THE MARKET VALUE. CI Investments and CI Investments design are registered trademarks of CI Investments Inc. SunWise is a
registered trademark of Sun Life Assurance Company of Canada. ©CI Investments Inc., 2014.
Sun Life Assurance Company of Canada
227 King Street South
P.O. Box 1601 STN Waterloo
Waterloo, Ontario N2J 4C5
CI Investments, 15 York Street, Second Floor, Toronto, Ontario M5C 0A3 I www.ci.com
Head Office / Toronto
416-364-1145
1-800-268-9374
Calgary
403-205-4396
1-800-776-9027
Montreal
514-875-0090
1-800-268-1602
Vancouver
604-681-3346
1-800-665-6994
Client Services
English: 1-800-563-5181
French: 1-800-668-3528
1402-0310_E (02/14)