Quebec Power of Attorney Form - Free Download | Page 4
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Quebec Power of Attorney Form Page 4
Quebec Power of Attorney Form
Privacy Consent
Please read the “Client Information Consent Agreement” section of the Client Terms and Conditions booklet. I consent to the collection, use and disclosure of
Client Information in the manner and for the purposes specified in the Client Terms and Conditions.
I agree to the following optional uses of my Personal Information:
1. HSBC InvestDirect may collect and use my personal information and, where permitted by law, share it within the HSBC Group, to identify and inform me of
products and services provided by the HSBC Group that may be of interest to me.
2. HSBC InvestDirect may collect and use my Personal information to promote the products and services of select third parties that may be of interest to me; and
3. HSBC InvestDirect may collect, use and share my SIN for the additional optional purposes of conducting Financial Crime Risk Management Activities, and for
internal audit, security, statistical, and record keeping purposes.
Yes
No (Default - unless instructed otherwise)
I may at any time refuse or withdraw my consent to 1,2, or 3 above by contacting HSBC at 1-800-760-1180; or visiting the HSBC InvestDirect website at
www.investdirect.hsbc.ca. I understand that if I do refuse or withdraw my consent to 1,2, or 3 it will not affect my eligibility for products or services.
Signature
I verify that I have carefully reviewed the applicable section of the Client Terms and Conditions with respect to suitability reviews and I understand and
acknowledge that HSBC InvestDirect does not provide investment advice or recommendations regarding any investment decisions or securities transactions
and that HSBC InvestDirect will not determine the general investment needs and objectives or the suitability of any investment decisions or securities
transactions.
I acknowledge that I have sole responsibility for all investment decisions and securities transactions and I understand that orders may be sent directly to the
exchange or market without prior review by HSBC InvestDirect.
I agree to comply with all applicable rules and customs of the Investment Industry Regulatory Organization of Canada and those governing the exchanges or
markets (and their clearing houses, if any) where the orders are executed. HSBC InvestDirect, however, reserves the right to review any transactions prior to
the exchange or market and to reject, change or remove any order for credit reasons or non-compliance with the requirements of those exchanges, markets or
securities regulations.
I acknowledge and agree that a credit check may be performed on me.
X
Signature – Authorized Individual Date (mm/dd/yyyy)
Internal Use Section
Method of Anti Money Laundering Verification
Face to Face Date of Verification (mm/dd/yyyy):
ID#1
Type of ID Verified:
Drivers License
Passport
Other:
ID Number:
Place of Issuance:
Expiry Date:
Verified by: Name:
Entity:
HSBC Bank
Other:
Branch Location/Transit Number:
ID#2
Type of ID Verified:
Drivers License
Passport
Other:
ID Number:
Place of Issuance:
Expiry Date:
Verified by: Name:
Entity:
HSBC Bank
Other:
Branch Location/Transit Number:
Non Face to Face (Canadian Residents Only)
Credit Bureau (plus one of the following)
Bank Reference Letter/Group Introduction Form
Cheque (in name of individual) attached for clearing
Bank Name:
Cheque Number: Cheque Amount: $
HIDC Reviewing Representative Comments
Comments:
Representative Name:
Date (mm/dd/yyyy):
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