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Omnibus Participation Form By completing this form, you are requesting Fidelity to track and remit short-term redemption fees in omnibus accounts that hold your funds. 1. Provide your fund company
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Example: AUS-RBA-3-4, BND, FCA) 4. Provide the account from which you need to remit short-term Redemption fees: (example: brokerage account, RESP, pension fund, etc.) 5. Provide the details of the funds in the short-term redemption account: (example: Canada Pension Plan — AUS) 6. Provide Fidelity with your signature on the submission: 7. Fidelity will email you confirming that you received the email. Submit this form directly to: (If you would like your confirmation to include a contact name and/or email address, please complete the Contact Info portion of this email.) 1. Fidelity Group, Inc. / Brokerage Services / Retirement (Canada) Company, Fidelity Brokerage Services / Retirement 1.250 – 562 Somerset Street Mississauga, Ontario L5S 1K4 Canada 2. TD Waterhouse / Advisor / Advisor 2.904 – 687 Queen Street Toronto, Ontario M5S 1U8 Canada Fidelity. Com.SMS.IMG Fidelity, Inc. 562 Somerset Street Mississauga, Ontario L5S 1K4 4. Fidelity Brokerage Services / Retirement 1085 York Street Toronto, Ontario M5V 3×9 Canada 5. Fidelity Mutual Funds / Advisor / Advisor 830 – 1350 Bloor Street West Toronto, Ontario, M4W 1×6 6. Fidelity Income-earning Account 1085 York Street Toronto, Ontario M5V 3×9 7. Fidelity Canadian Dividend Fund / Advisor / Advisor 830 – 1350 Bloor Street West Toronto, Ontario, M4W 1×6 8. Fidelity Canadian Equity Income Fund / Advisor / Advisor 830 – 1350 Bloor Street West Toronto, Ontario, M4W 1×6 9. Fidelity Canadian Small Value Fund / Advisor / Advisor 830 – 1350 Bloor Street West Toronto, Ontario, M4W 1×6 10. Tangerine Investment Funds 1085 York Street Toronto, Ontario M5V 3×9 11. Fidelity Canadian Equities Income Fund / Advisor / Advisor 830 – 1350 Bloor Street West Toronto, Ontario, M4W 1×6 12.

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The omnibus participation form is a document that allows individuals or entities to report their participation in various activities or programs.
Any individual or entity that has participated in the activities or programs specified in the form is required to file the omnibus participation form.
To fill out the omnibus participation form, you need to provide the required information about your participation in the specified activities or programs. This may include details such as the dates of participation, the nature of the activities, and any relevant documentation.
The purpose of the omnibus participation form is to gather information about individuals or entities participating in specific activities or programs. This information may be used for record-keeping, statistical analysis, or compliance purposes.
The specific information that must be reported on the omnibus participation form can vary depending on the activities or programs being reported. However, it generally includes details such as the participant's name, contact information, and a description of their participation.
The deadline to file the omnibus participation form in 2023 has not been specified. Please refer to the official guidelines or contact the relevant authority for the specific deadline.
The penalty for the late filing of the omnibus participation form may vary depending on the jurisdiction and the specific rules and regulations. It is recommended to consult the official guidelines or contact the relevant authority to determine the applicable penalty.
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