supplementary death benefit form

Complete the following form if you are the guardian of the surviving child of a deceased plan member and are applying for the children's allowance. Complete the following form if you wish to provide information about your common-law relationship. Complete the following form to indicate your pension option. Complete the following form if you wish to name or change your beneficiary under the Supplementary Death Benefit Plan. If you are requesting an estimate of the maximum transferable amount allowed for division, complete the following form to establish your period of cohabitation (including any interruptions). Complete the following form if you are eligible to apply for Public Service Health Care Plan coverage. Complete the following form if you are applying for a pension division and your court order or agreement does not include the cohabitation period. x��]o�8�@����>ԊH���WHg��6�kr�8���8N��gm�����R�-q�8l�&��8����0���uu[N�ћ7���u9���D����^==N?�w�C����_����ݴ��.�����'џ��8���Qe��2ZN^�������۫�W�g""N�������qIOL�<22�����0��Kݭ`���r{����O�h�{t�σWc��_�v��A���It�Y���z���Wz�X�����8�i��8�i��>ZV4�Y5��j�ip��K���u\�S��`��p0�,��R>�e6��V͠� �Ɠ��}�*6q�D��pz���`�X�?�J�81?FZ~Z}(�-w�t0�}!�-�Z��I��*-U\�X�i�Z큱���6����R@���$�����?ϯ9τpd˼I$&��ր�4���:��#;��wS!��E䐊? Please read it carefully. The following form is used to apply for Pensioners' Dental Services Plan coverage. :�O�O��NEEB�E��TL��&����Q+Y�O ]��=�HԽ�7�ه��ߏ/��?G��Ñ���S|7>ƟWÑ��ގ/�x{v~���� �9ˋXw���IS���0`����p�n����r5�� ��k��z(�Yd�ox{/�C�V2�+���{M#ni�%ra������%%4rq������/�06\��������j�I$�\�. Have two persons who know of your common-law relationship each complete the following form in support of your claim for a survivor pension as a common-law partner of a deceased plan member. From: Treasury Board of Canada Secretariat. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Provision of the personal information, including the social insurance number (SIN), is required pursuant to the Department of Public Works and Government Services Act, para. This form is only available on the Government of Canada network. 1 0 obj Government of Canada Pension Centre – Employer Support Services forms, Service Buyback Payment Transmittal for Plan Member on Leave Without Pay, Election Not To Count Leave Without Pay As Pensionable Service, Service Buyback Form for Transfer Value Service, PWGSC-TPSGC 2347-18 - Certification of Lock-In For Purposes of the Public Service Superannuation Act or the Pension Benefits Division Act, Statutory Declaration - In the matter of Provision of Pension Benefits Information Under the Pension Benefits Division Act, Statutory Declaration - In the matter of an application for Division of Pension Benefits under the Pension Benefits Division Act, Application for Division of a Public Service Superannuation Act Pension Benefits in Accordance with the Pension Benefits Division Act, Request for Pension Benefits Division Information with Respect to a Public Service Superannuation Act Pension in Accordance with the Pension Benefits Division Act, Application for Diversion from a Public Service Pension in Accordance with Part II of the "Garnishment, Attachment and Pension Diversion Act", Deductions From Annuity or Annual Allowance, Certification of Lock-In For Purposes of the Public Service Superannuation Act or the Pension Benefits Division Act, Direct Transfer of a Single Amount Under Subsection 147(19) or Section 147.3, Foreign direct deposit enrolment form (HTML and PDF format), Election To Continue As A Participant Under The Supplementary Death Benefit (SDB) Plan, Public Service Health Care Plan Pensioner Application, Public Service Health Care Plan (PSHCP) Relief Provision Application Form, Statutory Declaration (Public Service Superannuation Act Administration), Election to Reduce Benefit to $10,000 - Form A, Supplementary Death Benefit Plan - Beneficiary Information, Service Buyback Payment transmittal for Plan member on Leave without Pay, Direct Transfer of a Single Amount Under Subsection 147(19) or section 147.3, Supplementary Death Benefit Plan - Beneficiary information, Supplementary Death Benefit Plan - Beneficiary Information, Declaration of Attendance at an Educational Institute, Statutory Declaration - In the matter of the Public Service Superannuation Act, Statutory Declaration - Public Service Superannuation Act- Subsections 25(4), 25(4.1) and 25(10) - Claimant's Statement, Statutory Declaration - Public Service SuperannuationAct - Subsections 25(4), 25(4.1) and 25(10) - Supporting Statement, TD1-WS Worksheet for the Personal Tax Credits Return, TD1AB Alberta Personal Tax Credits Return, TD1AB-WS Worksheet for the Alberta Personal Tax Credits Return, TD1BC British Columbia Personal Tax Credits Return, TD1BC-WS Worksheet for the British Columbia Personal Tax Credits Return, TD1MB Manitoba Personal Tax Credits Return, TD1MB-WS Worksheet for the Manitoba Personal Tax Credits Return, TD1NB New Brunswick Personal Tax Credits Return, TD1NB-WS Worksheet for the New Brunswick Personal Tax Credits Return, TD1NL Newfoundland and Labrador Personal Tax Credits Return, TD1NL-WS Worksheet for the Newfoundland and Labrador Personal Tax Credits Return, TD1NT Northwest Territories Personal Tax Credits Return, TD1NT-WS Worksheet for the Northwest Territories Personal Tax Credits Return, TD1NS Nova Scotia Personal Tax Credits Return, TD1NS-WS Worksheet for the Nova Scotia Personal Tax Credits Return, TD1NU Nunavut Personal Tax Credits Return, TD1NU-WS Worksheet for the Nunavut Personal Tax Credits Return, TD1ON Ontario Personal Tax Credits Return, TD1ON-WS Worksheet for the Ontario Personal Tax Credits Return, TD1PE Prince Edward Island Personal Tax Credits Return, TD1PE-WS Worksheet for the Prince Edward Island Personal Tax Credits Return, TD1SK Saskatchewan Personal Tax Credits Return, TD1SK-WS Worksheet for the Saskatchewan Personal Tax Credits Return, TD1YT-WS Worksheet for the Yukon Personal Tax Credits Return.

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