Pay Centre forms

Pay action request

This form must accompany all requests submitted by email, fax or mail to the Pay Centre.

• Pay action request form

Tax forms

Upon hiring, or when you wish to make a change to your tax credits, complete both the TD1 Personal tax credits return form and the provincial form. Please complete the provincial form based on where you report to work rather than where you reside.

TD1 Personal tax credits return

• TD1 Personal tax credits return
• TD1-WS Worksheet for the personal tax credits return
• TD1-IN Determination of exemption of an Indian's employment income

Alberta

• TD1AB Alberta personal tax credits return
• TD1AB-WS Worksheet for the Alberta personal tax credits return

British Columbia

• TD1BC British Columbia personal tax credits return
• TD1BC-WS Worksheet for the British Columbia personal tax credits return

Manitoba

• TD1MB Manitoba personal tax credits return
• TD1MB-WS Worksheet for the Manitoba personal tax credits return

New Brunswick

• TD1NB New Brunswick personal tax credits return
• TD1NB-WS Worksheet for the New Brunswick personal tax credits return

Newfoundland and Labrador

• TD1NL Newfoundland and Labrador personal tax credits return
• TD1NL-WS Worksheet for the Newfoundland and Labrador personal tax credits return

Northwest Territories

• TD1NT Northwest Territories personal tax credits return
• TD1NT-WS Worksheet for the Northwest Territories personal tax credits return

Nova Scotia

• TD1NS Nova Scotia personal tax credits return
• TD1NS-WS Worksheet for the Nova Scotia personal tax credits return

Nunavut

• TD1NU Nunavut personal tax credits return
• TD1NU-WS Worksheet for the Nunavut personal tax credits return

Ontario

• TD1ON Ontario personal tax credits return
• TD1ON-WS Worksheet for the Ontario personal tax credits return

Prince Edward Island

• TD1PE Prince Edward Island personal tax credits return
• TD1PE-WS Worksheet for the Prince Edward Island personal tax credits return

Québec

• TP-1015.3-V Source Deductions Return

Saskatchewan

• TD1SK Saskatchewan personal tax credits return
• TD1SK-WS Worksheet for the Saskatchewan personal tax credits return

Yukon

• TD1YT Yukon personal tax credits return
• TD1YT-WS Worksheet for the Yukon personal tax credits return

Emergency Salary Advance (ESA) / Priority Payment (PP) Request Form

You must complete this form to start or amend an ESA or PP request.

• Emergency Salary Advance (ESA) / Priority Payment (PP) Request Form (60%) (accessible only on the Government of Canada network)
• Emergency Salary Advance (ESA) / Priority Payment (PP) Request Form (66%) (accessible only on the Government of Canada network)

Direct Deposit Form

You must complete this form to start or to amend the direct deposit of your pay cheque.

• PSPC-SPAC 8437 Direct Deposit (accessible only on the Government of Canada network): Enrollment Request.

Lost or Stolen Cheque

You must complete this form if you lose your Receiver General cheque.

• PSPC-SPAC 535 Undertaking and Indemnity (accessible only on the Government of Canada network): For cheques issued by the Receiver General.

For payments greater than $5,000, you must complete both the Undertaking and Indemnity form and this form:

• PSPC-SPAC 540 Affidavit (accessible only on the Government of Canada network): For cheques over $5,000 issued by the Receiver General.

Isolated Post Allowances

If you occupy an isolated post, you may be entitled to certain allowances. This form provides details of these amounts or changes to various allowance amounts. Have your manager or departmental human resources representative complete this form and forward it to the Public Service Pay Centre.

• PSPC-SPAC 7631 Isolated Post Allowances (accessible only on the Government of Canada network).

Determination of contact person and amount of Supplementary Death Benefit payment

Managers or departmental human resources personnel complete this form and forward it to the Public Service Pay Centre to provide particulars about the death of an employee.

• PSPC-SPAC 2014 Determination of contact person and amount of Supplementary Death Benefit payment (accessible only on the Government of Canada network).

Public Service Health Care Plan

Use these forms to apply to the Public Service Health Care Plan and claim medical expenses.

• Public Service Health Care Plan forms

Public Service Dental Care Plan

Complete this form to make a claim for dental expenses under the Public Service Dental Care Plan.

• Public Service Dental Care Plan form

Complete this form to authorize someone else to make a claim for dental expenses for your eligible children under the Public Service Dental Care Plan.

• Public Service Dental Care Plan: Authorization for claims submission and re-direction of payment (accessible only on the Government of Canada network)

Disability Insurance

Complete this form to apply for disability benefits under the Disability Insurance Plan.

• Claim for disability insurance: Employee's statement policy no.12500-G (accessible only on the Government of Canada network)

Have your physician complete this form if you are applying for disability benefits under the Disability Insurance Plan.

• Claim for disability insurance: Employee's medical information and attending physician's statement policy number 12500-G (accessible only on the Government of Canada network)

Public Service Management Insurance Plan

• Long-term disability insurance
• Basic life insurance
• Change of name or beneficiary

Long-term disability insurance

Complete form 5946 if you are making a claim for long-term disability benefits under the Public Service Management Insurance Plan.

Have your physician complete form 5945 if you are making a claim for long-term disability benefits under the Public Service Management Insurance Plan.

• Public Service Management Insurance Plan claim for long-term disability benefit (accessible only on the Government of Canada network)

Complete form 5955 if you are making a claim for accidental dismemberment benefits under the Public Service Management Insurance Plan. Have your physician complete form 5954 if you are claiming accidental dismemberment benefits.

• Public Service Management Insurance Plan claim for accidental dismemberment benefit (accessible only on the Government of Canada network)

Complete forms 5948 and 5949 if you are making a claim for death benefit under the Public Service Management Insurance Plan.

• Public Service Management Insurance Plan claim for death benefit (accessible only on the Government of Canada network)

Basic life insurance

If you are entitled to employer-paid coverage, complete this form to apply for the Public Service Management Insurance Plan.

• PSPC-SPAC 2028-7: Public Service Management Insurance Plan: Members entitled to government-paid coverage (accessible only on the Government of Canada network)

If you are a full-time employee, complete this form to apply for the Public Service Management Insurance Plan.

• PSPC-SPAC 2028: Public Service Management Insurance Plan (accessible only on the Government of Canada network)

If you are a part-time employee, complete this form to apply for the Public Service Management Insurance Plan.

• PSPC-SPAC 2028-5: Public Service Management Insurance Plan (accessible only on the Government of Canada network)

Change of name or of beneficiary

Complete this form to change your beneficiary under the Public Service Management Insurance Plan.

• PSPC-SPAC 2028-1: Public Service Management Insurance Plan (accessible only on the Government of Canada network)

British Columbia Medical Services Plan

Complete this form to apply for group enrolment under the British Columbia Service Plan.

• Application for group enrolment with British Columbia Medical Services Plan (HLTH 167) (English only)

Pre-retirement transition leave

Complete this form to apply for pre-retirement transition leave.

Application for pre-retirement transition leave (accessible only on the Government of Canada network)

Leave with income averaging

Complete this form to apply for leave with income averaging.

Application for leave with income averaging (accessible only on the Government of Canada network)

Self-funded leave

Complete this form to apply for self-funded leave.

Application for self-funded leave (accessible only on the Government of Canada network)

Leave application and absence report

The leave and absence form is available from your department or agency. Complete it when you go on leave without pay or when you cannot access the leave reporting system.

Leave application and absence report (accessible only on the Government of Canada network)