PWGSC-TPSGC 2017: Election to continue as a participant under the supplementary death benefit plan

1. To constitute an election, this form must be completed and sent by mail to the following address within one year prior to, or within 30 days after ceasing to be employed:

   Public Works and Government Services Canada
   Public Service Pension Centre - Mail Facility
   150 Dion Blvd
   PO Box 8000
   Matane QC  G4W 4T6

2. This form is not required if the benefit entitlement is an immediate annuity for reason of age or disability or an immediate annual allowance. If approval of an immediate annuity due to disability is pending at termination, this form must be completed to guarantee continuation of coverage under the SDB plan
3. If proof of age has not been submitted to the Public Service Pension Centre (PSPC), it should accompany this form
4. You may name or change a beneficiary at any time by submitting a completed designation form PWGSC-TPSGC 2196. To obtain this form and further information, please refer to the Web portal Your Public Service Pension and Benefits or contact the Public Service Pension Centre
5. If your entitlement is a deferred annuity or an annual allowance payable later than 30 days after termination of employment, at the time the annuity becomes payable, the contributions will be deducted from your pension on a monthly basis, unless you advise the Public Service Pension Centre otherwise

Caution: You should submit the annual contribution with this form within 30 days after ceasing to be employed or the date your public service pension plan membership status changed. In no case will contributions be accepted if received more than 60 days after ceasing to be employed or after a change in your public service pension plan membership status. To obtain the annual contribution amount, refer to the Supplementary Death Benefit (SDB) Estimates Statement provided to you or call the Public Service Pension Centre to obtain the annual contribution amount.