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Forms: Public service pension plan

Find forms related to your pension that are specific to you as an active or retired member of the Public Service and to your survivors/dependants.

How to use a fillable PDF form

Public service pension plan forms
Number Name Description Audience
570 Fillable PWGSC-TPSGC 570 - Service Buyback Payment Transmittal for Plan Member on Leave Without Pay Complete this form to send your payments in respect of a period of leave without pay or a service buyback.
  • Active members
  • Retired members
2480 Fillable PWGSC-TPSGC 2480 - Election Not To Count Leave Without Pay As Pensionable Service Complete this form if you choose not to count your period of leave without pay, in excess of the first 3 months, as pensionable service.
  • Active members
2005 Fillable PWGSC-TPSGC 2005 - Service Buyback Form for Transfer Value Service Complete this form if you wish to buy back prior service for which you received a transfer value.
  • Active members
2069 Fillable PWGSC-TPSGC 2069 - Pensionable Employment Questionnaire Ask your former employer to complete this form if you are buying back prior service outside the federal public service.
  • Active members
2092 Fillable PWGSC-TPSGC 2092 - Surrender of Benefits Complete this form if you wish to surrender your pension benefits under the Canadian Forces or the Royal Canadian Mounted Police and have that service counted as pensionable service under the public service pension plan.
  • Active members
3006 Fillable Form 3006 E - Service Buyback Form (accessible only on the Government of Canada network) Complete this form if you wish to buy back prior service and have it counted as pensionable under the public service pension plan.
  • Active members
2347-18 Fillable PWGSC-TPSGC 2347-18 - Certification of Lock-In For Purposes of the Public Service Superannuation Act or the Pension Benefits Division Act This form is used to certify the lock-in of pension funds for the division of pension benefits. Complete the Plan Member's Personal Information section and ask your financial institution to complete the certification section.
  • Active members
2483 Fillable PWGSC-TPSGC 2483 - Statutory Declaration In the matter of Provision of Pension Benefits Information Under the Pension Benefits Division Act If you are requesting an estimate of the maximum transferable amount allowed for division, complete this form to establish your period of cohabitation (including any interruptions).
  • Active member
  • Retired members
2484 Fillable PWGSC-TPSGC 2484 - Statutory Declaration In the matter of an application for Division of Pension Benefits under the Pension Benefits Division Act Complete this form if you are applying for a pension division and your court order or agreement does not include the cohabitation period.
  • Active member
  • Retired members
2486 Fillable PWGSC-TPSGC 2486 - Application for Division of a Public Service Superannuation Act Pension Benefits in Accordance with the Pension Benefits Division Act Complete this form if you are applying for a division of the pension benefits accumulated during the period of cohabitation.
  • Active member
  • Retired members
2488 Fillable PWGSC-TPSGC 2488—Request for Pension Benefits Division Information (for estimate purposes) with respect to a Public Service Superannuation Act pension in accordance with the Pension Benefits Division Act Complete this form to request an estimate of the maximum transferable amount allowed for division.
  • Active member
  • Retired members
2460 Fillable PWGSC-TPSGC 2460 - Application for Diversion from a Public Service Pension Complete this form if you are applying for a diversion from your pension under the federal public service pension plan.
  • Active member
  • Retired members
1422 Fillable PWGSC-TPSGC 1422—Deductions From Annuity or Annual Allowance Complete this form to authorize deductions from a monthly pension benefit payable on termination.
  • Active members
2265 Fillable PWGSC-TPSGC 2265 - Disability Benefit from CPP or QPP This form is required to verify your entitlement to Canada and Quebec Pension Plan disability and retirement benefits.
  • Active member
  • Retired members
T2151 Fillable T2151 Direct Transfer of a Single Amount Under Subsection 147(19) or Section 147.3 This form is used to transfer out pension funds.
  • Active member
  • Retired members
8001-52 Fillable PWGSC-TPSGC 8001-552 Canada direct deposit enrolment form Complete this form if you wish to have your pension payment direct deposited to your Canadian bank account.
  • Active member
  • Retired members
  • Survivor
8002-501 Fillable PWGSC-TPSGC 8002-501 Foreign direct deposit enrolment form Complete this form if you wish to have your pension payment deposited to your foreign bank account.
  • Active member
  • Retired members
  • Survivor
2017 Fillable PWGSC-TPSGC 2017 Election to continue as a participant under the Supplementary Death Benefit (SDB) plan Complete this form if you wish to continue coverage under the Supplementary Death Benefit Plan at commercial rates.
  • Active member
  • Retired members
6492 Form 006492 - Public Service Health Care Plan Pensioner Application (PDF, 92KB) Complete this form if you are eligible to apply for Public Service Health Care Plan coverage.goes directly to a PDF on the PSHCP page
  • Active member
  • Retired members
  • Survivor
481 Fillable PWGSC-TPSGC 481 - Public Service Health Care Plan Relief Provision Application Form Complete this form if you are eligible to apply for the PSHCP Relief Provision.
  • Active member
  • Retired members
  • Survivor
2040 Fillable PWGSC-TPSGC 2040 - Statutory Declaration (Public Service Superannuation Act Administration) This form is required in cases where the pensioner is unable to manage his own affairs.
  • Active member
  • Retired members
  • Survivor
2196 Fillable PWGSC-TPSGC 2196 – Naming or changing your beneficiaries This form is required in cases where the pensioner is unable to manage his own affairs.
  • Active member
  • Retired members
2041-1 Fillable PWGSC-TPSGC 2041-1 - Election to Reduce Benefit to $10,000 - Form A Complete this form if you wish to reduce your Supplementary Death Benefit coverage to $10,000.00.
  • Active member
  • Retired members
2223 Fillable PWGSC-TPSGC 2223 - Supplementary Death Benefit Plan - Beneficiary Information The designated beneficiary must complete this form to claim the Supplementary Death Benefit payment.
  • Active member
  • Retired members
  • Survivor
2016 Fillable PWGSC-TPSGC 2016 - Statutory Declaration Survivor Complete this form if you wish to provide information about your common-law relationship.
  • Active member
  • Retired members
  • Survivor
439E Form 439-E - Pensioners' Dental Services Plan Form Complete this form to apply for Pensioners' Dental Services Plan coverage. This form is only available from the Government of Canada Pension Centre for federal employees.
  • Active member
  • Retired members
2011E-PF Form 2011E-PF - Pension Benefit Options Statement Complete this form to indicate your pension option. This form is only available from the Government of Canada Pension Centre for federal employees.
  • Active member
2002 Fillable PWGSC-TPSGC 2002 - Declaration of Attendance at an Educational Institute Complete this form if you are an eligible dependant of a deceased plan member and are requesting a student allowance.
  • Survivor
TD1 Fillable TD1 Personal Tax Credits Returns Access CRA TD1 Personal Tax Credits Returns forms
  • Active member
  • Retired members
  • Survivor
2429 Fillable PWGSC-TPSGC 2429 - Request for a pension reduction waiver under the Public Service Superannuation Act This form is used to confirm that upon termination of employee from the Public Service, the Pension Reduction Waiver requirements have been met to qualify an individual for a Pension reduction waiver under the Public Service Superannuation Act (PSSA). This form must be completed by the Deputy Head (generally the Deputy Minister, Chief Executive Officer, or Statutory Deputy Head), or a person with the delegated authority.
  • Active member
  • Retired members
2012 Fillable PWGSC-TPSGC 2012 - Interpretation Of Medical Examination For Pension Purposes Complete this form to determine if you qualify to a pension for a medical reason.
  • Retired members
2451-1 Fillable PWGSC-TPSGC 2451-1 - Post-retirement Life Insurance Plan (Change of Name/Change of Beneficiary) Complete this form if you have recently changed your name or want to change your beneficiary.
  • Retired members

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