pension
plan

Spousal Declaration Form

Use
At retirement, members should use the Spousal Declaration Form to declare whether they have or do not have a spouse.

Select the appropriate form on the right side, based on the Member's province of residence.

Information Needed to Complete the Form
To complete this form, the Member will need:

• Spouse's name and address (if spouse exists)
• Name, address and signature of a witness
• Photo-ID of witness, if no spouse exists

Notes
Questions on completing the form should be directed to the Plan Administrator.

Completed forms should be sent to the Plan Administrator.