Pension Plan Forms

Statement of Claimant – Spousal

After the Plan Member has died, the Member’s spouse, as beneficiary, should complete the Statement of Claimant – Spousal form to notify the Administrator of the Member’s death and select how he/she wishes to receive the Member’s pension benefit that has accumulated in the Plan.

Since Statement of Claimant – Spousal form is specific to each Pension Plan, please contact the Plan Administrator for a copy of your form.

Information Needed to Complete the Form

To complete the form, the spouse must provide:

  • Member’s personal information
  • Spouse’s personal information, and
  • Method of payment of pension funds.
  • The original death certificate (or a notarized copy) must be submitted with this form.

Depending on the method of payment selected by the spouse, additional forms may need to be submitted as outlined on the form or advised by the Plan Administrator.


If the beneficiary is a person other than the Member’s spouse, the Statement of Claimant – Non Spousal should be used instead of this form.

If the beneficiary is the Member’s estate, the Statement of Claimant – Estate should be used instead of this form.

Completed forms should be forwarded to the Plan Administrator.

Frequently Asked Questions

What do all these types of pension options mean?

  • You may wish to consult a personal financial advisor to determine which pension type best meets your needs.

Other questions on completing the form should be directed to the Plan Administrator.

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