Forms; Retired members: Royal Canadian Mounted Police pesions

Here you will find a collection of forms related to your pension and insurance benefits plans. To use the forms below, you must first print the form, complete it by hand and return it by mail to the following address:

Public Works and Government Services Canada
Government of Canada Pension Centre - Mail Facility
150 Dion Boulevard
PO Box 8500
Matane QC G4W 0E2

You may also obtain these forms and others by contacting the Government of Canada Pension Centre.

While every reasonable effort has been made to ensure the accessibility of this site, some content or services found here might be inaccessible to some visitors. In those circumstances, please Contact Us.

Public Service Health Care Plan

• Form TBS-006492 – Public Service Health Care Plan – Pensioner Application TBS PDF, 91KB

  Complete this form if you wish to apply for coverage under the PSHCP as a pensioner.

Royal Canadian Mounted Police pension plan

Pension benefits division

• RCMP-GRC 2483E – 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)
• Form RCMP-GRC 2484E – 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
• Form RCMP-GRC 2486E – Application for division of Royal Canadian Mounted Police 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
• Form RCMP-GRC 2488E – Request for Pension Benefits Division Information with respect to the Royal Canadian Mounted Police 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

Retirement

• RCMP-GRC 570E – Payment transmittal form

  Complete this form to send your payments in respect of a pension contributions and/or a service buyback payment.

• RCMP-GRC 2196E – Naming or Substitution of a Pension Beneficiary

  Complete this form if you wish to name or change your pension beneficiary.

• RCMP-GRC 2265E – Pension information release

  This form is required to verify Québec and Canada Pension disability information. Note: Form is only valid if printed on legal size paper (8^1/2 X 14)

• Form T2151 – Direct Transfer of a Single Amount Under Section 147(19) or Section 147.3 T2151

  This form is used to transfer out pension funds.

Other forms

If you wish to increase your tax credit beyond the basic personal amount, please complete the TD1 Personal Tax Credits Return form as well as the corresponding provincial form below.

TD1 Personal Tax Credits Return

• TD1 Personal Tax Credits Return
• TD1-WS Worksheet for the Personal Tax Credits Return

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

Quebec

• 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

Survivor

• RCMP-GRC 2002E – Declaration of attendance at an educational institute

  Complete this form if you are an eligible dependent of a deceased contributor of the Royal Canadian Mounted Police Superannuation Act (RCMPSA) and are requesting a Student Allowance. Note: Form is only valid if printed on legal size paper (8^1/2 X 14)

Declaration forms

• RCMP-GRC 2010E – Statutory declaration – In the Matter of the Royal Canadian Mounted Police Superannuation Act

  Complete this form if you are the guardian of the surviving child of a deceased plan member and are applying for the children's allowance.

• RCMP-GRC 2016E – Statutory declaration

  Complete this form if you wish to provide information about your common-law relationship

• RCMP-GRC 2467E – Statutory declaration – Royal Canadian Mounted Police Superannuation Act – Claimant's Statement

  Complete this form if you are the common-law or same-sex partner and are applying for the survivor pension.

• RCMP-GRC 2467-1E – Statutory declaration – Royal Canadian Mounted Police Superannuation Act – Supporting Statement - In the matter of Survivor Benefits under the Royal Canadian Mounted Police Superannuation Act

  Have two persons who know of your common-law relationship each complete this form in support of your claim for a survivor pension as a common-law partner of a deceased plan member.

Forms available from the Pension Centre

Below is a list of additional forms that you may require; however, they are only available from the Government of Canada Pension Centre.

• Form RCMP-GRC 2011E-PF – Pension Benefit Options Statement

  This form is used to indicate your pension option.

• Form PWGSC-TPSGC 439E – Pensioners' Dental Services