Forms; Survivor/dependant: Royal Canadian Mounted Police pension

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.

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Table of contents Survivor/Dependant

• Survivor/Dependant Public Service Health Care Plan
• Survivor/Dependant Royal Canadian Mounted Police Pension Plan
  • Survivor/Dependant Pension Benefits Division
  • Survivor/Dependant Retirement
  • Survivor/Dependant Other Forms
  • Survivor/Dependant Survivor

Public Service Health Care Plan

• Claim Form 6482

  Complete this form if your dependents wish to make a claim for eligible health care expenses from the PSHCP.

• Claim Form 6483 for Comprehensive Coverage.

  Complete this form if your dependents wish to make a claim for eligible health care expenses from the PSHCP.

• 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 Public Service Health Care Plan (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

• 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.

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.