Forms

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 Active Member

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.

RCMP Pension Plan

Pension Benefits Division

Retirement

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.

Service Buyback

  • RCMP-GRC 570EPayment Transmittal Form 

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

  • RCMP-GRC 1888E – Service in the Force Declaration 

    Complete this form to confirm your prior service as a police officer to receive service in the Force credit.

  • RCMP-GRC 2069EPensionable Employment Questionnaire 

    Have your former employer complete this form if you are buying back prior service outside the RCMP.

  • RCMP-GRC 2082E – Medical Examination Certificate 

    Complete this form if required to valid a service buy back.

  • RCMP-GRC A-2-2EElection for Prior Service and/or Surrender of Benefits under the Canadian Forces Superannuation Act or the Public Service Superannuation Act

    Complete this form if you wish to buy back prior service from the Canadian Forces, RCMP or Public Service and have that service count counted as pensionable service under the RCMP Pension Plan. This form may also be used to surrender your benefits under the Canadian Forces or the Public Service.

  • RCMP-GRC 3006-1EService Buyback Form   

    Complete this form if you wish to buy back prior service with another Canadian pension plan registered under the Income Tax Act and/or forservice for which you received a transfer value under the RCMPSA, CFSA or PSSA and/or for prior RCMP service previously transferred out under a pension transfer agreement that is no longer to your credit under the plan to which it was transferred to have this service counted as pensionable under the RCMP Pension Plan.

  • RCMP-GRC 3006-2E – Service Buyback Form – Balance of Pension Transfer Agreement 

    Complete this form if you wish to buy back the balance of service not covered by a Pension Transfer Agreement.

Leave Without Pay

Survivor

  • RCMP-GRC 2002EDeclaration 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 (81/2 X 14)

Declaration Forms

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.

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

    This form is used to indicate your pension option. 

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

Table of Contents Retired Member

Public Service Health Care Plan

RCMP Pension Plan

Pension Benefits Division

Retirement

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 2002EDeclaration 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 (81/2 X 14)

Declaration Forms

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

Table of Contents Survivor/Dependant

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-006492Public 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.

RCMP Pension Plan

Pension Benefits Division

Retirement

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 2002EDeclaration 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 (81/2 X 14)

Declaration Forms