Pension and benefit forms: 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 Services and Procurement Canada
Government of Canada Pension Centre; Mail facility
150 Dion Boulevard
PO Box 8500
Matane QC G4W 0E2
While we make every effort to ensure the accessibility of this site, some content or services found here might be inaccessible to some visitors. In this case, or to request any of our forms, please contact us.
Active member
Active member-Public Service Health Care Plan
- 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.
Active member-Royal Canadian Mounted Police Pension Plan
Active member-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) - 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 - 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 - 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
Active member-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 1422E: Deductions from annuity or annual allowance
This form is used to authorize deductions from a monthly pension benefit payable on termination. - 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 (81/2 x 14) - RCMP-GRC 2347-18E: Certification of lock-in purposes of the Royal Canadian Mounted Police Superannuation Act or the Pension Benefit Division Act
This form is used to certify lock-in of pension funds for a Transfer Value payment. Please complete the Plan Member's Personal Information section and ask your financial institution to complete the Certification section. - 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.
Active member-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
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Service buyback
- 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 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 2069E: Pensionable 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-2-2E: Election 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 3006-1E: Service 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
- RCMP-GRC 2480E: Election not to count leave without pay As pensionable service
Complete this form if you choose not to count your period of leave without pay, in excess of the first three months, as pensionable service.
Active member-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 (81/2 x 14)
Active member-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.
- RCMP-GRC 2011E-PF: Pension benefit options statement
This form is used to indicate your pension option. - Form PWGSC-TPSGC 439E: Pensioners' dental services
Retired member
Retired member-Public Service Health Care Plan
Complete this form if you wish to apply for coverage under the PSHCP as a pensioner.
Retired member-Royal Canadian Mounted Police pension plan
Retired member-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
Retired member-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 (81/2 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.
Retired member-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
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Retired member-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 (81/2 x 14)
Retired member-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
Survivor/Dependant
Survivor/Dependant-Public Service Health Care Plan
- 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.
Complete this form if you wish to apply for coverage under the PSHCP as a pensioner.
Survivor/Dependant-Royal Canadian Mounted Police pension plan
Survivor/Dependant-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) - 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 - 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 - 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
Survivor/Dependant-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.
Survivor/Dependant-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
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Survivor/Dependant-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 (81/2 x 14)
Survivor/Dependant-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.