Your RCMP Pension and Benefits
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Protected "B" when completed
Provision of the personal information is required pursuant to the Department of Public Works and
Government Services Act, para. 7(1)(d) and s.13 and will be used for the purpose of administrating the
Royal Canadian Mounted Police Superannuation Act (RCMPSA) and the Royal Canadian Mounted Police
Pension Continuation Act (RCMPPCA). Refusal to provide the personal information, or the provision of
incorrect information may result in loss of benefits and/or delays in processing incorrect pension
estimates, benefits, or statements. Personal information is protected, and only used and disclosed in
accordance with the Privacy Act and as described in Personal Information Bank PWGSC PCU 702 –
Federal Pension Administration. Under the Act, individuals have a right of access to their personal
information and request correction, if erroneous or incomplete.
This form must be completed electronically. If not possible, please complete it in dark ink using capital letters.
Carefully read instructions before completing.
Note: You may cancel or change your beneficiary at any time while a participant, whether employed or retired. Upon your death, your named beneficiary may become entitled to certain benefits which are payable under the Royal Canadian Mounted Police Superannuation Act. A naming takes effect the date this form is completed; however, this form must be received by the Government of Canada Pension Centre prior to your death. Therefore, it is recommended that the completed form, be forwarded by express mail to the address indicated on the instruction page.
You may designate:
An ineligible or ambiguous designation will render this form invalid. If at the time of the member's death there is a
survivor and/or dependent children, the payment of a lump sum amount or annual allowance will automatically be
made to them regardless of the designation of beneficiary.
Complete all unshaded areas. Please print.
It is important that this form be received at the address indicated below as soon as possible.
Government of Canada Pension Centre - Mail Service
150 Dion Boulevard
PO Box 8500
Matane QC G4W 0E2
It is recommended that you forward this form by express mail.
RCMP-GRC 2196E (2014-07-001)