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

PDF Version (791Kb) Help on Alternative Formats

Protected "B" when completed

For Designation of a Pension Beneficiary (Section 31 of the Royal Canadian Mounted Police Superannuation Regulations)

Privacy Notice

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.

Plan Member's Personal Information

Preferred Language

Instructions

Carefully read instructions before completing.

I hereby appoint the following beneficiary and revoke any previous designation.

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.

Important - You may only have one designated beneficiary at a time.

You may designate:

  • any person over 18 years of age on the date of naming;
  • any charitable or benevolent organization or institution;
  • any religious or educational organization (name is required);
  • your Estate (print "Estate" in the space provided for the beneficiary). If you only wish to cancel the previous designation and not name a new beneficiary, simply print "Estate".

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.

Instructions - Completion of the Form

Complete all unshaded areas. Please print.

  • Regimental Number or Pension Number must be provided.
  • Amendments are not acceptable unless initialed by the participant and the witness.
  • Both the participant and the witness must sign this form in dark ink.

Forwarding of the Form

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.

  • Government of Canada Pension Centre will acknowledge receipt of your "Naming or Substitution of a Pension Beneficiary" (RCMP-GRC 2196E) form.
  • This form will not be returned with the acknowledgement of receipt. Please retain a copy for your records.

RCMP-GRC 2196E (2014-07-001)