RCMP-GRC 2265E: Pension information release

Pension information release PDF, 1.1MB)

Protected "B" when completed

Privacy notice

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

Statement of undertaking

I do hereby attest that:

Important (please read carefully)

  • D. If you received your CPP or QPP benefit entitlement notice, please send a copy to the Public Service Pension Centre
  • E. You will be required to repay any overpayment of your public service pension benefit resulting from any subsequent or retroactive entitlement to disability benefits under the CPP or the QPP

Authorization

I have read the restrictions and I understand the nature and effect of this authorization to communicate the information in this form to the pension administration named herein.

Restrictions

Information will only be communicated if:

  • The pension administration certifies in a form satisfactory to the CPP or the QPP, that the information will not be disclosed to any creditor or person not entitled to the information
  • The person who signs the authorization is the plan member or his legal representative

This form is to be completed when the monthly RCMP pension becomes payable.

The completed form must be sent to the address below. You may wish to retain a copy for your records.

Organization:
Government of Canada Pension Centre—Mail facility
Address:
150 Dion Boulevard
PO Box 8500 
Matane QC  G4W 0E2

RCMP- GRC 2265E (2014-07-001)

Date modified: