Certification of lock-in for purposes of the Royal Canadian Mounted Police Superannuation Act or the Pension Benefits Division Act PDF, 723KB)
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 on the following page before completing.
We certify that the above-named individual's account to which the funds payable pursuant to the
RCMPSA or the
PBDA are to be credited meets one of the following requirements:
GRC 2347-18E (2014-07-001)