Other Related Documents

PROTECTED (when completed)

Paylist:

PRI:

Date

Name
Street
City
Province
Postal code

Pension No

Dear INSERT APPROPRIATE NAME:

SUBJECT: MAKING AN ELECTION

As requested, I am sending you the following form(s) which are necessary to make an election for prior pensionable service:

- Election Form for Pensionable Service 
- Occupational Health Assessment Report 
- Evidence of Medical Examination Form 
- Pensionable Employment Questionnaire 

Before completing the required documentation, you should refer to the Estimate of Cost and letter of explanation previously provided to you. Please be reminded that, except under very exceptional circumstances, a valid election under the Public Service Superannuation Act is irrevocable.

In order for your election to be accepted, you must undergo, at your own expense, a medical examination. This examination must take place no earlier than ninety (90) days before and not later than six (6) months after the date you sign your election form (Election Form for Pensionable Service).

PWGSC 2006 Election Form for Pensionable Service

Complete part B. Enter your name, date of birth, sex, home address, and the period(s) for which you wish to make an election and the method and amount of payment(s).

This office must receive this form within (30) days of the date it is signed; otherwise the election will be invalid. Please ensure that you have completed, dated, and signed the form. The form (copies 1,2,3) must be sent to the following address (registered mail is recommended):

Department
Street
City
Province
Postal code

Copy four (4) is to be retained for your records.

Should you choose to pay for your election by making a lump sum payment for the whole amount, or a portion of the amount (with monthly salary deductions for the balance), your certified cheque or money order should be made payable to the Receiver General for Canada and sent to the above address, within 30 calendar days, along with the form Election Form for Pensionable Service. You may transfer funds from an RRSP to pay for your election.

If you choose monthly salary deductions, you may later decide to change your method of payment as follows:

a) make a lump sum payment to pay the balance owing;

b) increase your monthly salary deductions (which will shorten the repayment period);

c) make a lump sum payment to pay a portion of the balance and have your monthly deductions continue for a shorter period of time.

The payment methods are flexible and you may choose any one or combination of the three options.

HC 3312E Occupational Health Assessment Report

Complete, sign and date section D. Your physician must complete sections B, E and F and mail the form to one of the following addresses (depending on your province of residence):

Note: A medical examination is not required if your election is a normal election made within one year of receiving form PWGSC 2018 Notice of Contributory Status.

PWGSC 2081 Evidence of Medical Examination Form

Your physician must complete this form, sign and return this form to you. Once it is returned to you the form must be distributed as follows:

(a) Copy 1 is mailed to Superannuation, Pension Transition and Client Services Sector

(b) Copy 2 is mailed to this office

(c) Copy 3 is retained by you for your records.

(d) Copy 4 is retained by your physician.

Note: A medical examination is not required if your election is a normal election made within one year of receiving form PWGSC 2018 Notice of Contributory Status.

PWGSC 2069 Pensionable Employment Questionnaire

Service with a separate employer (e.g. private enterprise, other level of government etc.) must be confirmed by completing this form and having the information certified by an official of the separate employer.

Complete part 1 and have your previous employer complete the remainder of the form. This form should then be sent to Superannuation Directorate (the address is previously indicated).

Note: Service with an outside employer which can be counted as pensionable employment must be service for which you contributed to a pension plan registered under the Canadian Income Tax Act. Your previous employer can provide you with this information.

Past Service Pension Adjustment (PSPA)

A PSPA arises when a benefit for a previous period of pensionable service is improved or past service is credited to a member. A PSPA is the additional pension credit that would have been included in the pension adjustment (PA) if the upgraded benefits had actually been provided, or the additional service credited, in those previous years.

A PSPA will usually reduce your RRSP deduction limit for the year it is reported. For information on how to calculate your RRSP deduction limit, refer to the chart in the RRSP and Other Registered Plans for Retirement T4040 guide (available through Canada Revenue Agency (CRA)).

A PSPA will not occur for past-service benefits based on service performed in 1989 or earlier.

Should Canada Revenue Agency not approve the PSPA required for post-1989 service, the election would be invalid. Any contributions made in respect of the invalid service would be refunded accordingly.

For information related to the Income Tax Act, the PA or the PSPA please contact CRA.

Should you require additional information, do not hesitate to contact me at (###) ###-#### or by e-mail INSERT E-MAIL ADDRESS.

Sincerely,

Compensation and Benefits Advisor

c.c. Employee file