Forms

To use the forms below, you must first print the form, complete it by hand and return it by mail to the following address:

Public Works & Government Services Canada
Superannuation Sector
P.O. Box 5010
Shediac, NB
E4P 9B4

You may also obtain these forms and others by contacting the Superannuation Sector .

The following forms are in .pdf format which means that you require the Adobe Acrobat Reader to be able to view and print them.

If you need assistance, our help file explains how to use various file formats available.

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Pension Administration

PWGSC 2002
(PDF, 117K)Declaration of Attendance at an Educational Institute

Complete this form if you are an eligible dependant of a deceased contributor of the Public Service Superannuation Act and are requesting a Student Allowance.

Note: Form is only valid if printed on legal size paper (8½ X 14)

PWGSC 2196
(PDF, 73K)Naming or Substitution of a Beneficiary

Complete this form if you wish to name or change your beneficiary for your Supplementary Death Benefit.

PWGSC 2265
(PDF, 38K) Pension Information Release

This form is required to verify Quebec and Canada Pension disability information.

Note: Form is only valid if printed on legal size paper (8½ X 14)

PWGSC 2040
(PDF, 32K) Statutory Declaration

This form is required in cases where the pensioner is unable to manage his/her own affairs.

Note: Form is only valid if printed on legal size paper (8½ X 14)

PWGSC 2486
(PDF, 18.4K) Application for Division of PSSA pension in accordance with PBDA

Complete this form if you are applying for division of a Public Service Superannuation Act pension in accordance with the Pension Benefit Division Act.

PWGSC 2488
(PDF, 19.5K) Request for Pension Benefit Division Information

Complete this form when requesting Pension Benefits Division Information with respect to a Public Service Superannuation Act Pension in accordance with the Pension Benefit Division Act.

PWGSC 2483
(PDF, 18.9K) Statutory Declaration - PBDA Form

Complete this form if you are requesting information under the Pension Benefits Division Act.

PWGSC 2484
(PDF, 95.8K) Statutory Declaration - PBDA Form

Complete this form if you are applying under the Pension Benefits Division Act.

Pensioners' Dental Services Plan (PDSP)

Sunlife Claim Form

Complete this form if you are a member and wish to make a claim for eligible dental services from the Public Service Dental Care Plan.

TBS 330-229A
(PDF, 12K) Enrolment Form

Complete this form if you are eligible to enrol in the Pensioners Dental Service Plan.

Public Service Health Care Plan (PSHCP)

TBS 006482
(PDF, 854K) Claim Form

Complete this form if you are a member and wish to make a claim for eligible health care expenses from the PSHCP.

TBS 006483Claim Form for Comprehensive Coverage

Complete this form if you are a member and wish to claim eligible comprehensive services from the PSHCP.

TBS 006492Public Service Health Care Plan - Pensioner Application