CF-FC 2480—Election Not to Count Leave Without Pay as Pensionable Service

PDF version (711KB)
Help with alternative formats and plug-ins

Protected "B" when completed

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 Canadian Forces Superannuation Act (CFSA). 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.

Note

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

Additional Information

Carefully read instructions before completing

For your period of leave without pay (LWOP) that commenced or will commence on the date indicated below, you have the option of not counting the entire period of LWOP as pensionable service.

If you elect not to count this period of LWOP, you will not be credited with the service and accordingly, you will not be required to pay deficiencies in pension contributions for your period of LWOP.

To make an election not to count the period of LWOP as pensionable service, you must sign and forward this form to the Government of Canada Pension Centre at any point before the contributions for the LWOP period have been fully paid back.

This election is irrevocable

If you do not exercise this option prior to paying back in full the LWOP contribution deficiencies, upon returning to work, deficiencies in pension contributions will be recovered for your entire period of leave without pay.

Retain a copy for your records and return the original form to the Government of Canada Pension Centre at the address below:

Government of Canada Pension Centre - Mail Facility
150 Dion Boulevard
Post Office (PO) Box 9500 
Matane QC G4W 0H3

To be completed by the plan member

I hereby elect NOT to count my entire period of LWOP as pensionable service. The date on which my period of LWOP began or will begin is indicated above.

I understand that by signing this form, the full period of LWOP will not be pensionable and that I am not required to pay the deficiencies for that period. This decision is irrevocable.

For office use only

CF-FC 2480E (2014-12-001)

Date modified: