PWGSC-TPSGC 2265 - Pension information release
Protected "B" when completed
Pension information release
Provision of the personal information (PI) including the social insurance number (SIN) is required pursuant to the Department of Public Works and Government Services Act, section 13 and will be used for the purpose of administrating the Public Service Superannuation Act (PSSA). The PI, including the SIN, will be disclosed between the administrators of the Canada Pension Plan (CPP), Quebec Pension Plan (QPP), and public service pension plan to confirm that the retiree is not receiving a disability pension and to calculate a reduced annuity, if required. Refusal to provide the personal information or the provision of incorrect information could result in the loss of benefits, and/or delays in processing 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 PCE 702 - Federal Pensions Administration. Under the Act individuals have the right to access their personal information and request corrections.
This form must be completed electronically. If not possible, please complete it in dark ink using capital letters.
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