CF-FC 2017—Election to continue Supplementary Death Benefit

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.


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

Carefully read instructions before completing this form

Election: I hereby elect to continue to be a participant under the Supplementary Death Benefit Plan in accordance with the terms of Part II of the Canadian Forces Superannuation Act. I understand that coverage is based on twice my annual salary at release and is rounded up to the next multiple of $250. The coverage is subject to a 10% reduction per year, beginning at age 61, and after age 70, the coverage will cease. I also understand that contributions are based on my age and the amount of my coverage and will be charged at commercial rates. I am making this election no later than 30 days after the date of my release from the Canadian Armed Forces.


  1. To constitute an election, this form must be completed and sent by mail to the following address within one year prior to, or no later than 30 days following release:

    Public Works and Government Services Canada
    Government of Canada Pension Centre - Mail Facility
    150 Dion Boulevard
    PO Box 9500 
    Matane QC G4W 0H3

  2. This form is not required if the benefit entitlement is an immediate annuity for reason of age or disability or an immediate annual allowance. If approval of an immediate annuity due to disability is pending at release, this form must be completed to guarantee continuation of coverage under the SDB plan.

  3. You may name or change a beneficiary at any time by submitting a completed designation form CF-FC 2196. To obtain this form and further information, please refer to the Website or contact the Government of Canada Pension Centre.

  4. SDB premiums/contributions must be paid in advance, once a year, in order to maintain your coverage. A cheque or money order, made payable to the Receiver General for Canada, must be mailed in to the Government of Canada Pension Centre.

  5. If your entitlement is a deferred annuity or an annual allowance payable later than 30 days after release, at the time the annuity becomes payable the contributions will be deducted from your pension on a monthly basis, unless you advise the Government of Canada Pension Centre otherwise.


You should submit the annual contribution with this form within 30 days after your release. In no case will contributions be accepted if received more than 60 days after release. To obtain the annual contribution amount, refer to the Supplementary Death Benefit (SDB) Estimates Statement provided to you or call the Government of Canada Pension Centre.

For office use only

CF-FC 2017E (2014-12-001)

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