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Note This document has been modified. The changes are identified by a vertical line "|". Revision (|)

| Annex A

May 1 , 2008 (revised April 4, 2011)

| SUBJECT :Amendment to the "Notification of Death in Service" (Public Works and Government Services Canada (PWGSC)-Travaux publics et Services gouvernementaux Canada (TPSGC) 2014) - formerly known as the "Determination of Contact Person and Amount of Supplementary Death Benefit Payment"


1.1. The purpose of this special advice is to provide Crown corporations and Agencies with information relating to modifications to the PWGSC-TPSGC 2014 form due to the change in responsibility concerning the Supplementary Death Benefit (SDB) beneficiary information.

| 1.2. Employer representatives will continue to inform the public service pension plan member to forward the PWGSC-TPSGC 2196 Publiservice form (Naming or Substitution of a Beneficiary) directly to the Public Service Pension Centre (Pension Centre).

| 1.3. Effective April 11, 2011, the employer representatives will inform the Pension Centre of a death in service via the PWGSC-TPSGC 2014 form.

| 1.4. The new procedures required as a result of these changes can be found in Annex A.


| 2.1. The employer representative will continue to supply a contact name and contact information. The contact name may be the spouse, executor or administrator of the estate, or the person who informed them of the employee's death.

| 2.2. A section has been added to allow the employer representative to provide details that may assist the Pension Centre in the counseling process.

| 2.3. The PWGSC 2014 must be sent to the Pension Centre to indicate the employee's authorized salary rate, the name and complete mailing address of the contact person. The employer representative should send the form as soon as possible to ensure timely payment of the death benefit. The facsimile number is 418-566-6298.

| 2.4. The Pension Centre will request any required certificates (birth, marriage, etc.) from the contact person, the executor or the administrator of the estate before the SDB may be paid.

| NOTE: The survivor must forward the death certificate directly to the Pension Centre. If the employer representative receives a death certificate, they must forward a copy to the Pension Centre.

| 2.5. Once the SDB payment is authorized, the Pension Centre will mail the payment and covering letter to the beneficiary.

| 2.6. The Pension Centre will contact the plan members' survivors or legal representatives to discuss pension benefit entitlements, along with required documentation and/or forms necessary to process a pension benefit payment.


| 3.1. The new procedures to complete the PWGSC-TPSGC 2014 form are found in Annex A.


4.1. Any request for information regarding the foregoing should be addressed to your Public Works Government Services Canada (PWGSC) Compensation Services Office.

Original Signed by
T. Labelle

Brigitte Fortin
Director General
Compensation Sector
Accounting, Banking and Compensation