PWGSC-TPSGC 1422—Deductions From Annuity or Annual Allowance
Protected "B" when completed
Deductions From Annuity or Annual Allowance
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 Public Service Superannuation Act (PSSA). 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 or in dark ink using capital letters.
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