Public Services and Procurement Canada
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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. If not possible, please complete it in dark ink using capital letters.
Upon request by the Government of Canada Pension Centre, this form is to be completed by employing organizations to provide salary and service certification when missing or conflicting data has been identified in the pension system or to report certified salary and service records prior to a salary revision.
E/D/A = Entitlement/Deduction/Salary Adjustment Code
DR = Duel Remuneration Indicator
PT = Pension Type Code
Provide the date of collective agreement, Treasury Board Minute or arbitral award applicable to the salary rate shown when reporting non-revised salary data.
I hereby certify that the data reported is an accurate transcript of the official records of this organization.
PWGSC-TPSGC 2020 (05/2014)