Pay Centre forms

A collection of forms related to your pay, insurance and leave requests.

Note:

A pay action request form must accompany all requests (pay service requests) submitted to the Public Service Pay Centre. The Pay Centre will reject service requests sent by email without this form and return them to you. If you fail to complete all mandatory fields in the form, the system will similarly reject your request and return it to you.

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Pay forms

Pay action request

This form must accompany all requests submitted by email, fax or mail to the Pay Centre.

Tax forms

Upon hiring, or when you wish to make a change to your tax credits, complete both the TD1 Personal tax credits return form and the provincial form. Please complete the provincial form based on where you report to work rather than where you reside.

TD1 Personal tax credits return
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Québec
Saskatchewan
Yukon

Direct Deposit Form

You must complete this form to start or to amend the direct deposit of your pay cheque.

Lost or Stolen Cheque

You must complete this form if you lose your Receiver General cheque.

For payments greater than $5,000, you must complete both the Undertaking and Indemnity form and this form:

  • PSPC-SPAC 540 Affidavit: For cheques over $5,000 issued by the Receiver General. (accessible only on the Government of Canada network)

Isolated Post Allowances

If you occupy an isolated post, you may be entitled to certain allowances. This form provides details of these amounts or changes to various allowance amounts. Have your manager or departmental human resources representative complete this form and forward it to the Public Service Pay Centre.

Determination of contact person and amount of Supplementary Death Benefit payment

Managers or departmental human resources personnel complete this form and forward it to the Public Service Pay Centre to provide particulars about the death of an employee.

Insurance forms

Public Service Health Care Plan

Use these forms to apply to the Public Service Health Care Plan and claim medical expenses.

Public Service Dental Care Plan

Complete this form to make a claim for dental expenses under the Public Service Dental Care Plan.

Complete this form to authorize someone else to make a claim for dental expenses for your eligible children under the Public Service Dental Care Plan.

Disability Insurance

Complete this form to apply for disability benefits under the Disability Insurance Plan.

Have your physician complete this form if you are applying for disability benefits under the Disability Insurance Plan.

Public Service Management Insurance Plan

Long-term disability insurance

Complete form 5946 if you are making a claim for long-term disability benefits under the Public Service Management Insurance Plan.

Have your physician complete form 5945 if you are making a claim for long-term disability benefits under the Public Service Management Insurance Plan.

Complete form 5955 if you are making a claim for accidental dismemberment benefits under the Public Service Management Insurance Plan. Have your physician complete form 5954 if you are claiming accidental dismemberment benefits.

Complete forms 5948 and 5949 if you are making a claim for death benefit under the Public Service Management Insurance Plan.

Basic life insurance

If you are entitled to employer-paid coverage, complete this form to apply for the Public Service Management Insurance Plan.

If you are a full-time employee, complete this form to apply for the Public Service Management Insurance Plan.

If you are a part-time employee, complete this form to apply for the Public Service Management Insurance Plan.

Change of name or of beneficiary

Complete this form to change your beneficiary under the Public Service Management Insurance Plan.

British Columbia Medical Services Plan

Complete this form to apply for group enrolment under the British Columbia Service Plan.

Leave forms

Pre-retirement transition leave

Complete this form to apply for pre-retirement transition leave.

Application for pre-retirement transition leave (accessible only on the Government of Canada network)

Leave with income averaging

Complete this form to apply for leave with income averaging.

Application for leave with income averaging (accessible only on the Government of Canada network)

Self-funded leave

Complete this form to apply for self-funded leave.

Application for self-funded leave (accessible only on the Government of Canada network)

Leave application and absence report

The leave and absence form is available from your department or agency. Complete it when you go on leave without pay or when you cannot access the leave reporting system.

Leave application and absence report (accessible only on the Government of Canada network)

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