Canadian Forces Superannuation Regulations (C.R.C., c. 396)

This Document is issued to

(Name)(Referred to herein as “the participant”)

(Address)

as evidence that the participant, who is a participant under Part II of the Canadian Forces Superannuation Act, ceased to be a member of the regular force on the day of , 19 and is entitled to all the benefits and subject to all the obligations applicable to the participant under the Canadian Forces Superannuation Act.

BENEFITS

• 1.1 The benefit payable in the event of the death of the participant is $ , except that

  • (a) on the April 1 or October 1 that first follows each birthday of the participant, as of the participant’s sixty-first birthday, the benefit will be reduced by ten percent; or

  • (b) the participant may elect, by completing and forwarding Appendix “A”, to reduce the benefit to $5,000, which election is irrevocable.

• 1.2 The benefit payable will never be less than $5,000 if the participant pays contributions until the participant attains 65 years of age.

CONTRIBUTIONS

• 2.1 Payment of the benefit is subject to the payment of contributions of $ per month, subject to a reduction of one tenth of the contribution payable for each year in excess of 60 years of age attained by the participant, which reduction will be made each year on the April 1 or October 1 that first follows each birthday of the participant, as of the participant’s sixty-first birthday.

• 2.2 An additional reduction of $0.50 per month will be made on the April 1 or October 1 that first follows the day on which the participant attains 65 years of age.

• 2.3 If the participant has elected to reduce the benefit to $5,000, the contribution will be $0.50 per month until the date mentioned in section 2.2, and no contribution is payable thereafter.

• 2.4 Contributions will be deducted in equal monthly instalments from the annuity or pension payable to the participant under the Canadian Forces Superannuation Act or the Defence Services Pension Continuation Act, as the case may be.

BENEFICIARY

• 3.1 The benefit is payable to

  • (a) any named beneficiary; or

  • (b) if the named beneficiary does not survive the participant or if a beneficiary has not been named, the participant’s estate.

• 3.2 Where a benefit was payable to the participant’s surviving spouse before December 20, 1975, it remains payable to that spouse unless

  • (a) that spouse does not survive the participant;

  • (b) the participant names the estate as the beneficiary; or

  • (c) the participant names another beneficiary.

• 3.3 The payment of the benefit is subject to proof of the death of the participant and of the entitlement of the person claiming to be the beneficiary.

DATE OF BIRTH

• 4 Proof that the date of birth of the participant was the day of , 19 has been accepted.

RE-EMPLOYMENT OR REAPPOINTMENT

• 5.1 This document ceases to have any effect and the benefit described herein is no longer payable on the day on which the participant becomes a participant under Part II of the Public Service Superannuation Act by reason of being actively employed in the public service.

• 5.2 If the annuity or pension, as the case may be, of the participant is suspended

  • (a) because the participant is re-employed in the public service,

  • (b) because the participant is appointed to the public service or enrols in the Canadian Forces, or

  • (c) for any other reason,

the contributions required to be paid will be deducted from the participant’s salary or from the participant’s pay and allowances, as the case may be, or, if that is not possible, a new document will be issued to the participant (as evidence that the participant is a participant under Part II of the Canadian Forces Superannuation Act) setting out the conditions under which, and the circumstances in which, contributions and benefits will be payable.

APPLICATION OF ACT AND REGULATIONS

• 6.1 The provisions of Part II of the Canadian Forces Superannuation Act and of the Canadian Forces Superannuation Regulations apply in the same manner and to the same extent as if they were set out in this document.

• 6.2 If there is a conflict between the provisions of Part II of the Canadian Forces Superannuation Act and of the Canadian Forces Superannuation Regulations and the provisions of this document, the provisions of the Act and the Regulations prevail.

ISSUED this day of , 19

Chief of the Defence Staff

File No.

APPENDIX AForm 1Election to Reduce Benefit to $5,000

I, , hereby irrevocably elect to reduce to $5,000 my Supplementary Death Benefit payable under Part II of the Canadian Forces Superannuation Act.

I understand that the contribution required until the April 1 or October 1 that first follows my sixty-fifth birthday will be fifty cents ($0.50) per month and that no contribution will be required after that time. I also understand that this election will take effect on the first day of the month following its receipt by National Defence Headquarters.

Signed Signed

(witness)(participant)

Date Date

This form is to be forwarded to:

This Document is issued to

(Name)(Referred to herein as “the participant”)

(Address)

as evidence that the participant, who is a participant under Part II of the Canadian Forces Superannuation Act, ceased to be a member of the regular force on the day of , 19 (referred to herein as the “cessation date”), and that on the day of , 19 the participant elected to continue to be a participant under that Part and as such is entitled to all the benefits and subject to all the obligations applicable to the participant under that Part.

BENEFITS

• 1 The benefit payable in the event of the death of the participant is $, subject to a reduction of one tenth of that amount for every year in excess of 60 years of age attained by the participant.

CONTRIBUTIONS

• 2.1 Payment of benefits is subject to the payment of contributions as follows: a first contribution of $ is payable in advance for the period of one year beginning on the thirtieth day after the cessation date, and a contribution of $ is payable annually thereafter in advance, subject to a reduction of one tenth of the contribution for each year in excess of 60 years of age attained by the participant, the first reduction to be made with respect of the contribution payable on the day of , 19 and subsequent reductions to be made annually thereafter.

• 2.2 A grace period of 30 days is allowed for the payment of any contribution and, if the participant dies during the grace period, any contribution then overdue will be deducted from the amount of the benefit payable.

• 2.3 In the event of failure to pay any contribution in full before the end of the grace period, the right to any benefit in respect of the participant thereupon ceases, without any right of reinstatement.

• 2.4 The payment of contributions is to be made to the Receiver General by money order, bank draft or cheque, payable in Canadian funds at Ottawa, Canada.

BENEFICIARY

• 3.1 The benefit is payable to

  • (a) any named beneficiary; or

  • (b) if the named beneficiary does not survive the participant or a beneficiary has not been named, the participant’s estate.

• 3.2 Where a benefit was payable to the participant’s surviving spouse before December 20, 1975, it remains payable to that spouse unless

  • (a) that spouse does not survive the participant;

  • (b) the participant names the estate as the beneficiary; or

  • (c) the participant names another beneficiary.

• 3.3 The payment of the benefit is subject to proof of the death of the participant and of the entitlement of the person claiming to be the beneficiary.

DATE OF BIRTH

• 4 Proof that the date of birth of the participant was the day of , 19 has been accepted.

RE-EMPLOYMENT OR REAPPOINTMENT

• 5 This document ceases to have any effect and the benefit described herein is no longer payable on and after the day on which the participant ceases to be an elective participant and becomes a participant, other than an elective participant, under Part II of the Public Service Superannuation Act.

APPLICATION OF ACT AND REGULATIONS

• 6.1 The provisions of Part II of the Canadian Forces Superannuation Act and of the Canadian Forces Superannuation Regulations apply as if those provisions were set out in this document.

• 6.2 If there is a conflict between the provisions of Part II of the Canadian Forces Superannuation Act and of the Canadian Forces Superannuation Regulations and the provisions of this document, the provisions of the Act and the Regulations prevail.

ISSUED this day of, 19

Chief of the Defence Staff