CF-FC 2196—Naming or Substitution of a Beneficiary

CF-FC 2196—Naming or Substitution of a Beneficiary (PDF, 1.2MB)

Protected "B" when completed

Privacy notice

The personal information is collected pursuant to the Department of Public Works and Government Services Act, para. 7(1)(d) and s.13. The personal information will be used by the Receiver General and Pensions branch of Public Services and Procurement Canada (PSPC) for the purpose of administrating the Canadian Forces Superannuation Act (CFSA). The personal information is described in the Personal Information Bank PWGSC PCU 702. Your personal information is protected, used, and disclosed in accordance with the Privacy Act. Under the Privacy Act, you have the right to access and correct your personal information, if erroneous or incomplete. The personal information provided for the pension program will be retained for a period of a minimum of 2 years after the last administrative action, and then destroyed. If you require clarification about this privacy notice, you may contact the Public Services and Procurement Canada’s Access to Information and Privacy Directorate by email at TPSGC.ViePrivee-Privacy.PWGSC@tpsgc-pwgsc.gc.ca. If you are not satisfied with the response to your privacy concern or if you want to file a complaint about the handling of your personal information, you may wish to contact the Office of the Privacy Commissioner of Canada.

Note

This form must be completed electronically. If not possible, please complete it in dark ink using capital letters.

To change the address of an existing beneficiary, contact the Government of Canada Pension Centre at 1-800-267-0325.

Carefully read instructions before completing

The information provided is collected under the authority of Treasury Board for the administration of the Canadian Forces Superannuation Act. The completion of this form is mandatory if you wish to designate a beneficiary under Part II of the Canadian Forces Superannuation Act. All information is protected under the provisions of the Privacy Act. The information will be banked in your Personal Pension File. Access to this information is controlled by the Custodian of the Pension File, the Director Canadian Forces Pensions Services (DCFPS).

Note—Before completing the form

You must be a plan member in the Supplementary Death Benefit (SDB) plan to complete this form; otherwise, the form will be invalid. You may cancel or change your beneficiary at any time while a plan member, whether serving or retired.

Upon your death, your named beneficiary may become entitled to certain lump sum benefits which are payable under Part II of the Canadian Forces Superannuation Act. A naming takes effect the date this form is completed; however, this form must be received by the Government of Canada Pension Centre prior to your death. Therefore, it is recommended that the completed form, be forwarded by express mail to the address indicated below.

Important—You may only have one designated beneficiary at a time.

You may designate:

  • Any person over 18 years of age on the date of naming
  • Your Estate (print "Estate" in the space provided for the beneficiary). If you only wish to cancel the previous designation, simply print "Estate"
  • Any registered charitable, benevolent, religious or educational organization or institution (the name, address and registration number of the institution are required)
  • An ineligible or ambiguous designation will render the form invalid

Instructions—Completion of the Form

Complete all unshaded areas. Please print.

  • The Service Number or Pension Number must be provided.
  • Amendments are not acceptable unless initialed by the plan member and the witness.
  • Both the plan member and the witness must sign this form in dark ink.

Note

The Government of Canada Pension Centre will review and validate your completed form. If valid, your SDB will be payable to your named (designated) beneficiary. A valid beneficiary naming will revoke any previous naming on file. If the form is not valid, your SDB will be payable to your last valid beneficiary on file. If you have no valid SDB beneficiary on file, your SDB will be payable to your estate.

Instructions for serving members only

Reserve Force members must be on Class C service on the date of signature. A break in Class C service will cause this form to become invalid. A new form must be completed at the commencement of each period of Class C service.

It is the responsibility of the base, wing or unit to ensure the form is completed correctly. This is indicated by the stamp and/or signature of the Commanding Officer. (By stamping and/or signing, the Personnel Office or Base Orderly Room verifies the form is completed as required.)

Submit a completed copy to your Personnel Office or Base Orderly Room, who will verify it correct and forward a stamped/signed copy to the Government of Canada Pension Centre on your behalf and place a cope on your file.

Forwarding of the Form

It is important that this form be received at the address indicated below as soon as possible.

Government of Canada Pension Centre - Mail Facility
150 Dion Boulevard
Post Office (PO) Box 9500 
Matane QC  G4W 0H3

It is recommended that you forward this form by express mail

No acknowledgement receipt will be sent. Please retain a copy for your records.

Plan member's personal information

Preferred language

Plan members additional information

Serving

I hereby appoint the following beneficiary and revoke any previous designation

Beneficiary's Information

For office use only

CF-FC 2196E (2022-03-30)

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