PWGSC-TPSGC 2196 –Naming or changing your beneficiaries

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Privacy notice

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.

Instructions and information

You must be a participant in the Supplementary Death Benefit (SDB) plan to name a beneficiary.

Naming a beneficiary: You can name up to 5 beneficiaries. You can’t name the same beneficiary more than once on this form.

You can name:

  • any person of any age, including minors
  • a registered charity organization
  • your estate

If you choose to name your Estate as one of the beneficiaries, place a check mark beside “Estate” in the beneficiary’s type box. No further information is required.

Changing your beneficiary: You can change your beneficiaries at any time while you’re a participant by completing a new form.

If you complete a new form, all beneficiaries you listed on the previous form will be replaced by the validly named beneficiaries on your new form.

Changing the contact person for a minor: Contact the Pension Centre if you need to change the contact person of any minor children.

Updating addresses: Contact the Pension Centre if your address, or that of a beneficiary, has changed. If we don’t have the correct address, we may not be able to find your beneficiary when the benefit becomes payable.

Important: Your Supplementary Death Benefit will be divided equally among all validly named beneficiaries. If there is any beneficiary who was not validly named or if a beneficiary predeceases you, the entire benefit will be divided equally among all remaining beneficiaries.

Print clearly and initial any corrections you make to the information on the form. If we cannot read or are uncertain about the information provided, the entire form may be considered invalid.

Mail this form

Mail this form to:

Government of Canada Pension Centre
Mail Facility
PO Box 8000
Matane QC G4W 4T6

You must send the original completed form. We can’t accept copies.

We won’t return a copy of the form to you. Please make a copy for your records.

Return date: The Pension Centre must receive the form prior to your death. If not, the benefit will be paid to your last valid naming of beneficiaries. Consider sending it to us by express mail.

Please enter a valid 9-digit number starting with zero.

Your personal information


Please enter a valid 9-digit number starting with zero.

Beneficiary

Type

By signing below, I hereby confirm that the information above is complete and accurate, that I want to name the beneficiaries provided on this form, and that I want to replace all previously named beneficiaries.

PWGSC-TPSGCPWGSC-TPSGC 2196E

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