PWGSC-TPSGC 2270 - Notice of Service Buyback Details

Protected "B" when completed

Notice of Service Buyback Details

To:

From:

This is to advise you that our office has received a "Service Buyback" form for:

Name of Plan Member

PRI

Plan Member's Personal Information Pension No.

Paylist

Department

Please commence monthly deductions of:

Effective (Y-M)

Reference Number

Pre-1990 Service while a plan member Single Rate Single Rate Monthly Deductions

Pre-1990 Service while a plan member Double Rate Double Rate Monthly Deductions

Pre-1990 Service while not a plan member Single Rate Single Rate Monthly Deductions

Pre-1990 Service while not a plan member Double Rate Double Rate Monthly Deductions

Post-1989 Service Single Rate Monthly Deductions

Post-1989 Service Double Rate Monthly Deductions

RCA Single Rate Monthly Deductions

RCA Double Rate Monthly Deductions

Cash Lump Sum Payment

Cash Lump Sum Payment Details Amount

Cash Lump Sum Payment Details Date (Y-M-D)

Amount indicated on RSP Transfer form

Amount indicated on RSP Transfer form Details Amount

Amount indicated on RSP Transfer form Details Date (Y-M-D)

Monthly deduction amount

Number of months

Pension operations

Telephone Number (999-999-9999)

Monthly Payment Information Date (Y-M-D)

PWGSC-TPSGC 2270 (09/2009)