Early Contribution Option: CF-FC 2582

Privacy notice

Provision of the personal information is required pursuant to the Department of Public Works and Government Services Act, para. 7(1)(d) and s.13 and will be used for the purpose of administrating the Canadian Forces Superannuation Act (CFSA). Refusal to provide the personal information, or the provision of incorrect information may result in loss of benefits and/or delays in processing incorrect pension estimates, benefits, or statements. Personal information is protected, and only used and disclosed in accordance with the Privacy Act and as described in Personal Information Bank PWGSC PCU 702 – Federal Pension Administration. Under the Act, individuals have a right of access to their personal information and request correction, if erroneous or incomplete.

Note

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

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Instructions for fillable PDF forms

Plan member's personal information

Rank

Surname

Given Names

Plan member's personal information Pension Number

Date of Birth (YYYY-MM-DD)

Preferred language

English

French

Service Number

Home address

Apartment Number

Preferred Telephone Number (999‑999‑9999)

City

Province

Postal Code

Country

Email Address (optional)

Election

I hereby elect as a Canadian Forces Superannuation Act (CFSA) annuitant, pursuant to subsection 8.2 of the Canadian Forces Superannuation Regulations, to become an early contributor under Part I of the CFSA
I understand that effective the day after the day upon which this election is made (dated), that my existing CFSA annuity will cease to be paid to me, and that pension contributions will commence to be deducted from my salary
I further understand that once made, this election is irrevocable

Signed at (Place) this day of (Month) (Year)

Signature

This form must be forwarded within seven days of signature to:

Public Works and Government Services Canada
Government of Canada Pension Centre - Mail Facility
150 Dion Boulevard
PO Box 9500
Matane QC G4W 0H3

For office use only

Form Number

Case Number

Service Number

Pension Number

CF-FC 2582E (2014-11-001)

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Early Contribution Option: CF-FC 2582

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Plan member's personal information

Election

For office use only

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