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Royal Canadian Mounted Police Superannuation Regulations

Version of the schedule from 2012-09-01 to 2013-06-06:


SCHEDULE III

Royal Canadian Mounted Police Superannuation Act

Election to Pay for Prior Pensionable Service

(This election must be completed and forwarded to the Commissioner, R.C.M. Police, Ottawa, Ontario, within the prescribed time limit.)

PART IElection and Manner of Payment

  • 1 I, (Christian Names) (Surname) Reg. No. blank line a (Rank) of the Royal Canadian Mounted Police hereby elect to pay for elective pensionable service performed prior to the date on which I became a contributor under the Royal Canadian Mounted Police Superannuation Act, as follows:

    • ☐ (a) 
      All my prior pensionable service;
    • ☐ (b) 
      Part only of my prior pensionable service, namely:

      (Specify type and period of service selected)

      blank line

      Date of Birth blank line Marital Status S M W

    GIVE DETAILS OF ALL PENSIONABLE SERVICE
    Approximate PeriodType of ServiceType of Benefit Received
    FromToCivil Service, War Service, Regular Force, Etc.Return of Contributions, Immediate Annuity, Deferred Annuity, Etc.
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    blank line
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  • 2 I will  make payment in the  following manner: (Place  “x” in appropriate block.)

    • ☐ (a) 
      In a lump sum at the time of making this election or,  if the cost is not known, within one month from date of demand;
    • ☐ (b) 
      in monthly instalments, to be paid beginning the first day of the month after the day on which the election was made, until full payment has been made.

    Period: blank lineblank line Amount: blank line

    Signed at (Place) thisblank line day of (Month) 19blank line

    Witnessed as to signature

    (Signature of Witness)blank line(Signature of Elector)

    • NOTE: 
      This form is to be completed in  four copies; one copy to be retained by the elector; the original and remaining two copies to be returned to: The Commissioner, R.C.M. Police, Ottawa, Ontario, without delay.

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TO BE COMPLETED BY THE FORCE

PART IICertification

Direction to the Chief Treasury Officer:

  • (a) (i) 
    Lump Sum Payment in the amount of $blank line is forwarded with this election to be credited to the Royal Canadian Mounted Police Superannuation Account.
  • (ii) 
    Instalments at the monthly rate of $blank line are to commence with effect from the first day of the month following the month in which election was made.
  • NOTE: 
    If the service elected for  is under section 6(b)(ii)(I) of the  Act, the Force should ensure that the elector has successfully completed a medical examination.
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(Commissioner, R.C.M. Police)

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Royal Canadian Mounted Police Superannuation Act

Election to Surrender Annuity or Annual Allowance Which Is Payable or Becomes Payable to a Former Contributor Under the Public Service Superannuation Act or the Canadian Forces Superannuation Act

PART IElection and Manner of Payment

  • 1 I, (Christian Names) (Surname) Reg. No. blank line a (Rank or Class) of the Royal Canadian Mounted Police hereby elect, pursuant to subsection 24(5) of the Royal Canadian Mounted Police Superannuation Act, to surrender my right to an annuity or annual allowance under:

  • 2 I  will pay  any amount  remaining unpaid  for the  above service  in the following manner:

    • ☐ (a) 
      In a lump sum at the  time of making this election or, if the cost is not known, within one month from date of demand;
    • ☐ (b) 
      By  lump sum  payment in  partial  settlement of  arrears the balance to be  paid  on monthly  instalments  commencing the first  day of  the month  following the  month in  which this election is made;

      Period: blank lineblank line Amount: blank line

    • ☐ (c) 
      In monthly instalments commencing the first day of the  month following the month in which this election is made.

    Witnessed as to signature

    (Signature of Witness)blank line(Signature of Elector)

  • NOTE: 
    This form is to be completed  in four copies: one copy to  be retained by the elector; the original and remaining two copies to be returned to: The Commissioner, R.C.M. Police, Ottawa, Ontario.
  • SOR/93-219, ss. 2, 3(F)
  • SOR/2012-124, s. 33

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