UAPP Forms

UAPP Designation of Spouse and Non-Spouse Beneficiary form PDFDocument

UAPP Request for Former Member's Service Record form PDFDocument

UAPP Beneficiary Change Form for Pensioners PDFDocument

UAPP Rehired Pensioner Form PDFDocument

Waiver Forms [Note: If your browser doesn't display a form when you click on the link, right-click on the link, select "Save link as…", save the form, and open it with Acrobat Reader.]

Pension Partner Waiver of Entitlement to a 60% Joint and Survivor Pension from a Pension Plan PDFDocument

Pension Partner Waiver of Entitlement to a Death Benefit Before Pension Commencement in a Pension Plan PDFDocument

Pension Partner Waiver to Permit Unlocking From a Pension Plan Due to Shortened Life Expectancy or Non-Residency PDFDocument

Pension Partner Waiver to Establish a Life Income Type Benefits Account PDFDocument

Pension Partner Waiver of Entitlement to a Death Benefit After Pension Commencement from a Pension Plan PDFDocument

Transfer and Tax Forms

Transfer form for the Purchase of Service under UAPP (T2033) PDFDocument

Transfer form for Termination Benefits from UAPP (T2151) PDFDocument

Tax form for pension payments - Alberta PDFDocument

Tax form for pension payments - Canada PDFDocument


CIBC Mellon Forms

Pensioner Change of Address Form
To change your address, you can either complete and submit the online form or you can print the PDF version of the form, complete the information (please print clearly) and mail it to the address listed below.

Electronic Deposit Request Form
To receive your pension by electronic deposit or to change your deposit account on file, please print the PDF version of the form, complete the information (please print clearly) and mail it to the address listed below.

Declaration of Eligibility for Benefits Under a Tax Treaty for a Non-Resident Taxpayer
This form is to be completed if you are a non-resident taxpayer in a country with which Canada has a tax treaty and you are eligible to receive a reduced rate of tax or an exemption provided by the treaty on all or certain income. Print the PDF version of the form, complete the information (please print clearly) and mail it to the address listed below.

CIBC Mellon Pension Benefits Department
PO Box 5858 Station B
London, Ontario
N6A 6H2
CANADA