Royal Canadian Mounted Police Superannuation Regulations (C.R.C., c. 1393)

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, (Given Names) (Surname) Reg. No. 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)

    

    Date of Birth Marital Status S M W

  GIVE DETAILS OF ALL PENSIONABLE SERVICE
  Approximate Period		Type of Service	Type of Benefit Received
  From	To	Civil Service, War Service, Regular Force, Etc.	Return of Contributions, Immediate Annuity, Deferred Annuity, Etc.

• 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: Amount:

  Signed at (Place) this day of (Month) 19

  Witnessed as to signature

  (Signature of Witness)(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.

TO BE COMPLETED BY THE FORCE

PART IICertification

Direction to the Chief Treasury Officer:

• (a) (i) 

  Lump Sum Payment in the amount of $ is forwarded with this election to be credited to the Royal Canadian Mounted Police Pension Fund.
• (ii) 

  Instalments at the monthly rate of $ 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.

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, (Given Names) (Surname) Reg. No. 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:

  • ☐ (a) 

    Public Service Superannuation Act; or
  • ☐ (b) 

    Canadian Forces Superannuation Act.

• 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: Amount:

  • ☐ (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)(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.