Form 5 - Waiver Of 60% Joint Pension printable pdf download

FORM 5

WAIVER OF 60% JOINT PENSION ENTITLEMENT

FOR PENSION PLAN OR LOCKED-IN RETIREMENT ACCOUNT

The Pension Benefits Act, Sections 23, Pension Benefits Regulation, Section 3.35,

Section 10.2 of Division 1, and Section 10.22 of Division 2 of Part 10

COMMENTS AND INSTRUCTIONS

This form must be completed where the retiring member of a pension plan wishes to



elect a form of pension or purchase a life annuity that provides the spouse or common-law partner with less

than the 60% joint survivor pension required by The Pension Benefits Act, or no survivor pension;



transfer the funds to a Life Income Fund (LIF) or Variable Benefit; or



elect a form of pension or purchase a life annuity that integrates payment with a pension payable under the

Canada Pension Plan (CPP)/Quebec Pension Plan (QPP) and/or Old Age Security program.

Prior to completing this form, the spouse or common-law partner should consider obtaining independent

legal advice concerning his or her individual rights and the effect of this waiver as well as qualified

financial advice about the financial consequences.

This form must be completed where the owner of a Locked-In Retirement Account (LIRA) wishes to



transfer the funds to a Life Income Fund (LIF) or Variable Benefit; or



withdraw all or a part of the LIRA account balance as a result of shortened life expectancy

This form must be



completed in its entirety;



signed by the spouse or common-law partner, and witnessed while the member is not present;



filed with the plan administrator;



used for benefits earned under pension plans subject to The Pension Benefits Act of Manitoba;



provided to the transferee if funds are moved from one financial institution to another; and



before money is transferred to another vehicle permitted under the Regulation, provided to the administrator of

the vehicle receiving the money.

For further information please contact the plan administrator or financial institution.

Definitions

Administrator

Means in relation to a pension plan, the person or body of persons responsible for administering the plan, and in

relation to a LIRA, the financial institution responsible for administering the plan or fund.

Common-law partner of a member or member-owner means

(a) a person who, with the member or former member, registered a common-law relationship under section 13.1

of The Vital Statistics Act, or

(b) a person who, not being married to the member or former member, cohabited with him or her in a conjugal

relationship

(i) for a period of at least three years, if either of them is married, or

(ii) for a period of at least one year, if neither of them is married.

FORM 5 - Waiver of 60% Joint Pension Entitlement for Pension Plan or Locked-In Retirement Account

MAY 2012

Office of the Superintendent – Pension Commission

Form 5 - Waiver Of 60% Joint Pension

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