Member Forms

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36 Forms

Disability

Form 153 - Additional Information for a Disability Benefit Review

If you are receiving a disability benefit, OMERS may ask you to complete this form to ensure that you still qualify.

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Pensions

Form 144 - Application for Retirement Pension - Deferred members

If you are no longer working for an OMERS employer, use this form to apply for your OMERS retirement pension.

Changing Member Information

Form 132 - Authorization for Disclosure of Personal Information

Use this form to provide OMERS with consent to disclose your personal information to your employer for reasons other than pension plan administration.

Additional Voluntary Contributions (AVCs)

Form 401 - Additional Voluntary Contributions (AVCs) - Automatic Contribution Plan

Use this form to start, change or stop automatic contributions to your AVC account.

Additional Voluntary Contributions (AVCs)

Form 406 - Additional Voluntary Contributions (AVCs) - Catch-Up Payments

Use this form to make a payment to catch up on your automatic contributions to your AVC account.

Additional Voluntary Contributions (AVCs) Income Option

Form 410 - Additional Voluntary Contributions (AVCs) Direct Deposit for Withdrawals

Use this form to set up or change direct deposit for withdrawals from your AVC account, beginning the year in which you turn age 72.

Additional Voluntary Contributions (AVCs)

Form 411 - Additional Voluntary Contributions (AVCs) Income Option - Withdrawal (Members Age 72 and Older)

Use this form if you participate in the AVC Income Option and wish to make an optional withdrawal from your AVC account.

Additional Voluntary Contributions (AVCs)

Form 403 - Additional Voluntary Contributions (AVCs) - Withdrawals (Active Members)

Use this form to withdraw funds from your AVC account if you are an active member.

Additional Voluntary Contributions (AVCs)

Form 404 - Additional Voluntary Contributions (AVCs) - Withdrawals (Retired and Deferred Members Under Age 72)

Use this form to withdraw funds from your AVC account if you are a retired or deferred member and you have not yet turned age 72.

Survivor Benefits

Form 206 - Beneficiary Designation

Login to myOMERS or use this form to register or change your beneficiary on file with OMERS.

Changing Member Information

Form 107 - Changing Deferred Member Information

If you are no longer working for an OMERS employer but haven't started your pension yet, use this form to change or update the information OMERS has on file for you.

Form 108 - Changing Information (Retired Member/Survivor)

Use to change your address, banking or tax information on file.

Pensions

Form 157 - Claim for former spouse pension

Provides OMERS with your former spouse's personal, address and banking information.

Survivor Benefits

Form 154 - Death benefit – survivor status confirmation

This form is to confirm that the deceased member does not have an eligible spouse and/or child.

Survivor Benefits

Form 155 - Declaration of full-time attendance at an educational institution

For an eligible child of a deceased OMERS member to confirm that they in full-time attendance at an educational institution.

Income Tax

T2033 - Direct Transfer

Canada Revenue Agency form T2033 required for a transfer to OMERS from an RRSP or LIRA.

Income Tax

T2151 - Direct Transfer of a Single Amount (Canada Revenue Agency form)

Canada Revenue Agency form T2151 required for a transfer of your OMERS benefit to a registered pension plan, LIRA, LIF, RRSP, or RRIF.

Direction to administrator

The Pension Benefits Act (PBA) form is required for locked-in commuted value transfers.

Employed OMERS retiree election form

Use to record a retired member's enrolment election.

Disability

Form 148 - Forfeiting rights to disability benefits

Completed by a member to give up rights to an OMERS disability benefit.

Retirement Planning

Income comparison worksheet: before/after retirement

This form will help you calculate what you can expect to receive after you retire, based on your income before retirement.

Information Request - Retired member spouse

If you are a retired member use this form to provide OMERS with your spouse’s / common-law spouse’s information, along with your contact details.

Retirement Planning

Location of Valuable Papers and Assets

This form is designed to help you and your family keep track of your important documents so they can be found quickly when needed.

Disability

Form 147 - Medical report - OMERS total disability benefits

Completed by the member and doctor(s) for disability pension or disability waiver of contribution requests.

Survivor Benefits

Form 141 - Medical report - child's total disability

This form is to provide medical information to determine if a deceased member’s child qualifies for an OMERS benefit under the definition of “totally disabled child.”

Service Purchases

Form 162 - Pre-authorized debit form

Use this form to change your existing pre-authorized debit instructions (PAD) for your past service purchase.

Pensions

Form 146 - Shortened life expectancy benefit application

Use this form to apply for a shortened life expectancy benefit.

Service Purchases

Form 169 - Statutory declaration for proof of eligible service - Members

Use this form to confirm eligible service in the OMERS Primary Pension Plan, where, as a former employee, you have tried but are unable to obtain proof of your service from your former OMERS participating employer.

Survivor Benefits

Form 159 - Statutory declaration of common-law relationship

Use this form to submit a claim that you are the common-law spouse eligible to receive an OMERS survivor benefit in the event of the death of an OMERS member.

Form 402 - Transferring funds to your AVC account

Use this form to transfer funds to your AVC account during the AVC transfer-in window. To process the transfer, you and your financial institution must also complete and sign the tax form included with this package.

Direct Deposit - U.S and U.K

Form 193 - U.K. direct deposit request

Use this form to have your OMERS pension payment deposited directly into your UK account.

Direct Deposit - U.S. and U.K.

Form 191 - USA direct deposit request

Use this form to have your OMERS pension payment deposited directly into your US account.

Additional Voluntary Contributions (AVCs)

Form 405 - Waiver of AVC spousal survivor benefits

Use this form to waive the right of a member's eligible spouse to receive a refund of the member's Additional Voluntary Contributions account balance in the event of the member's death.

Survivor Benefits

Form 151 - Waiver of joint and survivor pension

Use this form to waive OMERS spousal survivor benefits payable if a member dies after the commencement of the pension.

Survivor Benefits

Form 150 - Waiver of pre-retirement death benefit

A member’s spouse can use this form to waive the OMERS spousal survivor benefits payable if a member dies before the commencement of the pension.

Form 168 - Proof of eligible service

Use to confirm a member has eligible service in the OMERS plan.

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