1.1.Any application for a statement referred to in section 63.1.1 of the Act must be signed by the council member or former council member and his spouse. The application must contain the following information and be accompanied with the following documents:
(1) the name, address, Social Insurance Number and date of birth of the council member or former council member and of his spouse;
(2) an attestation by the council member or former council member and his spouse that neither was married or in a civil union on the date on which they ceased living together and, where applicable, the date of the divorce or the dissolution of the civil union and the documents attesting thereto, unless those documents have already been sent to Retraite Québec;
(3) an attestation by the council member or former council member and his spouse of the dates on which they began and ceased living together and, where applicable, proof that they were in a conjugal relationship. Furthermore, if the spouses lived in a conjugal relationship for at least 1 year but not more than 3 years preceding the date on which they ceased living together, they must also attest that a child was born or is to be born of their union and, where applicable, provide proof thereof;
(4) the information that must be provided by the employer in his annual report, in accordance with section 188 of the Act respecting the Government and Public Employees Retirement Plan (chapter R-10), for the year during which the assessment is determined up to the date set for that assessment, as well as for the previous year; that information must be certified by an authorized representative of the employer.