1. Any application to Retraite Québec to obtain a statement of the member’s or former member’s benefits, referred to in section 122.1 of the Act respecting the Government and Public Employees Retirement Plan (chapter R-10), must contain the following information and be accompanied by the following documents:(1) the name, address, social insurance number and date of birth of the member or former member and of his or her spouse;
(2) in the case of married spouses, a marriage certificate and, where applicable, the date on which the spouses resumed living together;
(2.1) in the case of spouses in a civil union, a certificate of civil union;
(3) a written confirmation from a certified mediator to the effect that he or she has obtained a mandate of family mediation or written confirmation from a notary that the civil union spouses have initiated a joint procedure for the dissolution of their union or, as the case may be, a joint declaration dissolving the civil union and the notarized transaction contract, or a copy of the application for separation from bed and board, divorce, annulment of marriage or civil union, dissolution of civil union or payment of a compensatory allowance or, where applicable, a copy of the judgment ruling on such an application; and
(4) the information that must be provided by the employer in its annual report, in accordance with the provisions of the Régime de retraite des membres de la Sûreté du Québec, 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.