67.7. The declaration provided for in section 88.1 of the Act is made in written form, signed by the waiving spouse and contains:(1) the date of the declaration;
(2) the names and addresses of the member and the waiving spouse;
(3) the name of the member’s pension plan and the number assigned to it by Retraite Québec;
(4) the name of the member’s employer;
(5) an indication of each benefit that the spouse declares to be waived, that is, the benefit provided for in section 86 of the Act or the pension provided for in section 87 or 88 of the Act.