R-15.1, r. 6 - Regulation respecting supplemental pension plans

Schedule Disposition versions

2018-01-04

SCHEDULE 0.3

(s. 16.2)

DECLARATION OF THE MEMBER OR THE SPOUSE

I declare:

(1) that I am not a party to any contract establishing a life income fund or locked-in retirement account or any registered retirement savings plan of which the balance must be converted into a life annuity (locked-in RRSP);

(2) that the total amount of the temporary pensions, variable benefits and temporary variable payments that I will receive during the current year under the following contracts:

(a) supplemental pension plans subject to or established by an act of the Parliament of Québec or any other legislative authority;

(b) annuity purchase contracts of which the capital comes directly or not from such a plan;

(c) the voluntary retirement savings plans governed by the Voluntary Retirement Savings Plans Act (chapter R-17.0.1) or an equivalent voluntary retirement savings plan emanating from a legislative authority other than the Parliament of Québec,

is $_______________.

__________(Date)__________ __________(Signature)__________

NOTE: Whosoever makes a false declaration with the intention of obtaining the lump-sum payment provided for in section 92 of the Act is subject to the penalties provided for in sections 257 and 262 of the Supplemental Pension Plans Act (chapter R-15.1).

O.C. 1681-97, s. 25; O.C. 173-2002, s. 68; O.C. 500-2014, s. 19; O.C. 1183-2017, s. 48.

2014-07-01

SCHEDULE 0.3

(s. 16.2)

DECLARATION OF THE MEMBER OR THE SPOUSE

I declare:

(1) that I am not a party to any contract establishing a life income fund or locked-in retirement account or any registered retirement savings plan of which the balance must be converted into a life annuity (locked-in RRSP);

(2) that the total amount of the temporary pensions and temporary variable payments that I will receive during the current year under the following contracts:

(a) supplemental pension plans subject to or established by an act of the Parliament of Québec or any other legislative authority;

(b) annuity purchase contracts of which the capital comes directly or not from such a plan;

(c) the voluntary retirement savings plans governed by the Voluntary Retirement Savings Plans Act (chapter R-17.0.1) or an equivalent voluntary retirement savings plan emanating from a legislative authority other than the Parliament of Québec,

is $_______________.

__________(Date)__________ __________(Signature)__________

NOTE: Whosoever makes a false declaration with the intention of obtaining the lump-sum payment provided for in section 92 of the Act is subject to the penalties provided for in sections 257 and 262 of the Supplemental Pension Plans Act (chapter R-15.1).

O.C. 1681-97, s. 25; O.C. 173-2002, s. 68; O.C. 500-2014, s. 19.

2012-09-01

SCHEDULE 0.3

(s. 16.2)

DECLARATION OF THE MEMBER OR THE SPOUSE

I declare:

(1) that I am not a party to any contract establishing a life income fund or locked-in retirement account or any registered retirement savings plan of which the balance must be converted into a life annuity (locked-in RRSP);

(2) that the total amount of the temporary pensions that I will receive during the current year under the following contracts:

(a) supplemental pension plans subject to or established by an act of the Parliament of Québec or any other legislative authority;

(b) annuity purchase contracts of which the capital comes directly or not from such a plan,

is $_______________;

__________(Date)__________ __________(Signature)__________

NOTE: Whosoever makes a false declaration with the intention of obtaining the lump-sum payment provided for in section 92 of the Act is subject to the penalties provided for in sections 257 and 262 of the Supplemental Pension Plans Act (chapter R-15.1).

O.C. 1681-97, s. 25; O.C. 173-2002, s. 68.