55. The statement that the administrator of a plan must send to the spouse of a deceased member or to his successors, in accordance with paragraph 3 of section 95 of the Act, must contain:(1) the name of the deceased member and his date of death;
(2) for the period elapsed since the last statement received in accordance with paragraph 1 of section 95 of the Act until the date of the member’s death, the information provided for in subparagraphs 1 to 11 and 15 of the first paragraph of section 53;
(3) the individual who, based on the information at the administrator’s disposal, is entitled to the amounts credited to each of the member’s accounts and in what capacity;
(4) the terms for payment;
(5) the fees for refunds or transfers.