Forms

Forms are available in PDF Format. Please print, complete and fax or mail to OMERS.

To avoid delays in processing, please ensure that all forms are filled out correctly and completely before returning to OMERS.

 

Form 107 - Changing Deferred Member Information

If you have a deferred OMERS pension, use this form to change or update the information OMERS has on file for you.

Form 108 - Changing Information (retired member/survivor)

Use to change your address, banking, tax or beneficiary information on file.

NOTE: You can change your address, direct deposit information or additional tax information online instead of Form 108. Change your information through our secure member service myOMERS

Form 141 - OMERS medical report - child's total disability

This form is to provide medical information to determine if a deceased member’s child qualifies for an OMERS benefit under the definition of “totally disabled child.”

Form 144 - Application for Retirement Pension - Deferred Members

If you have a deferred OMERS pension, use this form to apply for your OMERS retirement pension.

Form 146 - Application for a Shortened Life Expectancy Benefit

Use this form to apply for a shortened life expectancy benefit.

Form 147 - Medical Report - OMERS Total Disability Benefits

Completed by the member and doctor(s) for disability pension or disability waiver of contribution requests.

Form 148 - Forfeiting Rights to Disability Benefits

Completed by a member to give up rights to an OMERS disability benefit.

Form 150 - Waiver of Pre-retirement Death Benefit

A member’s spouse can use this form to waive the OMERS spousal survivor benefits payable if a member dies before the commencement of the pension. Please review “Waiver Forms for Spousal Survivor Benefits” attached to the form for further explanation. The form must be signed before the member’s death and provided to OMERS.

Form 151A -Waiver of Joint and Survivor Pension, Part A: Spousal Pension for a Retirement-Date Spouse and Form 151B - Waiver of Spousal Pension, Part B: Spousal Pension for a Post-Retirement-Date Spouse

Use this form to waive OMERS spousal survivor benefits payable if a member dies after the commencement of the pension. Please review “Waiver Forms for Spousal Survivor Benefits” attached to the forms for further explanation. Form 151A must be signed within 12 months prior to pension commencement. Form 151B must be signed before the member’s death.

Form 153 - Additional Information for a Disability Benefit Review

If you are receiving a disability benefit, OMERS may ask you to complete this form to ensure that you still qualify.

Form 154 - Death Benefit – Survivor Status Confirmation

This form is to confirm that the deceased member does not have an eligible spouse and/or child.

Form 155 - Declaration of Full-time Attendance at an Educational Institute

For an eligible child of a deceased OMERS member to confirm that they in full-time attendance at an educational institution.

Form 157 - Claim for Former Spouse Pension

Provides OMERS with your former spouse's personal, address and banking information.

Form 159 - Statutory Declaration of Common-law Relationship

Use this form to submit a claim that you are the common-law spouse eligible to receive an OMERS survivor benefit in the event of the death of an OMERS member.

Form 169 - Statutory Declaration for Proof of Eligible Service - Member

Use this form to confirm eligible service in the OMERS Primary Pension Plan, where, as a former employee, you have tried but are unable to obtain proof of your service from your former OMERS participating employer.

Form 190 - Request for a Pension Estimate

NOTE: You can use the OMERS Retirement Income Estimator instead of Form 190. Get your estimate in minutes through our secure member service: myOMERS.

Form 191 - USA Direct Deposit Request

Use this form to have your OMERS pension payment deposited directly into your US account.

Form 193 - U.K. Direct Deposit Request

Use this form to have your OMERS pension payment deposited directly into your UK account.

Form 206 - Beneficiary Information

Use this form to register or change your beneficiary on file with OMERS.

Form 401 - Automatic Contribution Plan

Use this form to start, change or stop automatic contributions to your AVC account.

NOTE: You can change start, change or stop automatic contributions to your AVC account online instead of Form 401. Use our secure member service myOMERS to start, change or stop automatic contributions.

Form 402 - Transferring Funds to your AVC Account

Use this form to transfer funds to your AVC account. To process the transfer, you and your financial institution must also complete and sign the tax form included with this package.

NOTE: Save time and start your transfer on the myOMERS secure member access site. Only one paper form is needed. myOMERS pre-populates the T2033 tax form with your information as well as OMERS transfer authorization and information. Form 402 isn’t needed because this information is entered online.

Form 403 - Withdrawing Funds from your AVC Account (Active Members)

Use this form to withdraw funds from your AVC account if you are an active member.

NOTE: You can withdraw funds from your AVC account through the myOMERS secure member access site. Your OMERS membership number and AVC account information are provided for you, and for non-locked-in funds, the withdrawal can be completed online.

Form 404 - Withdrawing Funds from your AVC Account (Retired and Deferred members under age 72)

Use this form to withdraw funds from your AVC account if you are a retired or deferred member and you have not yet turned age 72.

NOTE: Unless you're turning 71 this year, you can withdraw funds from your AVC account through the myOMERS secure member access site. Your OMERS membership number and AVC account information are provided for you, and for non-locked-in funds, the withdrawal can be completed online.

Form 405 - Waiver of AVC Spousal Survivor Benefits

Use this form to waive the right of a member's eligible spouse to receive a refund of the member's Additional Voluntary Contributions account balance in the event of the member's death.

Form 406 - AVC Catch-up Payments

Use this form to make a payment to catch up on your automatic contributions to your AVC account.

Form 410 - AVC Income Option Direct Deposit for Withdrawals

Use this form to set up or change direct deposit for withdrawals from your AVC account, beginning the year in which you turn age 72.

Form 411 – AVC Income Option Withdrawal (Members Age 72 and Older)

Use this form if you participate in the AVC Income Option and wish to make an optional withdrawal from your AVC account.

Employed OMERS Retiree Election Form

Use to record a retired member's enrolment election.

TD1 – Personal Tax Credits Return

TD1- Personal tax credits return >
Canada Revenue Agency federal and provincial forms for personal tax credits return.
TD1 Déclaration des crédits d'impôt personnels >

Direction to Administrator

The Pension Benefits Act (PBA) form is required for locked-in commuted value transfers.

T2033 - Direct Transfer

Canada Revenue Agency form T2033 required for a transfer to OMERS from an RRSP or LIRA.

T2151 - Direct Transfer of a Single Amount (Canada Revenue Agency form

Canada Revenue Agency form T2151 required for a transfer of your OMERS benefit to a registered pension plan, LIRA, LIF, RRSP, or RRIF.

Information Request - Retired Member Spouse

If you are a retired member use this form to provide OMERS with your spouse’s / common-law spouse’s information, along with your contact details.

Income Comparison Worksheet: Before/After Retirement

This form will help you calculate what you can expect to receive after you retire, based on your income before retirement.

Location of Valuable Papers and Assets

This form is designed to help you and your family keep track of your important documents so they can be found quickly when needed.