Forms

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 141 - Certificate of 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- Certificate of total disability

• 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 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 156 - Member’s spouse disclaimer of all OMERS death benefits

• By completing this form, a member’s spouse waives their rights to any death benefits from the OMERS plan.

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 160 - Service purchase application form

• Completed by a member and the current and/or past employer(s) for a service purchase or normal retirement age conversion and for proof of previous earnings and service. (Incorporates old Forms 161 and 162).

Form 190 - Request for a pension estimate

• Use to request an estimate for a normal or early retirement pension, a disability pension, or a separation (marital breakdown) estimate.

Form 206 - Beneficiary information

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

Direction to administrator

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

T2033 - Direct transfer (under paragraph 146(16)(a) or 146.3 (2)(e) of the Income Tax Act Canada Revenue Agency form (T2033))

• 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 (T2151))

• Canada Revenue Agency form T2151 required for a transfer from OMERS to an RRSP, LIRA or registered pension plan.