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 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 - Waiver of spousal survivor benefit

These forms are used to waive a survivor benefit in OMERS and replace the OMERS Form 156

FSCO Form 4 - Waiver of pre-retirement death benefit
applicable to pre-retirement death benefit
FSCO Form 3 - Waiver of joint and survivor pension
applicable to death after pension is in pay – must be signed within 12 months prior to pension commencement

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.

TD1- Personal tax credits return

Canada Revenue Agency federal and provincial forms for personal tax credits return

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.