pension
plan


	Declaration of Applicant on Removal of Funds

	Use The Declaration of Applicant for Removal of Funds form must be completed if you have terminated from the Pension Plan and want to withdraw your pension funds from the Plan.

	Information Needed to Complete the Form The Plan Member must sign and date the form and then have a witness sign the form.

	Notes To withdraw your Pension funds, you must also complete the Application for Withdrawal of Pension Contributions form. Questions on completing the form should be directed to the Plan Administrator. Completed forms should be forwarded to the Plan Administrator.

	Plan Administrator D.A. Townley. 160 – 4400 Dominion Street Burnaby, BC V5G 4G3 Phone: 604-299-7482 or 1-800-663-1356 Fax: 604-299-8136 Email: Pension

Form Link

pensionplan