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Statement of Claimant – Spousal

Use
After the Plan Member has died, the Member's spouse, as beneficiary, should complete the Statement of Claimant – Spousal form to notify the Administrator of the Member's death and select how he/she wishes to receive the Member's pension benefit that has accumulated in the Plan.


Information Needed to Complete the Form
To complete the form, the spouse must provide:

  • Member's personal information
  • Spouse's personal information, and
  • Method of payment of pension funds.
The original death certificate (or a notarized copy) must be submitted with this form.

Depending on the method of payment selected by the spouse, additional forms may need to be submitted as outlined on the form or advised by the Plan Administrator.


Notes
If the beneficiary is not the Member’s spouse, the Statement of Claimant – Non Spousal should be used instead of this form.

Completed forms should be forwarded to the Plan Administrator.



Frequently Asked Questions
What do all these types of pension options mean?
  • You may wish to consult a personal financial advisor to determine which pension type best meets your needs.

Other questions on completing the form should be directed to the Plan Administrator.


Plan Administrator
Millworkers Pension Plan (Unifor) Administrator
c/o 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
Statement of Claimant – Spousal
 

Related Links
Statement of Claimant – Non Spousal
Death of the Member Information
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