Régie des rentes du Québec

Forms for spouses concerning supplemental pension plans

  • Our PDF forms can be printed and the majority of them can also be completed on screen. However, you must have Acrobat Reader This link will open in a new window., version 7 or later.  Some documents are not available online but can be ordered.
  • There are several ways to obtain our forms.

Forms related to partition of the benefits accumulated in a supplemental pension plan

To help you with the procedures involved in the partition of benefits accumulated in a supplemental pension plan, the Régie des rentes du Québec can provide you with forms to fill out and then send to the plan administrator, not to the Régie.

Two kinds of forms are provided:

  • Applications for a statement of benefits (forms 1, 2, 3 and 4)
  • Applications for partition of benefits (forms 5 and 6)


Application forms for a statement of benefits, depending on your situation

Situation of the spouses

Number and title of the form

Benefits evaluation date

Married

In the course of family mediation

With or without institution of an action* 

1. Application for a Statement of Benefits in the Course of Family Mediation  

Date of the end of the conjugal relationship  

Married

Not in the course of family mediation

With or without institution of an action*

2. Application for a Statement of Benefits that May be Issued at the Plan Administrator's Discretion

(The administrator is not required to provide the statement)

Date of the end of the conjugal relationship

Married

Whether or not in family mediation 

With institution of an action*

3. Application for a Statement of Benefits Following Institution of the Action*

Date of institution of the action*

Former de facto (common law) spouses

4. Application for a Statement of Benefits for Former De Facto (Common Law) Spouses

Date of the end of the conjugal relationship


* Institution of an action for divorce, separation from bed and board or civil annulment of marriage. The date of institution of an action is the date on which the application is filed with the Court.

The plan administrator can charge a fee for issuing a statement. The fee varies depending on the type of plan or application. For example, for a defined benefit plan, the fee required for statements 1, 3 or 4 cannot exceed 250 $, of which each spouse pays 125 $



Application forms for partition of benefits, depending on your situation

Situation of the spouses

Number and title of the form

Former married spouses

5. Application for Partition after a Marriage Breakdown

Former de facto (common law) spouses

6. Application for Partition Between Former De Facto (Common Law) Spouses


The plan administrator can charge a fee for processing an application for partition. The fee varies depending on the type of plan. For example, for a defined benefit plan, the fee cannot exceed 150 $, of which each spouse pays 75 $.

Spouses

Form 1

Application for a Statement of Benefits in the Course of Family Mediation

Supplemental pension plan
RCR135 form. Last update: October 2006.

Form 2

Application for a Statement of Benefits that May be Issued at the Plan Administrator's Discretion

Supplemental pension plan
RCR136 form. Last update: October 2006.

Form 3

Application for a Statement of Benefits Following Institution of the Action

Supplemental pension plan
RCR137 form. Last update: October 2006.

Form 4

Application for a Statement of Benefits for Former De Facto (Common Law) Spouses

Supplemental pension plan
RCR138 form. Last update: October 2006.

Form 5

Application for Partition after a Mariage Breakdown

Supplemental pension plan
RCR139 form. Last update: October 2006.

Form 6

Application for Partition Between Former De Facto (Common Law) Spouses

Supplemental pension plan
RCR140 form. Last update: October 2006.

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