Application for a Statement of Benefits in the Course of a Dissolution of a Civil Union Before a Notary

No form is offered. This application for a Statement of Benefits regarding a voluntary retirement savings plan (VRSP) or a supplemental pension plan in the private, municipal or university sectors concerns couples who:

• are in a civil union
• have stopped living together
• have taken steps with a notary for a dissolution of a civil union.

The person must provide the plan administrator with:

• the name and address of the member
• the name and address of the spouse
• proof of the date of the civil union
• the declaration, signed by the couple, of the date on which the net value of the family patrimony was established
• the written confirmation from a notary who obtained a mandate to take steps for a dissolution of a civil union.

If needed, consult the table of forms for requesting a Statement of Benefits.