To use these forms, you must download them using a desktop or laptop computer and have Adobe reader installed.

To download and open the form to your desktop:

  1. Right click the link to the form and select save link as and save the form to your desktop.

    (To do this with a keyboard, tab to the link of the form. Hold down SHIFT and press F10. Then select save link as... and save the form to your desktop) 
     
  2. Open the form by right clicking and select open with... and select Adobe reader.

    (Use your operating systems keyboard shortcut to use the open with command and open with Adobe reader. NOTE: Using the keyboard only may require you to open Adobe reader then open the form)

Form Categories

Registration | Reporting | Member | Pension Unlocking | Financial Hardship Unlocking | Wind Up | Family Law | PRPPs | Variable Benefits | Other

Registration Form

Form 1 - Application for Registration of a Pension Plan: Use this form to apply to the Superintendent for registration of a new pension plan.

NewCheques made payable to FSRA. See updated payment information in the User Guide.

Form | User Guide

Form 1.1 - Application for Registration of a Pension Plan Amendment: Use this form to register a pension plan amendment with the Superintendent.

Form (PDF)

Form 1.2 - Individual Pension Plan Certification: Use this form to certify that the pension plan is an Individual Pension Plan under the Income Tax Act (Canada) for purposes of the Pension Benefits Act.

Form (PDF)

Reporting Forms

Effective January 1, 2013, certain prescribed filings required to be filed with the Superintendent must be filed electronically through the Pension Services Portal (PSP).

Effective December 11, 2019, section 76 of Regulation 909 was amended to increase the threshold for audited financial statements from $3 million to $10 million. For plans with a market value of assets as at the plan’s fiscal year end below $10 million, financial statements are still required to be filed, but are not required to be audited.

Form 2 - Annual Information Return (AIR)

Specimen Form ​(PDF)

Instructions: PDF | Accessible document​ 

Form 2.1 - Pension Benefits Guarantee Fund Assessment Certificate (PBGF)

To be used by plans filing with respect to a PBGF assessment date prior to January 1, 2019. 
NewCheques made payable to Pensions Benefit Guarantee Fund. See updated payment information in the User Guide.  

Specimen Form​ (PDF)
Instructions: PDF | Accessible document
(Revisions to box 301 - letter of credit amount to be excluded when calculating solvency assets) 

Form 2.2 - Pension Benefits Guarantee Fund (PBGF) Assessment Certificate 

To be used by plans filing with respect to a PBGF assessment date on or after January 1, 2019. 

Specimen Form (PDF)
Having trouble downloading this form? See Downloading and viewing dynamic forms.
User Guide 

Form 7 - Summary of Contributions/Revised Summary of Contributions: To be used by pension plan administrators and submitted to the pension fund trustee(s).
Form (Accessible PDF)
Having trouble downloading this form?  See Downloading and viewing dynamic forms.
User Guide: ​PDF | Accessible version

Non Remittance Reporting: To be used by pension fund trustee(s) and submitted to FSRA
Non-receipt of FSRA Form 7: ​Accessible PDF
Non-Remittance Reporting/Variance Reporting: ​Accessible PDF

Form 8 - Investment Information Summary: To be used by plan administrators of defined benefit pension plans other than designated plans, and filed with the Superintendent
Instructions: PDF | Accessible document
Specimen Form: ​PDF | ​Accessible document

Form 9 - Actuarial Information Summary: FSCO developed this form in collaboration with the Canada Revenue Agency and Retraite Québec. The AIS has now been updated to include, amongst other things, the new Ontario funding rules that came into effect in May 2018. The AIS must be filed in conjunction with a corresponding funding valuation report (Report), if the associated Report is required under sections 3, 4, 13 or 14 of Regulation 909, R.R.O. 1990. The Pension Services Portal has also been updated with the revised AIS and it will remain in effect after the launch of the Financial Services Regulatory Authority. 

Form 10 - Request for Superintendent's Approval of Commuted Value Transfers: Should be used by the pension plan administrator to obtain the Superintendent’s approval before transferring any funds under sections 42 or 43 of the Pension Benefits Act. It applies to situations where the administrator knows, or ought to know, that the transfer ratio in the most recently filed valuation report has declined by 10% or more.
Form (PDF)

Form 11 - Letter of Credit Certificate: Should be submitted with the letter of credit/notice of renewal.
Form (Accessible PDF)
User Guide:  PDF | Accessible version  

Form 14 - Statement of Investment Policies and Procedures (SIPP) Information Summary: The administrator must file Form 14 and a SIPP for each registered pension plan that it administers. A SIPP must be filed 60 days after a new plan is registered.  It does not need to be filed annually, but an amendment to the SIPP must be filed  within 60 days of the amendment.   
Form (Accessible PDF)
User Guide: PDF | Accessible version

DFC-1 Election Form to Defer Certain Contributions

DFC-2 Schedule to Defer Certain Contributions

DFC-3 Statutory Declaration For Contribution Deferral

Member Forms

Form 3 - Waiver of Joint and Survivor Pension: This form must be used by pension plan members and former members and their spouses to waive entitlement to a joint and survivor pension. Note: the definition of "spouse" has been amended effective January 1, 2017.
Form: PDF  | ​Accessible document   

Form 4 - Waiver of Pre-Retirement Death Benefit: This form must be used by spouses of pension plan members and former members to waive entitlement to a pre-retirement death benefit.  Note: the definition of "spouse" has been amended effective January 1, 2017. 
Form: ​PDF | Accessible document

Form 4.1 - Waiver of Survivor’s Benefit from an Ontario Locked-in Account -LIRA, Old LIF, New LIF OR LRIF: This form must be used by the spouse of the owner of an Ontario locked-in account to waive his/her right to receive any survivor’s benefit.  Note: the definition of "spouse" has been amended effective January 1, 2017.
Form (​PDF)

Form 4.2 – Waiver of Survivor Benefit from a Registered Pension Plan by Spouse of Non-resident Former Member: This form must be used by spouses of non-resident former members to waive entitlement to a survivor benefit if the pension plan allows unlocking by non-resident former members. Note: the definition of "spouse"  has been amended effective January 1, 2017.
Form (Accessible PDF)

Pension Unlocking Forms

Form 5 - Application to Withdraw or Transfer Money from an Ontario Locked-in Account

Form 5.2 - Application to Withdraw or Transfer up to 50% of the Money Transferred into a Schedule 1.1 LIF

Financial Hardship Unlocking Forms

The owner of an Ontario locked-in account must complete and submit the form to the financial institution which holds and administers the locked-in account. There are four Forms; one for each category of financial hardship. All applications must be made based on one of these four categories. Applications can be made under different categories but the form that applies to that category must be used. Note: the definition of "spouse" has been amended effective January 1, 2017.

Financial Hardship Unlocking – FORM FHU 1 Application for Medical Expenses, including Renovations to a Principal Residence for Medical Reasons

Financial Hardship Unlocking – FORM FHU 2 Application for Arrears of Rent or Secured Debt (Mortgage) on a Principal Residence 

Financial Hardship Unlocking – FORM FHU 3 Application for First and Last Months’ Rent for a Principal Residence

Financial Hardship Unlocking – FORM FHU 4 Application for Low Expected Income

Financial Hardship Unlocking - User Guide for Financial Institutions

Wind Up Forms

For Defined Benefit Plans:

For Defined Contribution Plans: 

Family Law Forms

The Family Law Forms page provides detailed information on these Forms. 
Note: the definition of "spouse" has been amended effective January 1, 2017 

FSCO Family Law Form 1 - Application for Family Law Value

FSCO Family Law Form 1A - Plan Administrator Request for Information/Payment of Fee

FSCO Family Law Form 2 - Joint Declaration of Period of Spousal Relationship

FSCO Family Law Form 3 - Contact Person Authorization

FSCO Family Law Form 4A - Statement of Family Law Value (Defined Contribution Benefit)

FSCO Family Law Form 4B - Statement of Family Law Value (Active Plan Member with a Defined Benefit)

FSCO Family Law Form 4C - Statement of Family Law Value (Active Plan Member with a Combination Benefit)

FSCO Family Law Form 4D - Statement of Family Law Value (Former Plan Member with a Defined Benefit or a Combination Benefit)

FSCO Family Law Form 4E - Statement of Family Law Value (Retired Member with a Defined Benefit Pension)

FSCO Family Law Form 5 - Application to Transfer the Family Law Value

FSCO Family Law Form 6 - Application to Divide a Retired Member's Pension

FSCO Family Law Form 7 - No Division of Family Law Value/Pension Assets

FSCO Family Law Form 8 - Post-retirement Waiver of Joint and Survivor Pension by the Former Spouse of a Retired Member on Spousal Relationship Breakdown

Pooled Registered Pension Plans

​The Office of the Superintendent of Financial Institutions (OSFI) is the regulatory authority responsible for supervising Ontario members of Pooled Registered Pension Plans (PRPP). However, the PRPP legislation requires the use of Financial Services Commission of Ontario (FSCO) forms.

Family Law: When PRPP assets are to be valued and/or divided on marriage breakdown, PRPP Administrators and members/spouses must use the following FSCO family law forms.

Member/Spouse forms:

PRPP Administrator form:

Pension Unlocking: Use this form if you have transferred money from a PRPP into a locked-in account with an Ontario financial institution and wish to withdraw or transfer this money.

For important information on the specific situations in which to use this form and details of other supporting documentation that may be required, refer to page 1 of this form.  

OSFI PRPP Form 1 and OSFI PRPP Form 3 are available under the Schedule [New Window] to the federal Pooled Registered Pension Plans Regulations.

  • OSFI PRPP Form 1: Certification Regarding Withdrawal Based on Financial Hardship 
  • OSFI PRPP Form 3: Certification of Total Amount Held in Locked-In Plans 
Please contact the Office of the Superintendent of Financial Institutions (OSFI) for all inquiries related to PRPPs, including questions about PRPP forms.

Nortel

Form 5.3 - Nortel Ontario Beneficiary Direction, Consent and Waiver Form - To be used to exercise the entitlement to transfer the commuted value of the pension benefit into a Nortel Life-Income Fund, if the individual is receiving pension benefits from the: 

  • Nortel Networks Limited Managerial and Non-Negotiated Pension Plan, Registration No. 0342048; or
  • Nortel Networks Negotiated Pension Plan, Registration No. 0587766; 

Form (PDF)
Instructions (PDF)
Qs & As (PDF)
 

Variable Benefits

Please visit FSRA’s Variable Benefits page for more information. Note: the definition of "spouse" has been amended effective January 1, 2017.

Form VB 1 - Waiver of Joint and Survivor Pension – Variable Benefit Account

Form VB 2 - Application to Withdraw or Transfer up to 50% of Amount Transferred to a Variable Benefit Account

Form VB 3 - Direction of Retired Member to Transfer an Amount out of a Variable Benefit Account

Form VB 4 - Spousal Waiver of Death Benefit from a Variable Benefit Account

Form VB 5 - Direction of Spouse as Specified Beneficiary to Continue Receiving Variable Benefit Payments

Form VB 6 - Direction of Spouse as Specified Beneficiary to Transfer an Amount out of a Variable Benefit Account

PBA Exemption Election Form and Consent Forms for IPPs or DPs

Form 15 – PBA Exemption Election Form

Form 15.1 – Consent Form: Member

Form 15.2 – Consent Form: Spouse

Form 15.3 – Consent Form: Other Person