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PDF Fillable/saveable: Form VB 4 (size 1.2 Mb)
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Last Update: June 2020
Form No.: PF-102E
Title: Spousal Waiver of Death Benefit from a Variable Benefit Account Form VB 4 (Under Section 39.1.1(14) of the Pension Benefits Act)
Purpose of Form: This Form is to be used by a spouse who wishes to waive the right to receive a death benefit from a retired member’s variable benefit account.
Instructions on How to Use the Form: Instructions are included in the form.