Disponible en français Application for a Canada …

Service Protected when completed - B. Canada Personal Information Bank HRSDC PPU 146. Disponible en fran ais Application for a Canada Pension Plan Death Benefit It is very important that you: - send in this form with supporting documents (see the information sheet for the documents we need); and - use a pen and print as clearly as possible. FOR OFFICE USE ONLY. SECTION A - INFORMATION ABOUT THE DECEASED. 1A. Social Insurance Number 1B. Date of Birth 1C. Country of Birth (If born in Canada , AGE ESTABLISHED. Year Month Day indicate province or territory). AA. 2A. Sex 2B. Date of Death ESTABLISHED PROV. DATE OF DEATH CODE. (See the information sheet for a list of Year Month Day Male Female acceptable proof of date of death documents). AA. 3. Marital status at the time of death SURNAME - VALIDATOR. (See the information sheet for important Single Married Separated information about marital status). Surviving spouse or Common-law Divorced common-law partner AR.

Service Canada. Application for a Canada Pension Plan Death Benefit. Service Canada delivers Human Resources and Skills Development Canada programs and services for the Government of Canada.

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