Forms
Below you will find a listing of our commonly used forms.
See instructions on how to complete and submit OPB's online forms.
OPB
OPB1004 – Retired Member Information Change (PDF)
OPB1004 – Agricorp Retired/Survivor or Deferred Information Change (PDF)
OPB1004 – ONTC Retired/Survivor or Deferred Information Change (PDF)
OPB1004 – TVO Retired/Survivor or Deferred Information Change (PDF)
OPB1006 – Increased Survivor Pension Application (PDF)
OPB1011 – Certificate of Health (PDF)
OPB 1015 – Beneficiary Designation (on e-services)
(you will be directed to e-services to complete your beneficiary designations online)
OPB1031 – Declaration of Attendance at School, College or University (PDF)
OPB1043 – Application to Purchase Pension Credit (PDF)
OPB1046 – Waiver of Basic Life Insurance Coverage (PDF)
OPB1048 – Locking-in Agreement for Funds Transferred from the PSPP to a LIRA/LIF (PDF)
OPB1057 – Termination of Optional Membership (PDF)
OPB1058 – Application to Transfer Pension Credit (PDF)
OPB1060 – Designating Life Insurance Beneficiaries (PDF)
OPB1061 – Member/Former Member Information Change (PDF)
OPB1062 – Survivor's Contact Information (PDF)
OPB1068 – Application for a Survivor Pension (PDF)
OPB1086 – Annual Per Diem Earnings Report for Retired Justices of the Peace (PDF)
OPB1095 – U.S. Direct Deposit Authorization (PDF)
OPB1096 – Foreign Direct Deposit Authorization (PDF)
OPB1121 – Insured Benefits Optional Upgrade Package Application (PDF)
OPB1122 – Post-Retirement Insured Benefits Application (PDF)
OPB1137 - Supplementary Life Insurance and Optional Upgrade Package Change (PDF)
OPB1151 - Temporary Part-Time Work Arrangement Application to Purchse Pension Credit (PDF)
OPB3001 – Disability Pension Application (PDF)
OPB3002 – Employer's Statement on Disability (PDF)
OPB3003 – Medical Examination Report (PDF)
OPB3007 – Declaration of Spousal Status (PDF)
OPB3008 – Physical Demands Analysis (PDF)
OPB3010 – Affidavit of Spousal Status (PDF)
OPB3011 – Application for a Survivor Pension for a Disabled Dependant (PDF)
OPB3012 – Financial Disclosure Report for a Disabled Dependant (PDF)
OPB3013 – Medical Examination Report for a Disabled Dependant (PDF)
OPB3017 – Registration of a Disabled Dependant (PDF)
Cowan
Cowan – Consent to Medical/Physical Information for Disability Pension (PDF)
Cowan – Consent to Medical/Physical Information for Disabled Dependant Pension (PDF)
FSCO/FSRA Waivers
FSCO Form 3 - Waiver of Joint and Survivor Pension
(opens in a new tab)
FSCO Form 4 - Waiver of Pre-Retirement Death Benefit(opens in a new tab)
FSRA Family Law
Application for Family Law Value (Family Law Form FL-1)(opens in a new tab)
Spouse’s Application for Transfer of a Lump Sum (Family Law Form FL–5)(opens in a new tab)
Spouse’s Application to Divide a Retired Member’s Pension (Family Law Form FL-6)(opens in a new tab)
Canada Life
Legacy Plan: Premium Free (plan #157836)
M445D Dental Benefits Claim (PDF)
M635D Supplementary Health and Hospital Claim (PDF)
Legacy Plan: 50% co-pay (plan #169493)
M445D Dental Benefits Claim (PDF)
M635D Supplementary Health and Hospital Claim (PDF)