pension
plan

Spousal Declaration Form

Use
At retirement, members should use the Spousal Declaration Form - BC to declare whether they have or do not have a spouse.

Information Needed to Complete the Form
To complete this form, the Member will need:

• Spouse's name and address (if spouse exists)
• Name, address and signature of a witness
• Photo-ID of witness, if no spouse exists

Notes
Questions on completing the form should be directed to the Plan Administrator.

Completed forms should be sent to the Plan Administrator.

Plan Administrator
Heat and Frost Local Union 118 Pension Plan Administrator
c/o D.A. Townley & Associates Ltd.
101 – 4190 Lougheed Highway
Burnaby, BC V5C 6A8

Phone: 604-299-7482 or 1-800-663-1356
Fax: 604-299-8136

Email: Pension