Section contents 13 Forms Section 13 Forms Municipal Pension Plan September 29, Employer Instruction Manual

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Section Contents 13 Forms Employee Information at Termination or Retirement 3 Claim and Request for Information and Notice 5 Group Disability Plan Application 7 Nomination of Beneficiary 8 Pension Application 10 Pension Enrolment Election 11 Purchase of Service Application Package 13 Reinstatement of a Refund Request for Cost 17 Remittance 18 Retirement Planning Package and Estimate Request 20 Spousal Declaration 25 Spouse s Waiver of 60% Lifetime Survivor Benefit and/or Beneficiary Rights from a Pension Plan or Annuity after payments start 27 Spouse s Waiver of Beneficiary Right to Benefits in a Pension Plan, Locked-in Retirement Account, Life Income Fund or Annuity before payments start 31 Termination of Group Disability Plan Benefits 34 Waiver of Pension Coverage 35 13-1

Amended Employee Information at Termination or Retirement The form below is a sample. If submitting the form, please use the fillable version available on the secure employer login forms page. INSTRUCTIONS: Read page 2 before completing this form. Only complete this form to amend data submitted online. AMENDED EMPLOYEE INFORMATION AT TERMINATION OR RETIREMENT MUNICIPAL PENSION PLAN CORPORATION USE ONLY PERSON ID EMPLOYEE LAST NAME FIRST AND MIDDLE NAME(S) PREVIOUS LAST NAME(S) (if applicable) PERMANENT MAILING ADDRESS (include street, city or town, province and postal code) HOME PHONE (include 10 digits) MSP COVERAGE CANCELLATION DATE YYYY - MM - DD EMPLOYER ORGANIZATION NAME DATE OF BIRTH YYYY - MM - DD EHB COVERAGE CANCELLATION DATE EMPLOYEE GROUP YYYY - MM - DD ORG ID SOCIAL INSURANCE NO. DENTAL COVERAGE CANCELLATION DATE EMPLOYEE SALARY, SERVICE AND CONTRIBUTION INFORMATION (ESSC) Indicate correct salary, service and contributions below. See the following page for sample data. SERVICE EVENT TYPE (RG, RT or RH) Add another row SPECIAL AGREEMENT EXISTS NO YES Add another row COMMENTS PENSIONABLE SALARY ($) PENSIONABLE SERVICE (up to 4 decimals) CONTRIBUTORY SERVICE (2 digits) CONTACT PHONE person who can answer questions about this completed form (include ten digits and extension, if applicable) CONTRIBUTIONS ($) Fax 250 953-0421 Email MPP@pensionsbc.ca DATE OF TERMINATION YYYY - MM - DD EFFECTIVE START DATE YYYY - MM - DD EMPLOYEE SPECIAL AGREEMENT ($) EMPLOYER SPECIAL AGREEMENT ($) START DATE (if applicable) YYYY - MM - DD EMPLOYER CERTIFICATION Certified that all final adjustments have been included? SAMPLE YYYY - MM - DD EFFECTIVE END DATE YYYY - MM - DD END DATE (if applicable) YYYY - MM - DD (fillable form accessible on secure Employer Login forms page) AUTHORIZED SIGNING OFFICER (print name) AUTHORIZED SIGNING OFFICER TITLE DATE COMPLETED YYYY - MM - DD? - - Send to Employer within Employer Send to Municipal P Print Form Clear Form PC/MPP 2015-085 (Page ) 2015.10.07 13-3

INSTRUCTIONS This form is to be completed by the employer to amend previously submitted data. The completed form must be received in the Plan as soon as the discrepancy has been identified. Contact the Plan if you have any problems with this timeline. Refer to Section 7 of the employer manual for detailed instructions on reporting payroll information. The amounts and service reported must be the same as those that appear on the payroll report. SAMPLE DATA: EMPLOYEE SALARY, SERVICE AND CONTRIBUTION INFORMATION Indicate correct salary, service and contributions below. SERVICE EVENT TYPE (RG, RT or RH) PENSIONABLE SALARY PENSIONABLE SERVICE (up to 4 decimals) If reporting retroactive (RT) or rehabilitative (RH) salary, report the RT or the RH salary and contributions on a separate line. Indicate start and end date for the retroactive or rehabilitative period, as well as the paid date for the RT or the RH salary. The employer is responsible for any errors reported in salary, service and contributions section. For assistance, see sample data below: CONTRIBUTORY SERVICE (2 digits) CONTRIBUTIONS EFFECTIVE START DATE YYYY - MM - DD EFFECTIVE END DATE YYYY - MM - DD RG $ 71,500 12 12 $ 5,362.35 2013-12 - 27 2014-12 - 25 RT $ 5,400 $ 377.46 2013-01 - 01 2014-07 - 31 RG $ 4,707.79 1 $ 329.02 2014-12 - 26 2015-01 - 22 RH $ 560.094 3 $ 47.60 2015-01 - 23 2015-04 - 30 EMPLOYEE SPECIAL AGREEMENT (If applicable) EMPLOYER SPECIAL AGREEMENT (If applicable) START DATE (if applicable) END DATE (if applicable) $ 1,579.70 $ 1,759.59 2013-12 - 27 2014-12 - 25 $ 104.00 $ 115.83 2014-12 - 26 2015-01 - 22 COMMENTS Retro paid 2015-04 - 30 DEFINITION OF TERMINATION OF EMPLOYMENT For purposes, an employee has terminated employment with your organization when the member has ceased employment, and in the case of a member who is receiving group disability (LTD) benefits and is no longer contributing to the pension fund, the LTD benefits must end. An employee who is on layoff, with a right to be recalled to work, is not considered terminated for pension purposes. An Employee Information at Termination or Retirement should not be completed if the above condition exists. Refer to Section 3 of the employer manual for more information on termination of employment. SAMPLE CONTACT INFORMATION Victoria 250 953-3000 PO Box 9460 Toll-free in Canada/U.S. 1 800 668-6335 Victoria BC V8W 9V8 Fax 250 953-0421 Location 2995 Jutland Road, Victoria Web mpp.pensionsbc.ca (fillable form accessible on secure Employer Login forms page) Freedom of Information and Protection of Privacy Act The personal information on this form is collected under the authority of the Public Sector Pension Plans Act and will be used by the Pension Corporation to administer a plan member s pension and other non-pension benefits. If you have any questions about the collection and use of this information, contact the Privacy Officer at 2995 Jutland Road, Victoria BC V8T 5J9 or by telephone at 250 387-1002. PC/MPP 2015-085 (Page ) 2015.10.07 13-4

Claim and Request for Information and Notice The form below is a sample. If submitting the form, please use the fillable version available on the public forms page by clicking here. FORM P1 (Division of Pensions Regulation, s.4 (a)) CLAIM AND REQUEST FOR INFORMATION AND NOTICE When to Use this Form A Form P1 is used by a spouse who is making a claim to an interest in the member s/annuitant s benefits. After this form is delivered to the administrator/annuity issuer, the spouse is entitled to receive information from the administrator/annuity issuer about the benefits, and 30 days advance notice of changes of circumstances affecting the benefits. [Please print] To: Administrator of plan/annuity issuer Name of plan/annuity From: Spouse of member/annuitant [Note: spouse includes a person who has lived in a marriagelike relationship with the member/annuitant for a continuous period of at least two years and also includes a former spouse.] Name of spouse Address Email address Telephone (home) (work) Social Insurance Number [The administrator/annuity issuer will use this information to contact you about important matters. Make sure it is accurate and that you promptly advise the administrator/annuity issuer of any changes.] In relation to: Plan member/annuitant Name of member/annuitant Address Email address Telephone (home) (work) Social Insurance or Plan Identity Number Employer Declaration of spouse claiming interest PO Box 9460 Victoria BC V8W 9V8 Address of administrator/ annuity issuer I, [name of spouse] am claiming an interest in the benefits of the member/annuitant based on section 81 of the Family Law Act. [see below] In support of that claim, I declare that (a) I began living in a marriage-like relationship with the member/annuitant on [date], (b) I was married to the member/annuitant on [date), and (c) I was separated from the member/annuitant on [date]. PC/MPP 2013-027 FORM P1(prescribed) (Page 1) 2013.02.22 13-5

[You are not required to authorize the administrator/annuity issuer to communicate with a representative. If you wish to authorize that communication, you must complete the following, otherwise, the administrator/annuity issuer cannot communicate with your representative.] I authorize you to communicate with and release information to my representative(s): [include name(s) and address(es) of representative(s)] This authorization expires on [date]. Signed (spouse) Date of Declaration Signed (witness to signature of spouse) Name of witness Address of witness Family Law Act, section 81: 81 Subject to an agreement or order that provides otherwise and except as set out in this Part and Part 6 [Pension Division], (a) spouses are both entitled to family property and responsible for family debt, regardless of their respective use or contribution, and (b) on separation, each spouse has a right to an undivided half interest in all family property as a tenant in common, and is equally responsible for family debt. PC/MPP 2013-027 FORM P1(prescribed) (Page 2) 2013.02.22 13-6

Group Disability Plan Application The form below is a sample. If submitting the form, please use the fillable version available on the public forms page by clicking here. instructions: Complete this form to request approval of: a long term disability (LTD) plan new to the work place, or a change of LTD policy carrier, or an amendment to an LTD plan (for example, the employee classes covered by the LTD plan have changed or the benefits have altered). attach the relevant pages of the ltd plan (see below for details). employer Name Group Disability plan application (for ) org id employer No. Corporation use only policy branch municipal pension plan Pension Corporation PO Box 9460 Victoria BC V8W 9V8 Web mpp.pensionsbc.ca Victoria 250 387-8297 Fax 250 953-0424 E-mail Policy@pensionsbc.ca employer address (include postal code) Previous Carrier Name (if applicable) Previous CoNTraCT No. employee Classes CovereD By Previous ltd PlaN DaTe CoNTraCT TermiNaTeD yyyy / mm / DD New Carrier Name (include name of third-party administrator, if applicable) New CoNTraCT No. employee Classes CovereD By ltd PlaN DaTe effective yyyy / mm / DD Gross monthly salary of highest paid employee covered by LTD plan Group Disability plan The Rules provide that a long term disability (LTD) plan may be approved as a group disability plan. By having an LTD plan approved as a group disability plan, any period during which a member receives a monthly benefit under the LTD plan is considered pensionable service and no contributions are required from the member or employer. To be approved as a group disability plan, the LTD plan must: 1. provide for continuous coverage to the member until one of the following events occurs: the member attains normal retirement age, the member accrues 35 years of service, or the member returns to active employment; 2. provide that the gross benefits paid during the period of disability will replace at least 50 per cent of the gross salary the member earned during employment immediately prior to the disability period; and employer CoNTaCT (print name) PosiTioN / DeParTmeNT PhoNe (include ten digits) $ 3. include a definition of disability which takes into consideration the member s vocation, training, education and experience. Where the benefits payable under the LTD plan are subject to a nonevidence limit, the LTD plan may still be approved if that limit is at least $2,500 per month, or if none of the covered employees earn in excess of double the limit. Where there is no non-evidence limit but there is a maximum amount that the LTD plan will pay, the LTD plan may still be approved if that amount is at least $2,500 per month or none of the covered employees earn in excess of double the amount. attach to this application the pages from the LTD plan that provide the name of the carrier, contract number, effective date of the LTD plan (or amendment to the LTD plan), description of eligible employees, definition of disability or disabled, and the benefit schedule. employer CoNTaCT signature DaTe signed yyyy / mm / DD Fax (include ten digits) ProCeeD For ChaNGe of Carrier New application to be CompleteD by policy branch reviewed By (print name) amendment DaTe reviewed yyyy / mm / DD DaTe effective yyyy / mm / DD approved By (print name) approved By (signature) DaTe signed yyyy / mm / DD Freedom of Information and Protection of Privacy Act The personal information on this form is collected under the authority of the Public Sector Pension Plans Act and will be used by the Pension Corporation to administer a plan member s pension and other non-pension benefits. If you have any questions about the collection and use of this information, contact the Chief Executive Officer at 2995 Jutland Road, Victoria BC V8T 5J9 or by telephone at 250 387-1002. PC/MPP 96-029 2007.01.18 return original To PoliCy BraNCh make a CoPy For your records 13-7

Nomination of Beneficiary The form below is a sample. If submitting the form, please use the fillable version available on the public forms page by clicking here. Complete sections A and B below. A PLAN MEMBER INFORMATION LAST NAME (please print) MAILING ADDRESS EMAIL B SPOUSAL INFORMATION SPOUSE LAST NAME NOMINATION OF BENEFICIARY (Pre-retirement) INFORMATION FOR PLAN MEMBER: You can change your beneficiary(ies) by completing and returning this form to the Municipal Pension Plan. For further information see Protecting your Pension Benefit: A Guide for Nominating Beneficiaries before Retiring on our website. This Nomination of Beneficiary will replace and revoke all previous nominations. Where you provide spousal information you are confirming your spouse is your beneficiary and that you are revoking all previous nominations. If you are a member of more than one pension plan that the Pension Corporation administers, you must complete a separate Nomination of Beneficiary form for each pension plan and, if applicable, a Form 4: Spouse s Waiver of Beneficiary Right to Benefits in a Pension Plan, Locked-In Retirement Account, Life Income Fund or Annuity Before Payments Start (Form 4) for each pension plan. If you are divorced or separated, all nominations are subject to separation agreements and entered court orders. For further information see How a separation or divorce affects your pension PensionFacts on our website. You are responsible for notifying the of any change of beneficiary designation. For further information go to our website or contact the if you are contemplating other beneficiary arrangements. FIRST NAME SPOUSE FIRST NAME WORK PHONE (include 10 digits) If you have a spouse at the time of your death, your spouse is automatically your beneficiary unless they waive their rights on Form 4. Definition of Spouse: Persons are spouses for the purposes of the Pension Benefits Standards Act on any date on which one of the following applies: (a) they (i) are married to each other, and (ii) have not been living separate and apart from each other for a continuous period longer than 2 years; Indicate your status by checking ( ) one of the three boxes below: (separation date, I have no spouse: if applicable) I am married OR SOCIAL INSURANCE NO. (death date, if applicable) SPOUSE DATE OF BIRTH PERSON ID HOME PHONE (include 10 digits) PENSION PLAN USE ONLY PO Box 9460 Victoria BC V8W 9V8 Location 2995 Jutland Road, Victoria Web mpp.pensionsbc.ca Victoria 250 953-3000 Toll-free in Canada/U.S. 1 800 668-6335 Fax 250 953-0421 Email MPP@pensionsbc.ca PERSON ID (8 digit number found on your Member s Benefit Statement or any other correspondence from the pension plan) DATE OF BIRTH (b) they have been living with each other in a marriagelike relationship for a period of at least 2 years immediately preceding the date. Explanatory Note: Circumstances where spouses live apart due to work commitments or as a result of illness means, for pension purposes, that they are not living separate and apart. If your relationship status changes, please notify the. SAMPLE I am in a marriage-like relationship (at least 2 years): " (fillable form accessible on secure Employer Login forms page) (cohabitation date) Go to section C on page 2 SPOUSE SOCIAL INSURANCE NO. If you have a spouse and wish to nominate other beneficiaries, check ( ) one of the boxes below and continue to page 2: My spouse has waived their rights on Form 4 and a completed Form 4 is attached or has been filed. I understand that unless my spouse s waiver is filed with the, then the beneficiary(ies) named on this form will not be valid. (Ensure Form 4 is attached and completed in full, if it has not previously been submitted.) My spouse is my beneficiary; however, I wish to nominate alternate beneficiary(ies) in the event I have no spouse at the time of my death. Freedom of Information and Protection of Privacy Act The personal information on this form is collected under the authority of the Public Sector Pension Plans Act and will be used by the Pension Corporation to administer a plan member s pension and other non-pension benefits. If you have any questions about the collection and use of this information, contact the Privacy Officer at 2995 Jutland Road, Victoria BC V8T 5J9 or by telephone at 250 387-1002. Reg. T.M. Municipal Pension Board of Trustees C O N T I N U E D O N P A G E 2 PC/MPP 98-104 (Page 1) 2015.06.26 13-8

C BENEFICIARY NOMINATION If your spouse waives their rights on Form 4 or you do not have a spouse at the time of your death, your pension entitlement will be paid to your nominated beneficiary(ies). You may nominate one or more person or organization (e.g., societies, charities, trusts, or corporations) beneficiary(ies). If you are divorced or separated, all nominations are subject to separation agreements and entered court orders. See the applicable marital breakdown fact sheet on our website for further details. The total percentage of the benefit allocated to your beneficiaries must equal 100%. If there are no percentages indicated, the benefit will be divided equally among all nominated beneficiaries, subject to rounding. BENEFICIARY #1 Complete this section if you wish to nominate a beneficiary to receive all or a portion of your pension benefits. ENTER SHARE OF BENEFITS D ENTER SHARE OF BENEFITS.. % % LAST NAME (OR ORGANIZATION NAME AND BRANCH) FIRST AND MIDDLE NAME(S) RELATIONSHIP TO MEMBER DATE OF BIRTH SOCIAL INSURANCE NO. (CRA OR REGISTRATION NO. if organization) PHONE NO. (include 10 digits) MAILING ADDRESS (street [include Apt No., if applicable], city or town, province or state, postal code and country) ONLY INCLUDE ADDRESS IF DIFFERENT THAN SECTION A BENEFICIARY #2 ENTER SHARE OF BENEFITS. Complete this section if you wish to nominate another beneficiary to receive all or a portion of your pension benefits. % LAST NAME (OR ORGANIZATION NAME AND BRANCH) FIRST AND MIDDLE NAME(S) RELATIONSHIP TO MEMBER DATE OF BIRTH SOCIAL INSURANCE NO. (CRA OR REGISTRATION NO. if organization) PHONE NO. (include 10 digits) MAILING ADDRESS (street [include Apt No., if applicable], city or town, province or state, postal code and country) ONLY INCLUDE ADDRESS IF DIFFERENT THAN SECTION A TO NOMINATE ADDITIONAL BENEFICIARY(IES) AND ALTERNATES For more information, read Protecting your Pension Benefit: A Guide for Nominating Beneficiaries before Retiring on our website I have attached a separate sheet to specify additional beneficiary information. The additional sheet must include your printed name and signature dated with the same date written on this form to be valid. Additional Beneficiary(ies) you can nominate multiple beneficiaries. You must include all information as above. Alternate Beneficiary(ies) you can nominate multiple alternates. You must include all information as above and ensure that each alternate beneficiary identified is associated with a nominated beneficiary. You can choose to give a different percentage to different alternate beneficiaries, but the total shares must always equal the same total percentage that has been allocated to their respective beneficiary. Trustee Information the Public Guardian and Trustee of BC is the default trustee if you nominate a minor under the age of 19. You may designate a different trustee to hold in trust for the minor. ESTATE BENEFICIARY Complete the share of benefits percent if you wish your estate to receive all or a portion of your pension benefit. EMAIL EMAIL SAMPLE (fillable form accessible on secure Employer Login forms page) E PLAN MEMBER SIGNATURE (You must sign and date this form and any additional sheets submitted in order for your nomination to be valid and accepted). I revoke any and all previous nominations I may have made for my Municipal Pension Plan benefit. I nominate the beneficiary(ies) named on this form (and any beneficiary(ies) named on attached sheets) to receive my benefit in the event of my death. PLAN MEMBER SIGNATURE (must be signed) DATE SIGNED Disclaimer: The information on this form is based on the pension plan rules, regulations and provincial legislation, which are subject to change. In cases where the information on the attached form is different from what is in the plan rules, regulations and legislation, the latter will apply. PC/MPP 98-104 (Page 2) 2015.06.26 Plan Member: Make a copy of this completed form for your records before forwarding to the pension plan 13-9

Pension Application The form below is a sample. This form is available by contacting the. Pension APPlicAtion PeRsOn ID Pension PlAn use only instructions for PlAn MeMber Complete this form only if you have decided on your retirement date. PLan MeMBeR LasT name If label is enclosed attach it here. Correct any wrong information. If you are not attaching a label please complete the information by hand. PLan MeMBeR PReVIOUs LasT name(s) (if any) PO Box 9460 Victoria BC V8W 9V8 Location 2995 Jutland Road, Victoria Web mpp.pensionsbc.ca your pension experience... we make it easy! Victoria 250 953-3000 Toll-free in Canada/U.s. 1 800 668-6335 Fax 250 953-0421 email MPP@pensionsbc.ca FIRsT name PeRManenT MaILIng address (include street, city or town, province, postal code) home PhOne (include ten digits) ReTIReMenT DaTe POsTaL CODe DaTe OF BIRTh social InsURanCe no. email address PURChase OF service You may be able to increase your future pension benefit by purchasing service for periods when you did not contribute to the Plan. see the appropriate fact sheet, on the Plan's website at mpp.pensionsbc.ca, for more information. (you must apply to purchase within 30 days after terminating employment) Direct DePosit i wish to have my monthly pension payments deposited to an account: please check ( ) one Paid within the Usa Contact the for information Paid within Canada Below must be completed: please check ( ) one below only if paid within Canada My Chequing account attach a sample cheque marked VoiD and submit with this signed form. My savings account Complete details below: please check ( ) one not applicable I have applied TO PURChase service BanK OR OTheR FInanCIaL InsTITUTIOn name BRanCh address (include street, city or town, province, postal code) TRansIT no. (include 5 digits) InsTITUTIOn no. (include 3 digits) 0 account no. PlAn MeMber signature i hereby APPly for My MuniciPAl Pension (must be signed) DaTe signed Freedom of Information and Protection of Privacy Act The personal information on this form is collected under the authority of the Public Sector Pension Plans Act and will be used by the Pension Corporation to administer a plan member s pension and other non-pension benefits. If you have any questions about the collection and use of this information, contact the Privacy Officer at 2995 Jutland Road, Victoria BC V8T 5J9 or by telephone at 250 387-1002. Plan Member: if you wish to keep a copy for your records, please photocopy. submit original to the pension plan. PC/MPP 2003-098 2013.10.30 P e n s i o n P l A n u s e o n l y PensIOn effective DaTe Reg. T.M. Municipal Pension Board of Trustees 13-10

Pension Enrolment Election The form below is a sample. If submitting the form, please use the fillable version available on the secure employer login forms page. PEnsion EnrolmEnt ElEction PeRSOn ID PEnsion Plan UsE only instructions: If you have waived participation in the (the Plan ) and subsequently elect to participate, then you must complete this form. Once eligible for enrolment, you remain eligible until you terminate employment. You do not need to re-qualify. (See page 2 for eligibility.) Submit a copy of the Waiver of Pension Coverage with this form. The employee and the employer should each retain a copy of this form for their records. This form should not be used for mandatory enrolment. employer name municipal Pension Plan PO Box 9460 Victoria BC V8W 9V8 location 2995 Jutland Road, Victoria Web mpp.pensionsbc.ca Victoria 250 953-3000 Toll-free in Canada/U.S. 1 800 668-6335 Fax 250 953-0421 e-mail mpp@pensionsbc.ca employer no. employee last name employee FIRST name employee SOCIal InSURanCe no. HIRe DaTe SPOUSe last name SPOUSe FIRST name SPOUSe DaTe OF BIRTH SPOUSe SOCIal InSURanCe no. Employee Declaration: 1. I understand that I am eligible to enrol in the Plan. 2. I have been provided with an explanation or summary of the Plan, and of the relevant entitlements and obligations under the Plan. 3. I wish to enrol in the Plan. 4. By signing this form, I understand that contributions will be deducted from each payment of salary made to me in accordance with the rules of the Plan. 5. I understand that this election is irrevocable and that I may not terminate my membership in the Plan, except in accordance with the rules of the Plan. 6. I understand that if I move to a position not covered by the Plan, I will not continue making contributions to the Plan. 7. I understand that by signing below, contributions to the Plan will not be retroactive in respect of any prior service. 8. I expressly revoke any previous election made by me to waive enrolment in the Plan. By signing below, i expressly elect to participate in the Plan. employee SIGnaTURe DaTe SIGneD (contribution start date) Freedom of Information and Protection of Privacy Act The personal information on this form is collected under the authority of the Public Sector Pension Plans Act and will be used by the Pension Corporation to administer a plan member s pension and other non-pension benefits. If you have any questions about the collection and use of this information, contact the Chief executive Officer at 2995 Jutland Road, Victoria BC V8T 5J9 or by telephone at 250 387-1002. PC/MPP 2000-060 (Page 1) 2012.04.19 RETURN ORIGINAL TO THE PLAN EMPLOYER AND EMPLOYEE MAKE A COPY FOR YOUR RECORDS Reg. T.M. Municipal Pension Board of Trustees 13-11

mandatory Enrolment municipal Pension Plan Eligibility conditions employees who do not have a choice about being enrolled cannot sign a waiver, and they must be enrolled in the Plan as soon as they are eligible. employees in this group include: employees who are regular, full-time employees, employees who are not regular employees but who have worked on a continuous full-time basis for one year (including employees who are not yet considered to be regular employees because they have not completed a probationary period), new employees who are already contributing to the Plan through another Municipal Pension Plan employer, new employees who were contributing to the Plan through a previous employer where the break in employment is one month or less, and employees who are required to enrol by resolution of the employer or as a requirement of a Memorandum of Understanding, a letter of Understanding or a collective agreement. optional Enrolment There are some employees who are eligible to enrol in the Plan, but are permitted to opt out of doing so by signing the waiver. These employees include: part-time, temporary or casual employees who earn at least 35 per cent of the YMPe* in each of two consecutive years of continuous employment, with one or more plan employers, existing employees who were employed when their employer first became a Plan employer, and who would otherwise be subject to mandatory enrolment, and employees who are permitted, but not required, to enrol by resolution of the employer or as a requirement of a Memorandum of Understanding, a letter of Understanding or a collective agreement. Once members begin to contribute to the Plan, they must continue to contribute, regardless of any change in their employment status (full- or part-time) and regardless of whether enrolment was mandatory or optional. If the member moves to another employer who is also an employer under the Plan, and has a break in service of one month or less, the member must also immediately begin contributing to the Plan with the new employer. an employee who has elected not to participate in the Plan may later elect participation under the Plan by applying to their employer to participate. *YMPe: The Year s Maximum Pensionable earnings (YMPe) is the maximum salary, including overtime, upon which Canada Pension Plan contributions are made, as set by the federal government. More information is available on Canada Revenue agency s website. PC/MPP 2000-060 (Page 2) 2012.04.19 13-12

Purchase of Service Application Package The form below is a sample. If submitting the form, please use the fillable version available on the public forms page by clicking here. Purchase of service application Package Please read pages 1, 2 and 4 before completing the attached form. Why would i purchase service? By purchasing service you increase the number of years that count toward your pension. This could get you closer to an unreduced pension and increases the amount of your benefit at retirement. This application package will help you understand this process. Who can purchase service? You may be able to purchase service if: you are currently a member of the Municipal Pension Plan, and the service was with the. What are the deadlines for purchase? There is a five year deadline for all purchase types. You must apply to purchase within 30 days after leaving your current employer. for deadlines, see the applicable fact sheet on the website or contact the pension plan. What are the types of eligible service? Leaves of absence: Time you were away on approved leaves. These include general leaves (which can include shared cost leaves under a collective agreement or the Employment Standards Act (ESA); for example, maternity, parental, adoption, compassionate and jury leaves). Non-contributory service: Service in which you worked for a employer but didn t contribute to the plan, such as during a probationary period, or casual work prior to joining the pension plan. For more information see the applicable fact sheets on the website at mpp.pensionsbc.ca or contact the pension plan. What information do i need? To begin with, you need to know the dates of the service in question. If your employer does not have records related to the period of service, you may also need: employment letters, leave approvals, timesheets, cheque stubs, T4s, employment insurance record of employment forms, letters from Canada Revenue Agency or the Canada Pension Plan. can i repay my refunded contributions? If you withdrew your pension contributions from the and are now an active plan member with the same employer you took the refund from, you may be able to reinstate your pension by repaying those funds, plus interest. This application package does not apply in that case. For deadlines and other information see the reinstatement fact sheet on the website or contact the pension plan. What service can t i purchase? Not all service is available for purchase. For instance: You can t purchase more service than you would normally have worked for example, you can t be a part-time employee and purchase service to full-time. You continue to be credited with service while on an approved Group Disability Plan (LTD) leave, and you do not need to purchase this service. You cannot purchase service that exceeds income tax limits for pension and RRSP contributions note that you may wish input from a financial advisor (see Tax considerations? on Page 4). mpp.pensionsbc.ca Pc/MPP 2002-001 2015.02.19 Reg. T.M. Municipal Pension Board of Trustees 1 13-13

how much will it cost? To estimate the cost of purchasing service you will need to know your full-time equivalent monthly salary. This is the amount of salary you would earn if working full-time. You will find the formula for converting part-time hours into full-time equivalent on page 4 or on the website. For a more accurate estimate of the purchase cost and the increase to your pension see our purchase cost estimator available on the web at mpp.pensionsbc.ca. Or, use the simple table below. Your current full-time gross monthly salary (or full-time equivalent if part-time) Percentage of full-time employment during purchase period Number of months available to purchase Estimated cost to purchase the service Maternity/parental/compassionate or other shared cost leaves (if applicable) Average Annual Earnings at Retirement $30,000 $40,000 $50,000.. = 2 = 100% how much will it increase my pension? Use the table below to estimate how much your monthly pension benefit may increase for every month of service you purchase. Multiply the approximate monthly increase by the number of months. This is an estimate of the lifetime pension payable, assuming you retire with the average annual earnings shown. X X example (numbers have been rounded) $3,500 Contribution rates (employee/employer combined) Group 2 (police or firefighter) = 22% Group 5 (police or firefighter) = 26% X 19% All others = 19% (note: Dividing by two assumes member and employer shares are both 50%) Approximate Monthly Increase $2 $3 $4 6 $3,990 $1,995 What are the next steps? to purchase service complete part A of the attached Purchase of Service Application; copy and attach all necessary documents send everything to your employer, who will complete part B and send it to the Municipal Pension Plan for arrears only: ensure that if the period being purchased was worked with a former employer that you first send them the application after they ve completed part c, forward the application to your current employer (note that if your former employer no longer exists you must provide proof of that employment to your current employer) how do i pay for my purchase? Don t send money at this time. You will receive an invoice which notes the payment due date, and any other necessary documents, from the pension plan. You may pay for your purchase by RRSP transfer and/or cheque, money order, etc. For more information see the applicable fact sheet available on the website or contact the pension plan. need help? More information is available by contacting your employer or the pension plan. You may also refer to the website at mpp.pensionsbc.ca. contact information: Questions can be directed to your employer or contact us at: PO Box 9460 Victoria Bc V8W 9V8 Location 2995 Jutland Road, Victoria Victoria 250 953-3000 Toll-free in Canada/U.S. 1 800 668-6335 $60,000 $70,000 $80,000 $90,000 $100,000 $110,000 Pc/MPP 2002-001 2015.02.19 $6 $7 $9 $10 $11 $13 mpp.pensionsbc.ca Fax 250 953-0421 Email MPP@pensionsbc.ca Web mpp.pensionsbc.ca Freedom of Information and Protection of Privacy Act The personal information on this form is collected under the authority of the Public Sector Pension Plans Act and will be used by the Pension corporation to administer a plan member s pension and other non-pension benefits. If you have any questions about the collection and use of this information, contact the Privacy Officer at 2995 Jutland Road, Victoria Bc V8T 5J9 or by telephone at 250 387-1002. 2 13-14

Purchase of service application PERSON ID Pension Plan use only instructions for Plan MeMber Read pages 1, 2 and 4 before completing this form. Do not send payment; the pension plan will send you an invoice. complete part A, copy and attach all required documents, then forward this form to your employer. Refer to What are the next steps? on page 2 if the arrears being purchased was with a former employer. Direct questions to your employer, or contact us. Part a PO Box 9460 Victoria Bc V8W 9V8 Location Web To be completed by the Plan MeMber please print clearly PLAN MEMBER LAST NAME FIRST NAME AND INITIAL (if any) 2995 Jutland Road, Victoria mpp.pensionsbc.ca Victoria 250 953-3000 Toll-free in canada/u.s. 1 800 668-6335 Fax 250 953-0421 Email MPP@pensionsbc.ca MAILING ADDRESS (include street, city or town, province and postal code) DAYTIME PhOnE (include 10 digits) EMAIL (optional) DATE OF BIRTH SOCIAL INSURANCE NO. Type of purchase (separate application required for each purchase type) please check ( ) one of the types below leave of absence or arrears GENERAL MATERnITY (child date of birth) GENERAL SHARED PAREnTAL (child date of birth) LEAVE: Employer pays ADOPTIOn its share (e.g., as per a (adoption date) collective agreement) OThER (e.g., compassionate care, jury duty, etc.) period of service applying To purchase EMPLOYER name DuRInG PuRchASE PERIOD START DATE ENROLMENT PAYROLL ERROR non-contributory service non-contributory service default (no records, see page 4 for explanation) END DATE Did you contribute to a registered pension plan with any other employer during this period? YES NO amount of service applying To purchase PEnSIOnABLE SERVIcE contributory SERVIcE FULL-TIME PART-TIME or or non-contributory (indicate percentage) % MONTHS MONTHS SERVIcE DEFAuLT PLAN MEMBER SIGNATURE I understand that I must meet all eligibility requirements in order to purchase this period of service. DATE SIGNED Part b To be completed by current employer please print clearly refer to employer manual for clarification current EMPLOYER name CONTACT PHONE (include 10 digits) EMPLOYER no. (include 5 digits) current AnnuAL PEnSIOnABLE SALARY (full-time equivalent pensionable salary must be completed by current employer) FOR current YEAR REQuESTS Indicate the amount of pensionable service earned but not yet reported to the plan. $ MONTHS current employer certification By signing this form I certify that I am an authorized signing officer for the employer indicated above. I also realize that by signing this form it is irrevocable and I accept the respective employer responsibility. I certify that the information completed in Parts A and B of this form are true, complete and correct to the best of my knowledge. AUTHORIzED SIGNING OFFICER (print name) AUTHORIzED SIGNING OFFICER TITLE AUTHORIzED SIGNING OFFICER SIGNATURE DATE SIGNED or FOR LEAVE OF ABSEncE REQuESTS Indicate the amount of pensionable service earned during the purchase period (e.g., Maternity top up, partial leaves), if applicable. CHECk ( ) IF PLAN MEMBER IS currently On GROuP DISABILITY (e.g., LTD) MONTHS Part c for arrears only: To be completed by former employer, if required please print clearly This part is to be completed by the former employer for arrears pertaining to them in Part A above. former employer certification By signing this form I certify that I am an authorized signing officer for the employer indicated above. I also realize that by signing this form it is irrevocable and I accept the respective employer responsibility. I certify that the information completed in Parts A and C of this form are true, complete and correct to the best of my knowledge. AUTHORIzED SIGNING OFFICER AUTHORIzED SIGNING OFFICER TITLE AUTHORIzED SIGNING OFFICER SIGNATURE DATE SIGNED (print name) employer and Plan Member: Make a copy of this completed form for your records before forwarding to the pension plan Pc/MPP 2002-001 2015.02.19 Reg. T.M. Municipal Pension Board of Trustees 3 13-15

notes contributory service Number of months you (and your employer) made contributions to the plan. It is used to determine if you are eligible for a pension and whether your pension will be reduced (and by how much) should you decide to retire before normal retirement age. You earn one month of contributory service for any month in which you and/or your employer make the required contribution for that time. Deadlines Arrears You have five years from receiving the notice of arrears or 30 days after termination of employment, whichever is earlier, to apply to purchase the arrears period. Leave of Absence You must apply to purchase your leave within five years of the end of the leave or within 30 days after termination of employment with the employer with which the leave occurred, whichever is earlier. Non-Contributory Service You must apply within five years from the time contributions commenced or within 30 days after termination of employment with the employer which the service occurred, whichever is earlier. Non-contributory Service Default In cases where employment records are missing, inaccessible or incomplete, and where both the employer and member agree, a default pensionable service option can be accepted. The default option is 50% pensionable service and 100% contributory service for the period of eligible time you want to purchase. Full-time equivalent The amount of salary you would earn if you were working full-time. Divide the current full-time gross monthly salary you are paid by the percentage of part-time you are working. Multiply by 12 to determine the full-time equivalent annual salary. You can determine the percentage of full-time by dividing the hours you work into the hours a full-time member works. The full-time hours vary by employer and job so contact your employer if you need details. example: You are working 30 hours per week and a full-time employee works 40 hours per week: 30 divided by 40 equals 75%. You earned $3,000 last month: $3,000 divided by.75 equals $4,000. $4,000 is the full-time equivalent monthly salary. $4,000 multiplied by 12 equals $48,000 and is the full-time equivalent annual salary. Pensionable service The actual time you worked while contributing to the plan. You earn one full month of pensionable service when you work full-time for a month. If you work half-time, you receive half a month of pensionable service. Pensionable service is used to determine your benefit amount. tax considerations? When you purchase service the value of your pension increases. Canada Revenue Agency (CRA) places limits on how much you can deduct for contributions made to RRSPs and registered pension plans. If you purchase service that occurred in 1990 or later the pension plan will contact cra for approval of past service pension adjustments and report any amended pension adjustments. Generally, if you pay for your purchase by RRSP transfer there are no tax implications, though you should always seek the advice of a qualified financial advisor. More information is available on cra s website. Pc/MPP 2002-001 2015.02.19 mpp.pensionsbc.ca 4 13-16

Reinstatement of a Refund Request for Cost The form below is a sample. If submitting the form, please use the fillable version available on the public forms page by clicking here. INFORMATION AND INSTRUCTIONS: If you took a refund from the municipal Pension Plan, you may reinstate that service by repaying the refund with interest if you meet all eligibility requirements. You must apply to reinstate a refund within five years from the time contributions to the plan recommence or within 30 days after you terminate employment, whichever occurs first. Return this form to the pension plan with copies of supporting documentation (T4A, pay stubs, Income T4, Canada Pension Plan statement) from the year in which you took the refund, if available. REINSTATEMENT OF A REFUND REqUEST FOR COST PERSON Id PENSION PLAN USE ONLy PO Box 9460 Victoria BC V8W 9V8 location 2995 Jutland Road, Victoria Web mpp.pensionsbc.ca If you are providing details of more than four refunds, you may wish to photocopy this page before you complete it, or you can provide the same information on a separate piece of paper. Do not send your payment now. If you are eligible to reinstate, the pension plan will send you a statement of cost, which will indicate when your payment is due. For additional information refer to the reinstatement fact sheet available on the web. If you have questions regarding your eligibility, please contact the pension plan. EmPlOyEE last NAmE (use legal name) first NAmE middle INITIAl former NAmE(S) (include all names in full if applicable) home AddRESS (include street, city or town, province and postal code) SOCIAl INSuRANCE NumBER REFUND #1 EmPlOyER NAmE date Of BIRTh yyyy / mm / dd To help our research, please provide approximate dates below Start date yyyy / mm / dd CONTRIBuTIONS End date yyyy / mm / dd date REfuNd WAS PAId TO you yyyy / mm REFUND #2 EmPlOyER NAmE CONTRIBuTIONS Start date End date yyyy / mm / dd yyyy / mm / dd date REfuNd WAS PAId TO you yyyy / mm REFUND #3 EmPlOyER NAmE CONTRIBuTIONS Start date End date yyyy / mm / dd yyyy / mm / dd date REfuNd WAS PAId TO you yyyy / mm REFUND #4 EmPlOyER NAmE CONTRIBuTIONS Start date End date yyyy / mm / dd yyyy / mm / dd date REfuNd WAS PAId TO you yyyy / mm Freedom of Information and Protection of Privacy Act The personal information on this form is collected under the authority of the Public Sector Pension Plans Act and will be used by the Pension Corporation to administer a plan member s pension and other non-pension benefits. If you have any questions about the collection and use of this information, contact the Chief Executive Officer at 2995 Jutland Road, Victoria BC V8T 5J9 or by telephone at 250 387-1002. If you have any questions about this form please contact us at: Victoria 250 953-3000 Toll-free in Canada/u.S. 1 800 668-6335 fax 250 953-0421 E-mail mpp@pensionsbc.ca PC/mPP 97-020 2012.12.19 Reg. T.m. municipal Pension Board of Trustees 13-17

Remittance The form below is a sample. If submitting the form, please use the fillable version available on the secure employer login forms page. MUNICIPAL PENSION PLAN REMITTANCE INSTRUCTIONS Attach your cheque and mail to: PO Box 8500 Stn Terminal, Vancouver BC V6B 6E6 Please make sure that you are using a remittance slip for the correct pension plan. Coding on the bottom of this remittance slip is linked to the only. You can also remit electronically. Refer to Web Services, E-Remit Overview on our website at mpp.pensionsbc.ca or contact Municipal Plan Finance at 250 387-8293 for more information. Reg. T.M. Municipal Pension Board of Trustees Additional information is available in the remittance section of the employer instruction manual on our website at mpp.pensionsbc.ca. If you wish to place an order for forms, contact us by email at PCFINOPS@pensionsbc.ca or by fax at 250 953-0430. Line 4 below Enter total special agreement contributions. Line 5 below Enter total invoice amounts and record invoice number(s). Line 6 below Adjustments: fax detailed background information to 250 953-0430 or email to PCFINOPS@pensionsbc.ca. MUNICIPAL PENSION PLAN REMITTANCE PC/MPP 97-039 2014.04.09 Detach the bottom portion and submit with your payment. PAYROLL PAY DATE (i.e., the actual date your members are EMPLOYER (print name) PREPARED BY (print name) PHONE NO. (include 10 digits) EMPLOYER NO. right paid, not the pay period end date) justify (i.e., 301 = 00301) YYYY MM DD 1. Plan member s pensionable earnings for the pay period $ 2. Employee contributions deducted through payroll $ 3. Employer contributions for the period $ 4. Special agreement contributions $ 5. Invoice number(s) $ 6. Adjustments: fax detailed background information to 250 953-0430 or email to PCFINOPS@pensionsbc.ca $ 7. Payment (equal total of lines 2, 3, 4, 5 and 6). 0 4 $...... 0 0 SAMPLE (This form is available by contacting Municipal Plan Finance) 13-18

MUNICIPAL PENSION PLAN REMITTANCE EMPLOYER (print name) PREPARED BY (print name) PHONE NO. (include 10 digits) 0 4 EMPLOYER S COPY TOTAL PAYMENT $ Keep the top portion for your records.. EMPLOYER NO. right justify (i.e., 301 = 00301) PAYROLL PAY DATE YYYY MM DD PAID STAMP MUNICIPAL PENSION PLAN REMITTANCE PAID STAMP PC/MPP 97-039 2014.04.09 BANK COPY SAMPLE (This form is available by contacting Municipal Plan Finance) No marks or paid stamps to appear below this line. PC/MPP 97-039 2014.04.09 13-19

Retirement Planning Package and Estimate Request The form below is a sample. If submitting the form, please use the fillable version available on the public forms page by clicking here. Retirement Planning Package So you re thinking about retiring. Congratulations; it s an exciting time. It s also a time when you ll need to do some planning, as you would for any important event in your life. This package will help you get started. We are here to help guide you through the process. Throughout this pamphlet, we refer to publications where you can get more information. These publications are available on our website at mpp.pensionsbc.ca, or request print copies by completing the enclosed Estimate Request form, or by contacting the. Please keep this pamphlet for future reference. At what age can I retire? The normal retirement age for most members of the is 65, and the earliest retirement age is 55. There are some exceptions. For example, the normal retirement age for police and firefighters is 60, and the earliest retirement age is 50. Can I afford to retire now? This is a question only you can answer, after you understand what your pension will pay, what other benefits are available, what other income you ll have, and what your income requirements are. Your Municipal pension is only one source of income. You should also consider all other income available to you. We suggest that you talk to a financial planner before making a decision. How much will I get when I retire? Log on to My Account and use the online personalized Pension Estimator to get an idea of what your pension will pay. You can also request an estimate by submitting the enclosed Estimate Request form. Remember that the following will affect your pension payment: 1. The amount of service you have In general, the more service you have, the more your pension will be, though there are other things that may affect your pension payment. For details, see your Member s Benefit Statement or our website at My Account. 2. The pension option you choose When you retire the pension option you choose will affect your pension payments. See the Choosing your best pension option booklet for details. 3. Whether you can purchase or transfer service You may be able to increase your pension payment by purchasing or transferring service. See the relevant fact sheet for details. 1 13-20