I.A.M. Labour-Management Pension Fund (Canada)

The contents of this form will be submitted to: I.A.M. Labour-Management Pension Fund (Canada)

116 Lisgar Street, Suite 304, Ottawa, Ontario K2P 0C2

Tel: 613.567.8259 Toll-free: 1.888.354.5444

The above designation revokes any previous beneficiary designation the Trustees of the I.A.M. Labour-Management Pension Fund (Canada) may have on file. I reserve the right to revoke and change my beneficiary designation at any time by giving written notice on the form prescribed by the Trustees of the I.A.M. Labour-Management Pension Fund (Canada

I certify that the information I have provided on this form is accurate and complete. I authorize the collection and use of all information contained in this form, and any additional personal information which I may hereafter provide, by the Trustees of the I.A.M. Labour Management Pension Fund (Canada) and their designated agents and advisors, including the use of social insurance number for identification, administration and tax reporting purposes. I also authorize the collection, retention, disclosure and sharing of my personal information by the Trustees and their designated agents, advisors and service providers as may be required to administer the Plan including but not limited to determining eligibility for benefits, processing and paying benefits and on-going financial management of the Plan including cost analysis and internal audits. I understand that I may withdraw all or part of my consent at any time, in writing, but that doing so may interfere with the administration of the Plan and any benefits that may be payable to me. I understand that for more information on how the Fund Office ensures my personal information is protected, I may refer to the Fund’s Privacy Note to Members.

Who qualifies as my spouse? (Ontario)

A spouse is someone who, at the time of determination is legally married to you and not living separate and apart from you. A spouse may also be someone who has been living with you continuously in a conjugal relationship for at least 3 years or is the mother or father (natural or adoptive) of your child and lives with you in a relationship of some permanence.

Generally, your spouse is first in line for survivor benefits. Your spouse may waive entitlement to the survivor benefits by completing and submitting a spousal waiver form to the Fund Office. In this event, your designated beneficiary is the person who would receive the death benefit, if any are payable after your death.

Naming beneficiary or beneficiaries.

The beneficiary designation applies if you die before retirement and you do not have a spouse at the time of your death or your spouse has waived his/her entitlement to the pre-retirement survivor pension. Your beneficiary can be a person(s), organization or your estate. You can change your beneficiary at any time by completing another Marital Status / Beneficiary Change Form and submitting it to the Fund Office. Your designation is not valid until this form is received by the Fund Office.

If you have a spouse and you complete the Beneficiary Designation section, should your spouse die before you, your designated beneficiary is the person who would receive the death benefit, if any death benefit is payable after your death.

You may name more than one beneficiary. In this event, any death benefit that is payable will be divided in equal shares among them unless you indicate otherwise. If one of the beneficiaries dies before you, his/her share would be divided among the remaining beneficiaries.

What if I want to name a minor as a beneficiary?

Someone under the age of 18 (known legally as a minor) cannot directly receive survivor benefits. If you want to ensure your child will benefit from any death benefit upon your death, you should get independent legal advice on how this can be done.

Please note that the information provided above does not cover all details of the Plan. The official Plan document governs in the event of a conflict, discrepancy or omission.