Municipal Pension Plan
Employment Declaration
Name
*
First Name
Last Name
Are you currently a contributor to the Municipal Pension Plan? An active member can be on a leave of absence, long term disability, or on a recall list. You do not have to be currently contributing to be considered an active member.
*
Yes
No
Have you been in the last 30 days?
*
Yes
No
Are you currently receiving a pension from the plan?
*
Yes
No
I have been provided with a handout that explains the pension plan, and the relevant entitlements and obligations under the Pension Plan.
*
Yes
No
I understand how I may combine service and earnings with more than one plan employer to qualify for membership in the plan.
*
Yes
No
I understand that I must inform my employer if I begin contributions with another Municipal Plan employer. If I do not inform my employer, enrolment arrears will be billed to me and my employer.
*
Yes
No
Signature
Submit
Should be Empty: