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Pension Forms

FCNB now has an online portal and no longer accepts paper filings for the following submissions;

  • Pension Plan Registrations
  • Pension Plan Amendments
  • Annual Information Returns
  • Actuarial Valuation Reports
  • LIF to RRIF Transfer Requests
  • Standard Contract Registrations
  • Standard Contract Amendment Registrations

All of the above filings must now be done online through our portal at https://portal.fcnb.ca. Fees associated with these submissions (if applicable) may be paid online through the portal. If you wish to pay by cheque, it should be made payable to the Financial and Consumer Services Commission and mailed, along with the transaction identification number to:

Financial and Consumer Services Commission
225 King Street, Suite 200
Fredericton, NB E3B 1E1

FCNB also provides prescribed forms under the Pension Benefits Act to be submitted to third parties. Some of the forms require that the signature be notarized prior to submitting the form. Please note that the signature may be taken before a Commissioner of Oaths or Notary Public if declared in New Brunswick. However, it must be taken before a Notary Public if declared outside the province of New Brunswick.


Member forms

Form 3.01 - Waiver by Spouse or Common-Law Partner (Reduced Life Expectancy) - LIRA, LIF, Annuity

This waiver should be completed where funds are to be unlocked for a member of the pension plan or an owner of a LIRA, LIF, or annuity due to reduced life expectancy.

Form 3.02 - Waiver by Spouse or Common-Law Partner (General) - LIRA, LIF, Annuity

This waiver should be completed when the spouse or common-law partner waives all their rights they have in the LIRA, LIF or prospective annuity.

Form 3.5 - Waiver of Spouse or Common-Law Partner

This waiver must be completed where funds are to be unlocked for a member of the pension plan or an owner of a LIRA, LIF, or Annuity who is neither a resident of Canada nor a Canadian Citizen.

Form 3.6 - Request for Withdrawal from a Locked-in-Retirement Account (LIRA)

This form is completed and filed with the financial institution for the unlocking of a small LIRA.

Form 3.7 - Consent of Spouse or Common-Law Partner to Withdraw from a Locked-in Retirement Account (LIRA)

This form must be completed if the owner requesting the unlocking of funds from a small pension or LIRA has a spouse or common-law partner.

Form 3.8 - Consent of Spouse or Common-Law Partner to Unlock Small Pension Balance

This form gives consent of spouse or common-law to unlock small pension balance.

Form 4 - Direction to Administrator to Exercise Rights

This form should be completed and submitted to the administrator of a pension plan where the member requests that funds from the pension plan are to be transferred to a LIRA, LIF, or be used to purchase an annuity or differed annuity.

Form 5 - Joint and Survivor Pension Waiver

This waiver should be completed where rights to a joint and survivor pension are waived.

Form 6 - Revocation of Joint and Survivor Pension Waiver

This form should be completed where the spouse or common-law partner is revoking the previously completed Joint and Survivor Pension Waiver.

Form 9 - Pre-Retirement Death Benefit Waiver

This waiver should be completed where rights to a pre-retirement death benefit are waived.

Form 10 - Revocation of Pre-Retirement Death Benefit Waiver

This form should be completed where the spouse or common-law partner is revoking the previously completed Pre-Retirement Death Benefit Waiver.

Form 11 - Religious Exemption

This form should be completed when an employee is requesting to be exempted from a pension plan based on their religious beliefs.


Transfer Forms

Form 3.2 - Record of Transfer of Locked-in Retirement funds

This form must be completed by the administrator of a pension plan or Financial Institution for all transfer of pension funds which must remain locked-in.

Form 4.1 - Request to Transfer from a Pension Plan to a RRIF

This form should be completed and kept by the administrator of the pension plan if a member requests the transfer of funds from a pension plan to an RRIF.

Form 4.2 - Spousal Consent to Transfer from a Pension Plan to a RRIF

This form must be completed if the member of a pension plan requesting a transfer from a pension plan to an RRIF has a spouse or common-law partner.


Forms required for Application for Exemptions—Solvency Special Payments

Form 7 - Notice

The notice must be sent by the administrator of a pension plan, to each member, former member, and any other person entitled to payments under a pension plan, when an application for exemptions—solvency special payment is made.

Form 8 - Reply Form

The reply must be sent by the administrator of a pension plan, to each member, former member, and any other person entitled to payments under a pension plan, when an application for exemptions—solvency special payment is made.