Forms
NR73
Complete this form if you have left or are planning to leave Canada temporarily or permanently and need help determining your residency status for income tax purposes.
LCBO Employees – Canada Life Insured Benefits Change
Information in this form is collected by OPTrust for LCBO employees and the coverage of benefits is provided through Canada Life.
International Banking – Direct Deposit Election – Great British Pound
Complete this form to authorize OPTrust to convert your monthly pension payment from Canadian dollars to Great British Pounds.
Dentalcare Claim – Retired before 2017 – Pensioner Legacy Plan A1 – Original Plan
Dentalcare claim for those who retired before 2017 and are part of the Pensioner Legacy Plan A1 (Policy 157838) Original Plan.
Healthcare Claim – Retired after 2016 – Pensioner Alternative Plan B1 – Government-Paid Plan
Healthcare claim for those who retired after 2016 and are part of the Pensioner Alternative Plan B1 (Policy 169974) Government-Paid Plan.
Release of Information – Insured Benefits Appeal Authorization
This is a release of information form for the Insured Benefits Appeal.
Dentalcare Claim – Retired after 2016 – Pensioner Alternative Plan B1 – Government-Paid Plan
Dentalcare claim for those who retired after 2016 and are part of the Pensioner Alternative Plan B1 (Policy 169974) Government-Paid Plan.
Statement of Marital Status
Complete this form and return it to OPTrust if you are a member of the OPSEU Pension Plan and your spousal status has changed.
International Banking – Direct Deposit Election – Euro
Complete this form to authorize OPTrust to convert your monthly pension payment from Canadian dollars to Euros.
Need help accessing and submitting your forms?
Use the free Adobe Acrobat Reader to download the form you need and submit your completed form through our secure online account, by fax (416-681-6175) or mail it to our corporate office address.