Get Declaration Of Relationship

Financial Services Commission of Ontario Joint Declaration of Period of Spousal Relationship FSCO Family Law Form 2 Approved by the Superintendent of Financial Services pursuant to the Pension Benefits Act R.S.O. 1990 c* P. 8 IMPORTANT This form can only be used on or after January 1 2012. Family Law Value means imputed value under the Ontario Pension Benefits Act. You the Plan Member and the spouse/former spouse of the Plan Member may want to get legal advice before completing this form* Read the instructions before completing this form* the starting date and/or the separation date Family Law Valuation Date of your spousal relationship* Do not complete Part D of this form if you and your spouse/former spouse have chosen to provide two Family Law Values under Appendix A of the Application for Family Law Value FSCO Family Law Form 1. Send this form to the pension plan administrator Plan Administrator with your Application for Family Law Value Print clearly. Part A Pension Plan Information Name of Pension Plan Pension Plan Registration Number SKD Company Pension Plan for Hourly Employees of the Milton Division 0996363 Name of Employer/Union/Professional Association SKD Company bankrupt Plan Administrator PricewaterhouseCoopers Inc* appointed Administrator Mailing Address of Plan Administrator Street Number and Name Suite/Floor No* One Robert Speck Parkway City Province Postal Code Mississauga L4Z 3M3 For Plan Administrator Use Effective 2012-01-01 FSCO 1266E*1 Page 1 of 2 Part B Plan Member and Plan Member s Spouse/Former Spouse Information Last Name Plan Member First Name and Initials Plan Member s Employee/Pension Plan Identification Number if known Spouse/ Former Spouse Part C Confirmation of the Starting Date of our Spousal Relationship Married or Common-Law yyyy/mm/dd We confirm that the starting date of our spousal relationship is Part D Jointly Declared By Plan Member Signature of Plan Member Name of Plan Member printed Signature of Witness Name of Witness printed Witness Contact Information Apt. /Unit No* Telephone Number Main Spouse/Former Spouse of the Plan Member Signature of Spouse/Former Spouse of the Plan Member Name of Spouse/Former Spouse of the Plan Member printed. 1990 c* P. 8 IMPORTANT This form can only be used on or after January 1 2012. Family Law Value means imputed value under the Ontario Pension Benefits Act. You the Plan Member and the spouse/former spouse of the Plan Member may want to get legal advice before completing this form* Read the instructions before completing this form* the starting date and/or the separation date Family Law Valuation Date of your spousal relationship* Do not complete Part D of this form if you and your spouse/former spouse have chosen to provide two Family Law Values under Appendix A of the Application for Family Law Value FSCO Family Law Form 1. You the Plan Member and the spouse/former spouse of the Plan Member may want to get legal advice before completing this form* Read the instructions before completing this form* the starting date and/or the separation date Family Law Valuation Date of your spousal relationship* Do not complete Part D of this form if you and your spouse/former spouse have chosen to provide two Family Law Values under Appendix A of the Application for Family Law Value FSCO Family Law Form 1. Send this form to the pension plan administrator Plan Administrator with your Application for Family Law Value Print clearly.