Affidavits
OSFI Form 3: Attestation of Total Amount Held in Federally Regulated Locked-in Plans
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Name the institution that holds the money, then use Add plan for every federally regulated locked-in plan there that you want to withdraw or transfer from: a locked-in RRSP, life income fund, restricted life income fund or restricted locked-in savings plan. Add at least one plan; an empty list prints a blank line. If you also hold federal locked-in plans at another institution, ask the institution whether to list them here too.
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ATTESTATION OF TOTAL AMOUNT HELD IN FEDERALLY REGULATED LOCKED-IN PLANS
OSFI Form 3, Schedule V, Pension Benefits Standards Regulations, 1985
To: ______
Federally regulated locked-in plans held by that institution from which I intend to withdraw or transfer money:
• ______, account number ______
I, ______, of ______, in the city of ______, in the province of ______, MAKE OATH AND SAY:
I am the owner of the federally regulated locked-in plans listed above.
On the day I sign this attestation, the combined value of those plans is $______.
That combined value is less than half of the Year's Maximum Pensionable Earnings as defined in the Pension Benefits Standards Act, 1985.
Signed and sworn (or affirmed/declared) before me by videoconference in Ottawa, Ontario, while the Affiant(s)/Declarant(s) were located in ______________________, on ______________________, pursuant to O. Reg. 431/20, and Electronic Commerce Act, 2000.
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