D.A. Townley.  -  Plan Administrators    



Statement of Claimant – Non Spousal

If the Plan Member has died and the beneficiary is not the Member’s spouse, the beneficiary should use the Statement of Claimant – Non Spousal Benefit to advise the Plan Administrator of the Member’s death and request the lump sum pay–out of the Member’s pension funds.

Information Needed to Complete the Form
The Member's and beneficiary's personal information is needed to complete the form.

The original death certificate (or a notarized copy) must be submitted with this form.

If the beneficiary is the Member’s spouse, the Statement of Claimant – Spousal Benefit form should be use instead of this form.

Questions on completing the form should be directed to the Plan Administrator.

Completed forms should be forwarded to the Plan Administrator.

Plan Administrator
Millworkers Pension Plan (Unifor) Administrator
c/o D.A. Townley.
160 – 4400 Dominion Street
Burnaby, BC V5G 4G3

Phone: 604-299-7482 or 1-800-663-1356
Fax: 604-299-8136

Email: Pension

Form Link
Statement of Claimant – Non Spousal

Related Links
Statement of Claimant – Spousal
Death of the Member Information
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