Changing information (retired member/survivor)
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Any personal information provided on this form may be used to
update your membership profile.
Providing OMERS with your personal information is considered
consent for its use and disclosure for the purposes set out in our
Privacy Statement, as amended from time to time. You can find out
more about our collection, use, disclosure and retention of personal
information by reviewing our Privacy Statement at
Use this form if you are a retired OMERS member or survivor and want
to change your information on file.
IMPORTANT: If you participate in the AVC Income Option, you cannot
make any banking changes to the direct deposit instructions for your
AVC account using this form. Please complete the AVC Income Option
direct deposit form.
To help us serve you better, submit your documents quickly and securely
using your myOMERS account. Go to My Communications, start a new
conversation, attach your files, and submit.
SECTION 2 - NEW INFORMATION (Complete only the information that has changed)
Date of Birth (m/d/y)OMERS Membership Number*/Social Insurance Number
First Name Middle Name Last Name
F108 - Nov. 2020
Apt/Unit Address City Postal Code
First Name Middle Name Last Name
Apt/Unit Address City Postal Code
Home Number Email
Check all that apply and fill in the necessary information.
Name/address change
If you receive your pension payment by direct deposit, you can also change your address by contacting OMERS Member Services at the phone
number above. We cannot accept notice of these changes by email.
Effective Date of Change (m/d/y)
Banking information change
Please complete the following banking information (see sample on next page) OR attach a void cheque. For your protection, OMERS will not
accept changes to your banking information over the telephone.
Address City Postal Code
Transit Number Institution Number
Bank Name
*Your membership/reference number appears on any personalized statement from OMERS.
TIP: Keep your old account open until the deposit actually goes into your new account, in case we don’t receive your new information in time for your
next monthly payment.
Bank Account Number
Mobile Number
Home Phone Cell Phone
SECTION 3 - AUTHORIZATION (OMERS must have your signature to process these changes)
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F108 - Nov. 2020
OMERS Membership Number/Social Insurance Number
Tax deduction change
Please take more income tax off my monthly OMERS pension payment.
Please take less income tax off my monthly OMERS pension payment.
(This option applies only if OMERS is already withholding additional tax.)
Additional Tax Amount
Additional Tax Amount
I am the retired member or survivor.
I hold power of attorney or guardianship for property for the retired member (OMERS must have proof of power of attorney or guardianship on file).
Check the box that applies to you:
Member's Signature
Date (m/d/y)
Banking information change - cont'd