Fillable Information Sheet for the Old Age Security Pension

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Information Sheet for the Old Age Security Pension

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Country of origin: CANADA
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Page1of4
When to apply
Social Security Agreements
Qualifying for the Old Age Security pension
Human Resources
Development Canada
Développement des
ressources humaines Canada
Documents Required
Unable to apply
Ce formulaire est disponible en français.
Information Sheet for the Old Age Security Pension
This information sheet will help you complete the application for the Old Age Security pension. The Old
Age Security pension is a benefit payable to most Canadians who are 65 years of age or over and meet
the residence requirements.
You can apply for the OAS pension up to 12 months before your 65
th
birthday. If you have already reached age 65,
send your application as soon as possible so you won't lose any payments.
Please note that we can pay your pension back to a maximum of 11 months from the date we receive your
application, but no earlier than the month after your 65
th
birthday.
Canada has social security agreements with many countries that could help you meet the residence requirements to
qualify for the OAS. If you lived or worked in one or more of these countries, you may also qualify for benefits from
these countries. We will send you an application form if necessary.
If you now live outside Canada, you must have been a legal resident of Canada the day before you left Canada.
• be 65 years of age or older;
• have a legal residence status in Canada;
• meet the residence requirements;
• submit the necessary documents; and
•
complete and sign the application.
To receive the Old Age Security (OAS) pension you must:
PROOF OF BIRTH
You do not need to provide proof of birth with your application. However, the Old Age Security program has the
right to request proof of birth at any time, when deemed necessary.
(
Refer to question 4 on the application)
To be eligible for the OAS pension, you must be a legal resident of Canada. You are considered to be a legal
resident if you are a Canadian Citizen, a permanent resident (formerly called Landed Immigrant) or in Canada
under a Minister's Permit on the day before your application is approved or the day before you leave Canada.
If, due to a medical condition, you were unable to apply earlier or to ask someone to apply on your behalf, please
contact us to obtain a form called "
Declaration of Incapacity". If you meet all of the eligibility requirements, filling
out and returning this form may allow you to receive your pension with an earlier start date.
If you were born in Canada and have lived in Canada all your life, you do not need to prove your legal
residence status.
PROOF OF CANADIAN LEGAL RESIDENCE STATUS
(
Refertoquestion12ontheapplication)
ISP-3000A-06-07 E Internet Version
• Accountant
• Chief of First Nations Band
• Employee of a Service Canada Centre
acting in an official capacity
• Funeral Director
• Justice of the Peace
• Lawyer, Magistrate, Notary
• Manager of Financial Institution
• Medical and Health Practitioners: Chiropractor,
Dentist, Doctor, Pharmacist, Psychologist,
Nurse Practitioner, Registered Nurse
• Member of Parliament or their staff
• Member of Provincial Legislature or their staff
•
Minister of Religion
• Municipal Clerk
• Official of a federal government department or
provincial government department, or one of its
agencies
• Official of an Embassy, Consulate or High
Commission
• Official of a country with which Canada has a
reciprocal social security agreement
• Police Officer
• Postmaster
• Professional Engineer
• Social Worker
• Teacher
Certified photocopies of original documents
Information Sheet for the Old Age Security Pension
PROOF OF CANADIAN LEGAL RESIDENCE STATUS
(continued)
PROOF OF RESIDENCE HISTORY
If you have not lived in Canada all your life, you must send us certified photocopies of documents that prove your
history of residence in Canada. You can use the following documents to prove when you entered, departed or
returned to Canada:
• passports;
• immigration records (such as visas);
• customs declarations; or
• other approved documents that can prove your history of residence in Canada.
If you were born in Canada and became a citizen of another country before February 15, 1977,youmay
have given up your Canadian citizenship. If you are not sure what your status is, please contact a Citizenship and
Immigration office.
If you were born outside of Canada, a certified photocopy of one of the following documents is usually
sufficient to confirm your Canadian citizenship or legal residence status:
• Canadian Citizen - Certificate of Canadian citizenship, naturalization certificate, or Canadian passport
issued in 1970 or later;
• Permanent Resident (formerly known as Landed Immigrant) - Canadian immigration documents (for
example IMM1000 - Record of Landing or Permanent Resident Card) or Canadian immigration stamp
on your passport;
• Resident under a Minister's Permit - Minister's Permit.
(Refer to question 14 on the application)
It is better to send certified photocopies of documents rather than the originals. If you choose to send original
documents, send them by registered mail. We will return the original documents to you.
We can only accept a photocopy of an original document if it is legible and if it is a certified true copy of the
original. Our staff at any Service Canada Centre will photocopy your documents and certify them free of charge. If
you cannot visit a Service Canada Centre, you can ask one of the following people to certify your photocopy:
Page2of4
ISP-3000A-06-07 E Internet version
Certified photocopies of original documents (continued)
Guaranteed Income Supplement (GIS)
(Refer to question 11 on the application)
Page3of4
ISP-3000
A
-06-07 E Internet version
Allowance
Taxes and your pension
People who certify photocopies must compare the original document to the photocopy, state their official position
or title, sign and print their name, give their telephone number and indicate the date they certified the document.
They must also write the following statement on the photocopy:
This photocopy is a true copy of the original
document which has not been altered in any way
.
If a document has information on both sides, both sides must be copied and certified. You cannot certify
photocopies of your own documents, and you cannot ask a relative to do it for you. Please write your Social
Insurance Number on any photocopies that you send us.
Information Sheet for the Old Age Security Pension
The GIS is a non-taxable monthly benefit paid to residents of Canada who receive an OAS pension and who
have little or no other income. GIS payments may begin in the same month as OAS pension payments.
To receive the GIS, you must:
• be 65 years of age or older;
• be a resident of Canada;
• have low income; and
• be in receipt of the OAS pension.
If you qualify for the GIS and have a spouse or common-law partner
*
between the ages of 60 and 64, he or she
may be entitled to receive the Allowance. The Allowance is a non-taxable monthly benefit paid to the spouse or
common-law partner of someone who is receiving the OAS pension and who qualifies for the GIS. If this is your
situation, we will send your spouse or common-law partner a form with more information.
*A common-law partner is a person of the opposite or same sex who has been living with you in a conjugal
relationship for at least one year.
Your OAS pension is taxable. We will not deduct income tax from your monthly payment unless you request it.
Once we have approved your pension, we will send you a letter stating the amount of your pension. It will give you
information on how to ask for income tax to be deducted.
You may also obtain the tax deduction request form on our Internet site at
servicecanada.gc.ca and mail it with
your application.
INCOME TAX
If you wis
htobeconsidered for GIS, please check "yes" in question 11.
Even if you may not qualify today, you may become entitled in the future. By indicating "yes" today, we will assess
your current eligibility and review your account every year in the future.
We will contact you if you ever appear to be eligible for these benefits. To do this we will obtain information from
your annual income tax return. Therefore you must continue to file income tax returns in Canada every year,
otherwise you will need to contact us for an application form in the future if you believe that you are eligible.
Page4of4
ISP-3000
A
-06-07 E Internet version
(If your net world income* is more than $63,511 - Refer to question 16 on the application)
Protection of personal information
For more information
Information Sheet for the Old Age Security Pension
*Net world income means all the income that you earn or receive in a year from sources in Canada and outside
Canada. This includes total income derived from sources such as employment, business, pensions, rental property
and investments, minus allowable deductions.
Under a provision of Canada's
Income Tax Act, the amount of OAS pension that you receive may be reduced. For
Canadian residents, this provision is called the OAS Repayment. For non-residents of Canada it is called the OAS
Recovery Tax. For non-residents, the OAS Recovery Tax may not apply if the country you live in has a tax treaty
with Canada.
The Canada Revenue Agency calculates the amount of the Repayment or Recovery Tax deduction that is withheld
from your monthly OAS pension. If you are a resident of Canada, the amount of the deduction is based on
information found on your previous year's Canadian tax return. If you are a non-resident of Canada, the amount of
the deduction is based on your previous year's net world income.
REPAYMENT OF BENEFIT OR RECOVE RY TAX
The information requested is required under the Old Age Security Act (OAS). We may not be able to give you a
benefit if you do not give us all the information we need. We will keep this information in the Personal Information
Bank HRSDC PPU 116. Your personal information is governed by the Privacy Act and we may disclose it where
we are authorised to do so under the OAS Act.
Under the
OAS and the Privacy Act, you have the right to look at the personal information about you in your file.
You can ask to see your file by contacting a Service Canada Centre. To find out how to get your personal
information through the Access to Information Coordinator's office, see the Info Source, a directory that lists all the
information banks and the information they contain. Copies of the Info Source are available in all Service Canada
Centres.
To learn more about Canada Pension Plan, Old Age Security Program and Service Canada on-line services, please
visit our Internet site at :
servicecanada.gc.ca
In Canada or the United States,call
English: 1 800 277-9914
French: 1 800 277-9915
1 800 255-4786 (For TTY users w ho have speech or hearing impairments)
(Please have your Social Insurance Number ready when you call.)
This information sheet contains general information concerning the Old Age Security (OAS) pension and reflects the
OAS legislation. If there are any differences between what is in this document and the OAS Act, the Act is always
right.
If you live outside Canada, we may deduct a Non-Resident Tax from your monthly OAS pension. The tax rate is
25% of your monthly OAS pension unless you live in a country that has a tax treaty with Canada.
NON-RESIDENT TAX
Page1of4
Human Resources
Development Canada
Développement des
ressources humaines Canada
1. Social Insurance Number 2.
3. Name at birth 4. Date of birth
5. Country of Birth 6. Preferred language for correspondence
FrenchEnglish
7b. Mailing address
Postal code
7a.Home address
Postal code
Mr. Mrs.
Y
our first name, initial and last name
8. Direct deposit
For deposits outside of Canada, please contact us.
Name(s) on the account(s)
Branch Number Institution Number Account Number
Miss Ms.
Application for the Old Age Security Pension
Under the Old Age Security Program
Protected when completed - B
Personal Information Bank HRSDC PPU 116
Important: You do not need to provide proof of birth with your application. However, the Old Age Security program has the
right to request proof of birth at any time, when deemed necessary.
(If different from above)
(If different from home address)
DayYear
Month
(For Canada only)
Do you want your monthly payments deposited into your account at your financial institution?
No (Go to question 9)Yes(Complete this section)
Telephone number of your financial institution
chequing account, please attach an unsigned personalized cheque. Write the word "VOID" on the front of the
cheque and your social insurance number on the back.
savings account, complete the boxes below (you may want to contact your financial institution to get this
information):
Telephone number during the day
ISP-3000-06-07 E Internet version
Ce formulaire est disponible en français.
(If born in Canada, indicate province
or territory)
(See information sheet under "When to apply".)
(This information may help us determine your eligibility to other benefits.)
Social Insurance Number
First name, initial and last name of your spouse or common-law partner
If your marital status is married or common-law, please provide the following information:
Date of birth
Year Month
Note: If you indicate a date, no payment will be made for any period before that date, even if you qualify before.
If you are living in Canada now, indicate your current legal residence status.
(You must indicate your current residence status in Canada. If you were born outside of Canada, you must provide
roof of your residence status. See the information sheet under "Documents Required".)
ISP-3000-06-07 E Internet version
Page2of4
10. When do you want your pension to start?
9. Current marital status
Single Separated Divorced
Surviving spouse or
common-law partner
Married Common-law
As soon as I qualify OR (Indicateadate)
12. Canadian legal residence status
DayYear Month
If your Old Age Security pension is approved, do you want to apply for the Guaranteed Income Supplement?
Application for the Old Age Security Pension
Under the Old Age Security Program
13. If you were born outside Canada, please indicate:
OR
If you are living permanently outside Canada, indicate what your legal residence status was immediately before you left.
Canadian Citizen Resident under a Minister's Permit
Permanent Resident (formerly known as
Landed Immigrant)
Other (please specify)
The date you first entered Canada The city where you first entered Canada
(See the Information Sheet under "Guaranteed Income Supplement" for important information.)
11. Guaranteed Income Supplement
Yes No
DayYear Month
Have you lived in Canada all your life?
If you have lived or worked in a country other than Canada, you could qualify for benefits from that country. Please
provide the following information:
(See the information sheet under "Social Security Agreements".)
Application for the Old Age Security Pension
Under the Old Age Security Program
If you are not considered a resident of Canada for tax purposes, is your net world income for the year 2007 more
than $63,511?
(See information sheet under "Taxes and your pension".)
Page3of4
ISP-3000-06-07 E Internet version
DayYear Month DayYear Month DayYear Month
From To FromCountry
PERIOD LIVED PERIOD WORKED
Insurance
Number
Have you applied for or received
a benefit from that countr
y
?
DayYear Month
To
DayYear Month DayYear Month DayYear Month
From To FromCountry
PERIOD LIVED PERIOD WORKED
Insurance
Number
Have you applied for or received
a benefit from that countr
y
?
DayYear Month
To
14. Residence history
Yes (Go to Question 17)
No, list below all places where you have lived from age 18 to the present. Do not include periods when
you were outside Canada for less than six months at a time.
(You must provide proof of your residence history. See the information sheet under "Documents Required". If
you need more space, use a separate sheet of paper.)
Benefits from other countries15.
16.
Yes No
b)
Yes No
a)
Yes No
DayYear Month
ToPeriod from Country
DayYear Month
a)
DayYear Month DayYear Month
b)
DayYear Month DayYear Month
c)
Month DayYear Month DayYear
d)
Application for the Old Age Security Pension
Under the Old Age Security Program
Give the following information about one person, not related to you by blood or marriage, with whom we can confirm
your residence in Canada. Please note that if for any reason we lose contact with you, we could contact that person to
get in touch with you.
It is an offence to knowingly make a false or misleading statement on this application.
Telephone number during the day
Mailing address
I declare that the information on this application is true and complete. I realize that my personal information is governed
by the Privacy Act and may be disclosed where authorized under the Old Age Security Act.
Applicant's signature
Signature with a mark or by someone other than the applicant
If you (the applicant) signed with a mark (e.g. X), the mark must be made in the presence of a witness.
If the application was signed by someone who has the authority to act on behalf of the applicant, that person must
provide proof of authorization (contact us to find out what documents are required). In either situation, the witness or
the person who signed the application on behalf of the applicant must provide the following information:
If the applicant signed with a mark, the witness must also sign the following declaration:
I have read the content of this application to the applicant who appeared to fully understand and who made his or her
mark in my presence.
Witness's signature
DayYear
Month
DayYear Month
ISP-3000-06-07 E Internet version
Page4of4
SIGNATURE
17.
First name, initial and last name
Postal code
18.
Relationship to the applicant
Telephone number during the day
Name
Address
Postal code
Mr. Mrs. Miss Ms.
Date
Date
Date Stamp
FOR OFFICE USE ONLY
4
Signature Year Month Day
Year Month
Effective Date:
Aggregate:
Approve
Deny
Human Resources
Development Canada
Développement des
ressources humaines Canada
Go
Go
Go
Go
Go
Go
Go
Guaranteed Income Supplement
Common-law union Statutory
Declaration
Allowance
International benefits
Request for federal voluntary tax
deduction
CPP Retirement pension
Request for voluntary Quebec
provincial income tax deductions
Below you will find links to forms that you may have to complete as well as
information on other benefits and services to which you may be eligible.
Important
Complete this form to indicate the amount of
federal income tax you would like to have
automatically deducted from your CPP retirement
pension and send it in with your application. This
form cannot be completed online.
If you apply for the Guaranteed Income
Supplement and your spouse or common-law
partner is between 60 and 64 years of age, he/
she should complete and return this form.
If you have lived or worked in another country,
you may be eligible for benefits from that country.
Please consult our Internet site for more
information.
If you apply for the Guaranteed Income
Supplement (GIS) and you are living in a
common-law union, please complete and return
this form with your GIS application. This form
cannot be completed online.
Important:
By proceeding to the next step,
the information you entered on
your application might be erased.
Before you proceed, we
recommend that you print your
completed application using the
Print button shown at the top of
your screen.
If you have contributed to the Canada Pension
Plan and you wish to apply for your CPP
Retirement pension, please complete and return
this form with your application.
If you wish to apply for the Guaranteed Income
Supplement please complete and return this
form with your application. This form cannot be
completed online.
Complete this form to indicate the amount of
provincial income tax you would like to have
automatically deducted from your Old Age Security
pension and send it with your application.
Service Canada Offices
Your form(s) should be mailed to the nearest Service Canada office. These offices are shown below. If
you need any help while you are completing your form(s) and you are in Canada or the United States,
you can phone our toll-free number 1 800 277-9914. For people with speech or hearing impairments
using a teletypewriter device TTY, call 1 800 255-4786. Please have your social insurance number
ready. Note: If you are applying from outside of Canada, mail your form(s) to the office in the province
where you last resided.
ONTARIO (Timmins)
Service Canada
P.O. Bag 2013
Timmins ON P4N 8C8
ONTARIO (Chatham)
Service Canada
P.O. Box 2020
Chatham ON N7M 6B2
MANITOBA AND SASKATCHEWAN
Service Canada
P.O. Box 818
Station Main
Winnipeg MB R3C 2N4
ALBERTA / NORTHWEST TERRITORIES
AND NUNAVUT
Service Canada
P.O. Box 2710
Main Station
Edmonton AB T5J 4C2
BRITISH COLUMBIA AND YUKON
Service Canada
P.O. Box 1177
Victoria BC V8W 2V2
NEWFOUNDLAND AND LABRADOR
Service Canada
P.O. Box 9430
St. John's NL A1A 2Y5
PRINCE EDWARD ISLAND
Service Canada
P.O. Box 20105
Sherwood Postal Outlet
Sherwood PE C1A 9E3
NOVA SCOTIA
Service Canada
P.O. Box 1687
Station Central
Halifax NS B3J 3J4
NEW BRUNSWICK
Service Canada
P.O. Box 250
Fredericton NB E3B 4Z6
QUEBEC
Service Canada
P.O. Box 1816
Quebec QC G1K 7L5
ONTARIO (Scarborough)
Service Canada
P.O. Box 5100
Postal Station "D"
Scarborough ON M1R 5C8
Ce formulaire est disponible en français - ISP-3501F
ISP-3501-12-06E Inte
r
net Ve
r
sion
Human Resources
Development Canada
Développement des
ressources humaines Canada
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Information Sheet for the Old Age Security Pension

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Completed 19 November 2021

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