Forms

Access to Information

• Access to Information Request Form (TBC/CTC 350-57)
• Personal Information Request Form (TBC/CTC 350-58)
• Access to Information Tracking Document (TBC/CTC 350-59)
• Record Correction Request Form (TBS/SCT 350-11)
• Report on the Access to Information Act (TBS/SCT 350-62)
• Report on the Privacy Act (TBS/SCT 350-63)

Disability Insurance

• Claim for Disability Insurance - Employee's Statement Policy No. 12500-G (TBS/SCT 330-302)
• Claim for Disability Insurance - Employer's Statement Policy No. 12500-G (TBS/SCT 330-303)
• Claim for Disability Insurance - Employee's Medical Information and Attending Physician's Statement Policy No. 12500-G (TBS/SCT 330-304)

Leave

• Application for Self-Funded Leave (TBS/SCT 330-109)
• Application for Leave with Income Averaging (TBS/SCT 325-10)
• Application for Pre-retirement Transition Leave (TBS/SCT 325-9)

Dental Care

• Claim Form for Public Service Dental Care Plan (The Great-West Life Assurance Company)
• Public Service Dental Care Plan - Authorization to Redirect Payment (M5103 BIL-2/01)
• Public Service Dental Care Plan - Authorization for Claims Submission and Re-Direction of Payment (M6591-3/05)

Pensioners' Dental Services Plan

Some PDSP forms were made obsolete as of April 1st 2006. For more information on PDSP enrolment and eligibility, see the PDSP menu.

• Pensioners' Dental Services Plan Claim Form
• Pensioners' Dental Services Plan Authorization for Claims Submission and Re-direction of Payment Form (00093-E-3-05)

Health Care

• PSHCP Claim Form (Public Service Health Care Administration Authority Web Site)
• PSHCP Claim Form-Out-of-Country claims (Comprehensive Coverage) (Public Service Health Care Administration Authority Web Site)

Public Service Management Insurance Plan

• PSMIP Long-Term Disability Benefit (TBS/SCT 5945, 5946)
• PSMIP Accidental Dismemberment Benefit (TBS/SCT 5954, 5955)
• PSMIP Claim For for  Death Benefit (TBS/SCT 5948, 5949)

Security

Security in Contracting

• Security Requirements Check List (SRCL) (TBS/SCT 350-103) (Rev 2004/12)

Security Screening

• Personnel Screening, Consent and Authorization Form (TBS/SCT 330-23e)
• Security Clearance Form (TBS/SCT 330-60e)
• Security Screening Certificate and Briefing Form (TBS/SCT 330-47)
• Notification of Change in Security Clearance (CSIS/SCRS 4160e)

Submission

• Treasury Board Submission (Form number TBC 300-1)
• Notification of Delegation of Signing Authority for Submissions to Treasury Board (Form number TBC 300-8)
• Specimen Signature (Form number GC 136)

Labour Relations

• Bargaining Agent Identification - Notice of Change (TBS/SCT 340-51)
• Employee Consent to Provide Personal Information to Bargaining Agents (TBS/SCT 340-51a)
• Grievance Transmittal Form (TBS/SCT 340-54)
• Group Grievance Presentation (PSLRA s. 215) (TBS/SCT 340-56)
• Individual grievance presentation (PSLRA s. 208) (TBS/SCT 340-55)
• Managerial or Confidential Position (TBS\CTS 340-10)
• Policy Grievance Presentation (PSLRA s. 220) (TBS/SCT 340-53)

Miscellaneous

• Application for the Refund of Union Dues (TBS/SCT 340-50)
• Bank of Montreal MasterCard Acquisition Card, Employee Account Request Form (TBS/SCT 350-126)
• Confidential Report Form (CPSA/AFPC 610-30 E)
• Employee Declaration Document (TBS/SCT 325-8)
• Elavon Visa Acquisition Card Cardholder – Application Form (TBS/SCT 350-125)
• Nomination Form - Public Service Award of Excellence 2010
• Objection on Grounds of Conscience to Dues Check-off (TBS/SCT 340-52)
• Request for payment to Audit Committee Members appointed by Treasury Board (TBS/SCT 300-0074)