Atomic Energy of Canada Limited Pension Regulations (C.R.C., c. 1356)

• TO: 

  SUN LIFE ASSURANCE COMPANY OF CANADA HEAD OFFICE, MONTREAL, CANADA.
• RE: 

  ATOMIC ENERGY OF CANADA LIMITED PENSION PLAN.

In connection with Policy No issued by your Company, I hereby request that each annuity payment as it falls due, commencing with the payment due on or after the first day of the second month following Atomic Energy of Canada’s receipt of this form be paid to the Receiver General for Canada (to be deposited in the Superannuation Account) and agree that such payment will constitute on your part a sufficient discharge of your obligations to me with respect to annuity payments under Policy No .

Dated at

this day

of 19

Signature

Address

S.I.N.

Witness

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