Confidential when completed; The data reported on this questionnaire are protected under the Statistics Act and will be treated in strict confidence, used for statistical purposes and published in aggregate form only.
Collected under the authority of the Statistics Act. Revised Statutes of Canada, 1985, Chapter S19 (22).
This is a mandatory survey.
To return completed questionnaire either:
- Use enclosed postage paid envelope;
- Address your own envelope to:
Pensions and Wealth Surveys Section
Income Statistics Division
Statistics Canada
170 Tunney's Pasture Driveway
Ottawa, Ontario K1A 0T6 - Fax to: (613) 951-4296
(Note : Data sent by facsimile may be at risk of disclosure during the transmission process.)
If you have questions:
- Call (613) 951-4092
- E-mail: tpfc@statcan.gc.ca
Français au verso
(Please make any necessary changes in above name or Mailing address; add the name of the fund if missing)
Please complete and return the questionnaire by May 31, 2011.
1. Does this organization operate, either by sponsoring or managing, the trusteed pension fund named at the top of this page? For a definition of a trusteed pension fund, please refer to "Definitions" on the "Notes/Instructions".
- Yes – Please complete the remainder of the questionnaire and return it to Statistics Canada.
- No – Please elaborate
- Fund closed (MM-YYYY)
- Fund is deposited in total with an insurance company under an insurance company contract
- Other, please specify
Please provide your name (bottom of this page), complete question 8 and return the questionnaire to Statistics Canada.
2. If this pension fund participates in a master trust fund, indicate the name of this master trust:
Please complete and return the questionnaire to Statistics Canada.
3. If it is necessary to obtain the financial data on this pension fund from a trustee outside your company, please complete the following authorization notice, as well as Section A (Administrative Data) and forward this document to the trustee or return it to Statistics Canada for forwarding.
- Authorization Notice (to be completed only if item 3 above applies)
- This is to authorize (contact name), (telephone number) to supply Statistics Canada with the information requested in Section B of this questionnaire. We understand that the information will be treated as strictly confidential and used only in compiling aggregates.
- (Name of company)
- (Date)
- (Signature)
- (Title)
Name of person completing questionnaire (please print)
Telephone ()
Fax ()
E-mail address
Thank you for your cooperation
Section A: Administrative Data
1. Year of Inauguration of This Fund
2. Fund Fiscal Year End (MM-DD)
3. Investment Decision made by (check one or more)
Note: If a committee is actively involved in directing the investments, indicate which of the following are represented on the committee.
- (a) Trustee(s)
- (b) Employer (includes investment staff of the employer and public sector funds whose investment is governed by legislation)
- (c) Outside investment counsel
- (d) Employee (plan members)
- (e) Other (specify)
4. Insurance Company Holdings
Is any of the money in this pension fund invested with or managed by an insurance company?
(If part of a master trust, consider only money associated with this participant.)
- Yes
- No
If yes, what is the amount involved?
- Market value $ (omit cents)
5. Members Covered
Note: Should be as of same time period as assets, preferably December 31.
Indicate if at:
- December 31, 2010
- Other fiscal year end occurring between April 1, 2010 and March 31, 2011
- (a) Number of employed plan members (including employees on temporary lay-off)
- (b) Number of additional persons having equity in the fund (e.g. retired persons receiving pension, persons who will receive deferred pension, etc.)
6. Contributory Status(for the majority of members)
Are the majority of members required to contribute to the pension fund?
- Yes
- No
7. Type of Plan (for the majority of employed members participating in the fund – check one only)
- (a) Defined benefit / flat benefit
- (b) Defined contribution (money purchase/profit sharing)
- (c) Combination of above or as selected by employee
- (d) Other (specify)
8. Plan Registration Number(s)* (of all plans included in this fund)
(If space insufficient, attach another page.)
* Number used by Canada Revenue Agency (CRA). Also provide the number used by the provincial pension regulatory authority or the Office of the Superintendent of Financial Institutions (OSFI), if different from the Plan registration number.
Section B: Financial Information
Previous Year
9. Net Book (cost) value of assets for the year end occurring between April 1, 2009 to March 31, 2010
- $ (omit cents)
Current Year
Report for one year period ending December 31, 2010 if possible.
10. Year end used:
- December 31, 2010
- between April 1, 2010 and March 31, 2011
Note: Do not include any unrealized gains or losses
11. Total receipts and gains (if this fund is a participant in a Master Trust, please provide name of master trust):
- name of master trust
- $ (omit cents)
12. Total disbursements and losses (if this fund is a participant in a Master Trust, please provide name of master trust):
- name of master trust
- $ (omit cents)
13. Total assets
- Book (cost) value $ (omit cents)
- Market value $ (omit cents)
Confidential when completed; The data reported on this questionnaire are protected under the Statistics Act and will be treated in strict confidence, used for statistical purposes and published in aggregate form only.
Collected under the authority of the Statistics Act. Revised Statutes of Canada, 1985, Chapter S19 (22).
This is a mandatory survey.
To return completed questionnaire either:
- Use enclosed postage paid envelope;
- Address your own envelope to:
Pensions and Wealth Surveys Section
Income Statistics Division
Statistics Canada
170 Tunney's Pasture Driveway
Ottawa, Ontario K1A 0T6 - Fax to: (613) 951-4296
(Note : Data sent by facsimile may be at risk of disclosure during the transmission process.)
If you have questions:
- Call (613) 951-4092
- E-mail: tpfc@statcan.gc.ca
Français au verso
(Please make any necessary changes in above name or Mailing address; add the name of the fund if missing)
Please complete and return the questionnaire by May 31, 2011.
1. Does this organization operate, either by sponsoring or managing, the trusteed pension fund named at the top of this page? For a definition of a trusteed pension fund, please refer to "Definitions" on the "Notes/Instructions".
- Yes – Please complete the remainder of the questionnaire and return it to Statistics Canada.
- No – Please elaborate
- Fund closed (MM-YYYY)
- Fund is deposited in total with an insurance company under an insurance company contract
- Other, please specify
Please provide your name (bottom of this page), complete question 8 and return the questionnaire to Statistics Canada.
2. If this pension fund participates in a master trust fund, indicate the name of this master trust:
Please complete and return the questionnaire to Statistics Canada.
3. If it is necessary to obtain the financial data on this pension fund from a trustee outside your company, please complete the following authorization notice, as well as Section A (Administrative Data) and forward this document to the trustee or return it to Statistics Canada for forwarding.
- Authorization Notice (to be completed only if item 3 above applies)
- This is to authorize (contact name), (telephone number) to supply Statistics Canada with the information requested in Section B of this questionnaire. We understand that the information will be treated as strictly confidential and used only in compiling aggregates.
- (Name of company)
- (Date)
- (Signature)
- (Title)
Name of person completing questionnaire (please print)
Telephone ()
Fax ()
E-mail address
Thank you for your cooperation
Section A: Administrative Data
1. Year of Inauguration of This Fund
2. Fund Fiscal Year End (MM-DD)
3. Investment Decision made by (check one or more)
Note: If a committee is actively involved in directing the investments, indicate which of the following are represented on the committee.
- (a) Trustee(s)
- (b) Employer (includes investment staff of the employer and public sector funds whose investment is governed by legislation)
- (c) Outside investment counsel
- (d) Employee (plan members)
- (e) Other (specify)
4. Insurance Company Holdings
Is any of the money in this pension fund invested with or managed by an insurance company?
(If part of a master trust, consider only money associated with this participant.)
- Yes
- No
If yes, what is the amount involved?
- Market value $ (omit cents)
5. Members Covered
Note: Should be as of same time period as assets, preferably December 31.
Indicate if at:
- December 31, 2010
- Other fiscal year end occurring between April 1, 2010 and March 31, 2011
- (a) Number of employed plan members (including employees on temporary lay-off)
- (b) Number of additional persons having equity in the fund (e.g. retired persons receiving pension, persons who will receive deferred pension, etc.)
6. Contributory Status(for the majority of members)
Are the majority of members required to contribute to the pension fund?
- Yes
- No
7. Type of Plan (for the majority of employed members participating in the fund – check one only)
- (a) Defined benefit / flat benefit
- (b) Defined contribution (money purchase/profit sharing)
- (c) Combination of above or as selected by employee
- (d) Other (specify)
8. Plan Registration Number(s)* (of all plans included in this fund)
(If space insufficient, attach another page.)
* Number used by Canada Revenue Agency (CRA). Also provide the number used by the provincial pension regulatory authority or the Office of the Superintendent of Financial Institutions (OSFI), if different from the Plan registration number.
Section B: Financial Information
Previous Year
9. Net Book (cost) value of assets for the year end occurring between April 1, 2009 to March 31, 2010
- $ (omit cents)
Current Year
Report for one year period ending December 31, 2010 if possible.
10. Year end used:
- December 31, 2010
- between April 1, 2010 and March 31, 2011
Note: Do not include any unrealized gains or losses
11. Total receipts and gains (if this fund is a participant in a Master Trust, please provide name of master trust):
- name of master trust
- $ (omit cents)
12. Total disbursements and losses (if this fund is a participant in a Master Trust, please provide name of master trust):
- name of master trust
- $ (omit cents)
13. Total assets
- Book (cost) value $ (omit cents)
- Market value $ (omit cents)