Request to Deduct and Pay a One-time Retroactive Payment to an Insurer - ISP1618C
Purpose
This form is for use by disability insurance companies who have a valid Approval Deduction and Payment Agreement with the Minister of Human Resources and Social Development Canada and who are seeking a reimbursement from Service Canada for CPP Disability benefits paid to you while you were receiving benefits from your insurer for the same period. This form contains a statutory declaration which requires the insurer to declare that they are acting in accordance with the terms and conditions of the Approval Deduction and Payment Agreement.
Group
Canada Pension Plan
Forms
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Important Information
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Income Security Programs
Request to Deduct and Pay a One-time Retroactive Payment to an Insurer
PDF: Download ISP-1618(C), 180 KB, printed on 2 pages (8.5x11)