Formulaire

Application for the retirement of a public official, a magistrate or a member of the armed forces, in respect of disability

Cerfa 15684*01

This form applies to the following persons:

  • Civil servant or magistrate permanently unable to perform his or her duties or any other reclassification function because of a service-related or non-service-related disability resulting from injuries or illnesses acquired or aggravated during a period of pensionable service
  • Civil servant or magistrate with at least 15 years of service to the Crown and who, while no longer acquiring pension rights, infirmity or of a incurable disease making it impossible for him to practice any profession
  • Military suffering from disabilities attributable or not to the service, making them permanently unable to perform their service
  • Civil servant, magistrate or military with at least 15 years of service and spouse is suffering from an incurable infirmity or disease making it impossible for him to pursue any profession.
  • Service free
  • 4 steps
  • Language French

Fill out the form

Comment faire ?

  1. Print the form
  2. The fill by hand
  3. The sign
  4. THEsend through the hierarchy to your managing administration with the necessary supporting documents

  • Medical documents from your treating physician attesting to your inability to practice any profession or medical documents from your spouse's treating physician attesting to his inability to practice any profession
  • Copy of your up-to-date family record book or document certifying that you have had a dependent child (e.g. photocopy of the guardianship certificate)

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Verified 07 September 2026 - Public Service / (Prime Minister)