Canada / Latvia Agreement

Transcription

1 Canada / Latvia Agreement Applying for a Latvian Old Age Pension Here is some important information you need to consider when completing your application. Please ensure you sign the application. If you are signing with a mark, (for example: X ) the signature of a witness is required. Your application must be supported by documentation. Please submit the documents requested. Failure to complete the application and provide the requested documentation may result in delays in processing your application. Where original documents are specifically requested, originals must be submitted with your application. You should keep a certified true copy of any originals you send us for your records. Some countries require original documentation which will not be returned to you. You may submit the original or a photocopy that is certified as true for any of the documents where originals are not required. It is better to send certified copies of documents rather than originals. If you choose to send original documents, send them by registered mail. We will return the original documents to you. We can only accept a photocopy of an original document if it is legible and if it is a certified true copy of the original. Our staff at any Service Canada centre will photocopy your documents and certify them free of charge. If you cannot visit a Service Canada Centre, you can ask one of the following people to certify your photocopy: Accountant; Chief of First Nations Band; Employee of a Service Canada Centre acting in an official capacity; Funeral Director; Justice of the Peace; Lawyer, Magistrate, Notary; Manager of Financial Institution; Medical and Health Practitioners: Chiropractor, Dentist, Doctor, Pharmacist, Psychologist, Nurse Practitioner, Registered Nurse; Member of Parliament or their staff; Member of Provincial Legislature or their staff; Minister of Religion; Municipal Clerk; Official of a federal government department or provincial government department, or one of its agencies; Official of an Embassy, Consulate or High Commission; Officials of a country with which Canada has a reciprocal social security agreement; Police Officer; Postmaster; Professional Engineer; Social Worker; Teacher. People who certify photocopies must compare the original document to the photocopy, state their official position or title, sign and print their name, give their telephone number and indicate the date they certified the document. They must also write the following statement on the photocopy: This photocopy is a true copy of the original document which has not been altered in any way. If a document has information on both sides, both sides must be copied and certified. You cannot certify photocopies of your own documents, and you cannot ask a relative to do it for you. Return your completed application, forms and supporting documents to: International Operations Service Canada P.O. Box 2710 Station Main Edmonton, AB T5J 2G4 CANADA

2 Disclaimer: This application form has been developed by external sources in cooperation with Employment and Social Development Canada. The content and language contained in the form respond to the legislative needs of those external sources.

3 VALSTS SOCIĀLĀS APDROŠINĀŠANAS AĢENTŪRA STATE SOCIAL INSURANCE AGENCY OF LATVIA IESNIEGUMS/APPLICATION CAN/LV 1A Latvijas Republikas valsts vecuma pensijas piešķiršanai/ for a Republic of Latvia State Old Age Pension Saskaņā ar Latvijas Republikas un Kanādas sociālās drošības līgumu In accordance with the Agreement on Social Security between the Republic of Latvia and Canada 1. Informācija par pensijas pieprasītāju/details of applicant 1.1. Uzvārds/Surname 1.2. Vārds/Given name 1.3.Iepriekšējie uzvārdi, vārdi/previous names 1.4. Dzimšanas datums (dd/mm/gggg)/date of birth (dd/mm/yyyy) / / 1.5.Personas kods Latvijā/Latvian Identity Number 1.8. Dzīves vietas adrese/home address Iela, mājas Nr., dzīvokļa Nr./No and Street, Apt. No Dzimums/Sex vīrietis/male sieviete/female 1.7. Pilsonība/Citizenship Pilsēta, pasta indekss, valsts/city, town, postal code, country 1.9. Kanādas sociālās apdrošināšanas numurs/canadian Social Insurance Number Pēdējā dzīves vietas adrese Latvijā/Last address in Latvia Iela, mājas Nr., dzīvokļa Nr./No and Street, Apt. No. Pilsēta/apdzīvota vieta, pasta indekss/city, town, postal code 2. Lūdzu/I request that you piešķirt/grant pārrēķināt/recalculate atjaunot/renew vecuma pensiju no (dd/mm/gggg)/old age pension from (dd/mm/yyyy) / / Pieprasītāja izvēlētais datums Date chosen by applicant pievienojot uzkrāto fondēto pensijas kapitālu/adding the accrued funded pension capital 3. Apdrošinātās personas darba un tam pielīdzinātie periodi/insured person s employment and equivalent periods No (dd/mm/gggg) Līdz (dd/mm/gggg) Darba devēja nosaukums/ Darba devēja adrese, valsts/ From (dd/mm/yyyy) To (dd/mm/yyyy) Name of employer Address of employer, country 1 (3)

4 4. Papildus informācija/additional information Es joprojām esmu darba ņēmējs vai pašnodarbināta persona/i am still an employee or a self-employed person Es neesmu darba ņēmējs vai pašnodarbināta persona /I am not an employee or a self-employed person Es saņemu bezdarba pabalstu/i am receiving unemployment benefit 4.1. Latvijas pensija vai valsts sociālā nodrošinājuma pabalsts pēc cita pamatojuma/other types of pension or state security benefits from Latvia: nav piešķirts/not granted piešķirts no (dd/mm/gggg)/granted from (dd/mm/yyyy) / / 4.2. Citas valsts pensija/pension from another country nav piešķirta/not granted piešķirta (lūdzu norādīt datumu (dd/mm/gggg) un valsti)/granted (please indicate date (dd/mm/yyyy) and country) / / 5. Informācija par apdrošinātās personas bērniem/information concerning insured person s children Uzvārds/Surname Vārds/Given name Personas kods Latvijā un dzimšanas datums (dd/mm/gggg) /Latvian Identity Number and date of birth (dd/mm/yyyy) Piezīmes/Remarks (*) (*) Norādīt, vai bērns ir invalīds (invaliditātes noteikšanas datums) vai miris (miršanas datums) (*) Indicate whether the child is disabled (determination date of disability) or deceased (date of death) 6. Lūdzu pārskaitīt pensiju uz/please deposit the pension in: Bankas rekvizīti/bank particulars Saņēmēja vārds Name of the recipient Bankas nosaukums Name of the bank Bankas adrese Address of the bank Bankas konta numurs Bank account number Bankas SWIFT SWIFT address Bankas IBAN konta numurs International bank account number (IBAN) 6.1. Lūdzu veikt pensijas pārskaitījumu/please deposit (pay) the pension reizi mēnesī/monthly reizi ceturksnī/quarterly reizi gadā/annually 2 (3)

5 IESNIEGTIE DOKUMENTI/SUBMITTED DOCUMENTS darba grāmatiņa/employment record book darba līgums(i)/employment contract(s) skolas beigšanas apliecība/school graduation certificate diploms/degree bērna dzimšanas apliecība/child s birth certificate dokuments, kas apliecina bērna audzināšanu līdz astoņu gadu vecumam/document that proves child s upbringing up to age 8 dokuments, kas apliecina bērnam noteikto invaliditāti/document that proves child s disability represētās personas apliecība/certificate of the repressed person karaklausības apliecība/certificate of military service citi dokumenti (lūdzu norādīt)/other documents (please specify) Es apstiprinu, ka visa augstāk minētā informācija ir patiesa. Es pilnvaroju Kanādas pakalpojumu iestādi pārsūtīt visu informāciju un dokumentus, kas attiecas vai var attiekties uz šo iesniegumu, Valsts sociālās apdrošināšanas aģentūrai Latvijā. I declare that all the above information corresponds to the actual facts. I authorize Service Canada to furnish to the State Social Insurance Agency of Latvia all the information and documents which relate or could relate to this application for benefits. Datums (dd/mm/gggg)/ Date (dd/mm/yyyy) Iesniedzēja paraksts/signature of applicant Aizpilda Kanādas kompetentā iestāde/to be completed by the Competent Authority in Canada Iesniegumu pieņēma: Application received by: Uzvārds/Surname Vārds/ Given name Paraksts/Signature Iesniegums saņemts (dd/mm/gggg)/application received on (dd/mm/yyyy) / / Iesniegto dokumentu apstiprinātas kopijas (lūdzu norādīt skaitu)/certified copies of submitted documents (please specify quantity): 3 (3)

6 VALSTS SOCIĀLĀS APDROŠINĀŠANAS AĢENTŪRA STATE SOCIAL INSURANCE AGENCY OF LATVIA Instructions for Completing an application for an Old Age Pension, Disability Pension or Survivor s Pension from the Republic of Latvia pursuant to the Agreement on Social Security between the Republic of Latvia and Canada You should complete an application for an old age pension (application form CAN/LV 1A), disability pension (application form CAN/LV 1B) or survivor s pension (application form CAN/LV 1C) from the Republic of Latvia, if you: reside in Canada and want to apply for an old age pension, disability pension or survivor s pension from the Republic of Latvia. These instructions will help you to complete the application forms. Requirements for entitlement to an old age pension, disability pension or survivor s pension of the Republic of Latvia are described in the instructions under every respective type of pension. Please complete the application carefully, in block letters, writing above the dotted line. Please make sure you have included all the required information in the application as this will facilitate speedy processing of your application. Terms used in the Instructions: Insurance period period of time, expressed in full years, including insurance periods in Latvia and/or Canada. The insurance period in Latvia must be at least 1 year out of the total insurance period. Qualifying age the age at which a person becomes entitled to pension. 1

7 Application for an Old Age Pension from the Republic of Latvia CAN/LV 1A Complete this Application form, if: you are eligible for an old age pension from Latvia; you want a recalculation of an existing old age pension from Latvia; you want restitution of your old age pension from Latvia, the payments of which have been terminated. Qualifying for the pension You are entitled to claim an old age pension from Latvia, if you: are of age entitling to pension stipulated by law; Qualifying age: men and women from years 9 months, from years, from years 3 months, from years 6 months, from years 9 months, form years, from years 3 moths, from years 6 months, from years 9 months, from years have an insurance period of at least 15 years. You are entitled to claim a premature old age pension from Latvia, if you: are of age entitling to premature old age pension stipulated by law; Qualifying age: men and women from years 9 months, from years, from years 3 months, from years 6 months, from years 9 months, form years, from years 3 moths, from years 6 months, from years 9 months, from years have an insurance period of at least 30 years. You are entitled to claim an old age pension with preferential conditions from Latvia, if you: are a parent or a guardian, who has an insurance period of at least 25 years if he or she in the period until the child has reached the age of 18 years has cared for five or more children for not less than eight years or has cared for a child who according to the procedure established by the regulatory enactments has been acknowledged as a child with disability for a period of at least eight years; Qualifying age: men and women from years 9 months, from years, from years 3 months, from years 6 months, from years 9 months, form years, from years 3 moths, from years 6 months, from years 9 months, from years are a woman disabled for life, if the insurance period is at least 20 years; Qualifying age: women from years 6 months, from years, from years 6 months, from years, from years 6 months, from years, from years 2

8 6 months, from years, from years 6 months, from years 9 months, from years are a woman, who has raised five or more children up to 8 years of age or a child disabled since childhood, and if the insurance period is at least 20 years; Qualifying age: women from years 6 months, from years, from years 6 months, from years, from years 6 months, from years, from years 6 months, from years, from years 6 months, from years 9 months, from years until 1996 have worked under especially harmful and especially hard conditions, if the insurance period is at least 15 years (for women) or 20 years (for men) and at least one fourth of this period has been work under the above-mentioned conditions; Qualifying age: men from years 6 months, from years 9 months, from years, from years 3 months, from years 6 months, from years 9 months, from years, from years 3 months, from years 6 months, from years 9 months, from years women from years 6 months, from years, from years 6 months, from years, from years 6 months, from years, from years 6 months, from years, from years 6 months, from years, from years 6 months, from , from years 6 months, from years, from years 6 months, from years until 1996 have worked under harmful and hard conditions, if the insurance period is at least 20 years (for women) or 25 years (for men) and at least one fourth of this period has been work under the above-mentioned conditions; Qualifying age: men from years 9 months, from years, from years 3 months, from years 6 months, from years 9 months, form years, from years 3 moths, from years 6 months, from years 9 months, from years women from years 6 months, from years 9 months, from years, from years 3 months, from years 6 months, from years 9 months, from years, from years 3 months, from years 6 months, from years 9 months, from years are a participant of the Chernobyl NPS nuclear clean-up, if the insurance period is at least 15 years Qualifying age: men and women from years 9 months, from years, from years 3 months, from years 6 months, from years 9 months, form years, from years 3 moths, from years 6 months, from years 9 months, from years are a politically prosecuted person, if the insurance period is at least 30 years 3

9 Qualifying age: men and women from years 9 months, from years, from years 3 months, from years 6 months, from years 9 months, form years, from years 3 moths, from years 6 months, from years 9 months, from years are lilliputian, dwarf and the blind, if the insurance period is at least 15 years (for women) and 20 years (for men); Qualifying age: men from years 6 months, from years, from years 6 months, from years, from years 6 months, from years, from years 6 months, from years, from years 6 months, from years, from years 6 months, from , from years 6 months, from years, from years 6 months, from years, from years 6 months, from years, from years 6 months, from years women from years 6 months, from years, from years 6 months, from years, from years 6 months, from years, from years 6 months, from years, from years 6 months, from years, from years 6 months, from , from years 6 months, from years, from years 6 months, from years, from years 6 months, from years, from years 6 months, from years, from years 6 months, from years, from years 6 months, from years, from years 6 months, from years, from years 6 months, from years, from years 6 months, from years. When claiming the pension, please specify in section 3, periods of work and periods equivalent to them, until 1 January 1996; and insurance (work) periods, accumulated in accordance with the pension scheme of Latvia after 1 January At the end of the application you should list the documents enclosed with the application. Recalculation of a pension An application for recalculation of an old age pension from Latvia can be submitted in the following cases: if any social insurance contributions have been made for the period after awarding (recalculation) of an old age pension; if you have additional insurance periods before awarding (recalculation) of the pension. Requesting a recalculation of the pension in the case where you have additional insurance periods, in section 3, you should specify the additional insurance periods and/or at the end of the application you should list additional enclosed documents. Restitution of a pension An application for restitution of an old age pension from Latvia can be submitted in the following cases: 4

10 if payment of the pension has been terminated for the reason of leaving the country to live abroad permanently; if payment of the pension has been terminated for other reasons. When requesting for restitution of the pension, you do not have to complete section 3 of the application or the section listing the enclosed documents. 5

11 Application for a Disability Pension from the Republic of Latvia CAN/LV 1B Complete this Application form, if: you are eligible for a disability pension from Latvia; you want a recalculation of an existing disability pension from Latvia; you want restitution of your disability pension from Latvia, the payments of which have been terminated. Qualifying for the pension You are entitled to claim a disability pension from Latvia, if you: have not reached the retirement age stipulated by law: men and women from years 9 months, from years, from years 3 months, from years 6 months, from years 9 months, form years, from years 3 moths, from years 6 months, from years 9 months, from years have been recognised as disabled (except the cases where the disability was a result of a work-related accident or occupational disease);. have an insurance period of at least three years. When claiming the pension, please specify in section 3, periods of work and periods equivalent to them, until 1 January 1996; and insurance (work) periods, accumulated in accordance with the pension scheme of Latvia after 1 January At the end of the application you should list the documents enclosed with the application. Recalculation of a pension An application for recalculation of a disability pension from Latvia can be submitted in the following cases: if any social insurance contributions have been made for the period after awarding (recalculation) of the disability pension of category I or II; if you have additional insurance periods before awarding (recalculation) of the pension. if a different category of disability has been determined. Requesting a recalculation of the pension in the case where you have additional insurance periods, in section 3, you should specify the additional insurance periods and/or at the end of the application you should list additional enclosed documents. An application for restitution of a disability pension from Latvia can be submitted in the following cases: if payment of the pension has been terminated for the reason of leaving the country to live abroad permanently; 6

12 if payment of the pension has been terminated because you are not determined as disabled any more; if payment of the pension has been terminated for other reasons. A disability pension shall be awarded anew if you are not determined as having any disability category for more than 5 years. In that case an application for a disability pension must be completed. When requesting for restitution of the pension you do not have to complete section 3 of the application or the line listing the enclosed documents. 7

13 Application for a Survivor s Pension from the Republic of Latvia CAN/LV 1C Complete this Application form, if: you are eligible for a survivor s pension from Latvia; you want a recalculation of an existing survivor s pension from Latvia; you want restitution of your survivor s pension from Latvia, the payments of which have been terminated. Qualifying for the pension You are entitled to claim a survivor s pension from Latvia, if: the insurance period of the deceased person is at least 15 years (the insurance period of the deceased person shall include also the period from the date of death until the statutory retirement age): family members incapable of work, had been supported by the deceased person. The children of the deceased person shall be awarded a survivor s pension irrespective of whether they have or have not been supported by the deceased person. The adopted children have the same rights as natural children. Family members that shall be considered as incapable of work: children who are younger than 18 and children, irrespective of age, if they have become disabled before reaching the age of 18; brothers, sisters and grandchildren, younger than 18, if they do not have parents capable of work, as well as brothers, sisters and grandchildren, irrespective of age, if they do not have parents capable of work and if they have become disabled before reaching the age of 18; children, brothers, sisters and grandchildren, who, at the time of death of the supporter or later, study in general education schools, vocational training schools, colleges or a higher education establishment (full time studies) and are not older than 24. If the child has reached 18 and is continuing studies in a general education school, vocational training school, colleges or a higher education establishment (full time studies), the fact shall be proved by submitting a reference from the specific school stating that the person is continuing studies in the particular academic year. Dependants aged from 18 to 24 shall submit a reference from school every academic year. The academic year in Latvia is from 1 September to 31 August. A survivor s pension can be claimed and received by: mother/father or custodian; the child aged 15 to 18 himself/herself, if mother/father or custodian do not object; the child aged 18 to 24 himself/herself. 8

14 When claiming the pension, please specify in section 2, the deceased person s periods of work and periods equivalent to them, until 1 January 1996; and insurance (work) periods, accumulated in accordance with the pension scheme of Latvia after 1 January At the end of the application you should list the documents enclosed with the application. Recalculation of a pension An application for recalculation of a survivor s pension from Latvia can be submitted in the following cases: if the deceased had additional insurance periods before awarding of the pension. if there are changes in the number of dependants entitled to survivor s pension. Requesting a recalculation of the pension in the case where insurance periods have been added, in section 2, you should specify the deceased additional insurance periods and/or at the end of the application you should list additional enclosed documents. Restitution of a pension An application for restitution of a survivor s pension from Latvia can be submitted in the following cases: if payment of the pension has been terminated for the reason of leaving the country to live abroad permanently; if payment of the pension has been terminated for other reasons; if payment of the pension has been suspended because of failure to submit the reference from school When requesting for restitution of the pension, you do not have to complete section 2 of the application or the line listing the enclosed documents. Portion out of pension An application for portion out of a survivor s pension from Latvia can be submitted in the case: if a dependant has the right to require his or her rightful part of a survivor s pension to portion out from the total amount of the pension. When requesting for portion out of the pension, you do not have to complete section 2 of the application or the line listing the enclosed documents. 9

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17 Canada /Latvia Agreement Documents and/or information required to support your application [CAN/LV 1A] for a Latvian Old Age Pension Complete the attached form: Canadian Residence [ISP 5013] indicating your period(s) of residence in Canada Original or certified documents to be submitted: Birth certificate for you and any children listed in Section 5 of the application form (CAN/LV 1A) Proof of the dates of your entry(ies) to Canada and departure(s) from Canada (such as: Immigration 1000, passport, visa, ship or airline tickets etc.) Proof of your current citizenship (for assistance regarding Canadian citizenship, please contact your local Registrar of Canadian Citizenship) Latvian employment workbooks for periods before 1 January 1996 (if applicable) If Latvian employment workbooks are not submitted, statements from former employers for periods before 1 January 1996 (if applicable) Records of military service in Latvia (if applicable) School graduation certificate, such as diploma (if applicable) Degree (if applicable) Certificate of the repressed person (if applicable) Document that proves child s upbringing up to age 8 (such as: proof that child resides with you, medical or school documents proving that you are responsible for him/her, etc.) Document that proves child s disability IMPORTANT: If you have already submitted any of the documents required when you applied for a Canada Pension Plan or Old Age Security benefit, you do not need to resubmit them.