PARTICIPATION FORM

Ontario Sales Tax Administration Reform Pension Transfer Class Action

PARTICIPATION FORM

ONLY USE THIS FORM IF YOU WANT TO REGISTER YOUR SUPPORT OR OBJECTION TO THE PROPOSED
SETTLEMENT

TO: RavenLaw LLP

1600-220 Laurier Ave W
Ottawa, ON K1P 5Z9

RE: Ontario Sales Tax Administration Reform Pension Transfer Class Action

My name is ____________________________________________________

I am a (please specify):

 Person who commenced employment with the Canada Revenue Agency prior to November
1, 2012, as part of the Ontario Sales Tax Administration Reform (“OSTAR”) process, who
transferred their pensionable service from the OPSEU Pension Plan or the Public Service
Pension Plan to the Public Service Superannuation Plan, and whose pension transfers were
completed on the basis of the actuarial assumptions that took effect in the Public Service
Superannuation Plan on November 1, 2012

For the reasons stated below, I:

 SUPPORT the terms of the Settlement  OBJECT TO the terms of the Settlement

 SUPPORT the legal fees  OBJECT TO the legal fees

I am supporting or objecting to the Proposed Settlement or legal fees for the following reasons (please
add extra pages if you require more space):
 I have enclosed copies of documentation supporting my support or objection. (You do not

have to attach any documents).

 I have NOT enclosed documentation supporting my objections

I do NOT intend to appear at the hearing of the motion to approve the proposed settlement,
 and I understand that my support or objection will be filed with the court prior to the hearing
of the motion on June 12, 2024 in Ottawa, Ontario
I intend to appear, in person or by counsel, and to make submissions at the hearing on June

12, 2024 at 10:00 a.m. in Ottawa, Ontario.

MY ADDRESS FOR SERVICE IS: MY LAWYER’S ADDRESS FOR SERVICE IS (if

applicable, but you do not need a lawyer to
object):

Name: Name:

Address: Address:

Tel: Tel:

Fax: Fax:

Email: Email

 I consent to service of documents by email.

Date: Signature
_________________________________ _______________________________