When someone receiving Old Age Security or Canada Pension Plan benefits can no longer manage their own affairs, a trustee, agency or institution can apply to receive and administer those benefits on their behalf. Service Canada uses this certificate to decide whether the person is incapable. To qualify, the person must have a severe mental impairment or a physical illness or impairment.
A medical professional (physician, registered nurse, nurse practitioner, psychologist or psychiatrist) answers questions 1 to 9; for seniors, a designated social worker, lawyer or member of the clergy may certify using questions 10 and 11 instead. The person or agency applying to administer the benefits completes a separate agreement, ISP-3506 or ISP-3507.
Download the current version from the source each time; forms change without notice.
Certificate of Incapability-OAS/CPP
Certificat d'incapacité - SV/RPC
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A physician, registered nurse, nurse practitioner, psychologist or psychiatrist completes the medical questions. For seniors, a designated social worker, lawyer or member of the clergy may complete the non-medical questions instead. No one related by blood or marriage to the person or to the proposed administrator can certify.
After the five capacity questions, you state how long you have known the person, their date of birth, and whether they can manage their own affairs, with an expected improvement date if any. Questions 8 and 9 ask for the diagnosis of impairment, the date it started and comments.
Yes. Service Canada publishes it in both official languages; the French title is Certificat d'incapacité - SV/RPC. The current English version is dated 2024-03-15. False or misleading statements on the form can lead to an administrative monetary penalty or an offence charge.