Change of Address

Retiree Change of Address Form

To change your address, please complete the online form below and click the “submit” button. Your changes will be sent to us electronically (information sent online is encrypted). Fields with an "*" are mandatory fields, and must be completed before the form can be submitted.

Alternatively, you can print a PDF version of the Change of Address form, complete the information (please print clearly) and mail it to the address listed below. Adobe Acrobat 3.0 or higher is required to view this document. If you do not have this program, you can download Adobe Acrobat.

CIBC Mellon Pension Benefits Department
P.O. Box 5858 Station B
London, ON N6A 6H2
CANADA

Submit Online

Fields marked with an (*) must be completed.

Change of Address

Name

First name: *

Last name: *

Middle initial:

Pension plan name: *

Member ID: *
(This can be found on any correspondence that you have received from CIBC Mellon.)

Previous Address

Address *

Suite

City *

Province *

Country *

Postal code *

New Address

Address: *

Suite:

City: *

Province: *

Country: *

Postal code: *

Effective day: *

Effective month: *

Effective year: *

Phone number: *

Email

Email Address to which we can send confirmation

E-mail address: *