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Page 1 of 2. E-FORM 00546 (09/2017) Beneficiary Designation Form. to make or change a beneficiary designation. Standard Beneficiary Designation with Contingent Options
RECEIPT’OFBENEFICIARY’OFESTATE’ ’ ’!!!!!Re:!Estate!of!_____,!deceased!! ’ The!undersigned!beneficiary!of!the!above!referenced!estate!hereby!acknowledges ...
VRS-2 (Rev. 01/14) INSTRUCTIONS FOR COMPLETING THE DESIGNATION OF BENEFICIARY Complete this form to designate a beneficiary for VRS Basic and Optional Group Life Insurance and for your defined benefit
Important - The filing of this form will completely cancel any Civil Service Retirement System Designation of Beneficiary you may have filed before this date. Be sure to name in this form all persons you wish to designate as beneficiaries of any lump sum payable at your death.
CS-1781 REV 5/2010 State of Michigan Civil Service Commission EMPLOYEE BENEFITS DIVISION LIFE INSURANCE AND ACCIDENTAL DUTY DEATH BENEFICIARY DESIGNATION OR CHANGE FORM EMPLOYEE DATA INSU FOR HUMAN RESOURCES USE ONLY Employee I.D. Number Social Security Number Deduction Code Effective Date Unit Code Department/Agency
If you list primary or secondary and/or tertiary beneficiaries, be sure to include the full name, relationship, birthdate, Social Security number
Important Information About Designation of Beneficiaries Beneficiary Information • Primary Beneficiary(ies) means the person(s) you choose to receive your life insurance benefits.
1 of 4 X4219 10/04 What is a beneficiary designation with a preselected death benefit election? As the Owner(s) of an annuity contract, you have the right to designate a beneficiary…
Beneficiary Identification Codes The Medicare number is followed by an identifying suffix. When a claim is submitted to the Medicare Intermediary or Carrier