Transcription of Pension Funds Declaration of No Spouse - Concentra
1 302-434 (01/17) Concentra Bank, 2017 Pension Funds Declaration of No SpouseThis form is to be used to indicate that the annuitant of the contract has no Spouse or other individual who has been given similar rights as defined under the applicable Pension : _____(name of financial institution holding Pension Funds )I, _____, being the annuitant under contract # _____ , hereby declare that I have no Spouse or other individual who has been given similar rights as defined under the applicable Pension benefits legislation governing these Funds . I have been made aware of the applicable definition(s) that apply to this _____ day of _____, 20 (signature of annuitant)_____(signature of witness)(day)(month)(year)(annuitant)
