Psob beneficiary form 2026

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The document is a Designation of Beneficiaries Form for the U.S. Department of Justice Public Safety Officers' Benefits (PSOB) Program, outlining how benefits are distributed to survivors upon an officer's death. It specifies the criteria for beneficiaries, including spouses, children, and designated individuals, and provides instructions for completing the form to declare a beneficiary.

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Click ‘Get Form’ to open the psob beneficiary form in the editor.
Begin by entering your full name in the designated field. This identifies you as the officer completing the form.
Next, input your agency name where prompted. This is important for official records.
In the beneficiary section, list each beneficiary's name, address, and relationship to you. Ensure that the total percentage allocated equals 100%.
Sign and date the form at the bottom to validate your designation of beneficiaries.
If required, have a Notary Public witness your signature and complete their section, including their stamp or seal.

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