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Begin by entering the Retired Member's Name in section 1.a. Ensure you include the last name, first name, and middle initial.
In section 2, provide the Designated Beneficiary Information. For each beneficiary, fill out their full name, Social Security Number (SSN), relationship to you, share percentage, and address. You can designate up to five beneficiaries.
If you choose not to designate beneficiaries, complete section 3 with information about family members who may be contacted upon your death. Include their full names, SSNs (if available), relationships, and addresses.
Finally, sign and date the form in section 4. Make sure your Social Security Number is included for processing.
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