FD-253 Application Renewal of Membership Designation of beneficiary, Special Agents Insurance Fund, 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by entering your Official Bureau Name at the top of the form. This identifies your affiliation.
  3. Indicate whether you elect to enroll in the Special Agents Insurance Fund by checking the appropriate box and including the $20 membership fee.
  4. If you are declining membership, ensure you list your beneficiary(ies) for the Charles S. Ross Fund below, specifying their relationships.
  5. Fill out the designated beneficiary sections for both the Special Agents Insurance Fund and Charles S. Ross Fund, providing names and relationships accurately.
  6. Review all entered information for accuracy before signing and dating the form at the bottom.
  7. Once completed, submit two copies as instructed on the form.

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