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Public service insurance plan 2026
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- Click ‘Get Form’ to open it in the editor.
- Begin with the 'Initial Application' section. Fill in your name, initial, and surname clearly. Ensure that your mailing address is accurate for correspondence.
- Indicate your date of birth and sex. This information is crucial for processing your application.
- In the 'Beneficiary' section, provide the name and relationship of your chosen beneficiary. Remember, you can revoke this appointment later if needed.
- Next, confirm your employee coverage by selecting 'YES' or 'NO' for Basic Life Insurance and any optional coverage you wish to apply for.
- If applicable, indicate if you are insured under another group insurance plan and provide the last day of coverage.
- Authorize deductions from your pay for necessary premiums by signing and dating the authorization section at the bottom of the form.
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2002 | 4.8 Satisfied (128 Votes) |
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