Application for Change of Beneficiary Companion Life Insurance Company 3316 Farnam Street Omaha, NE -2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the Insured's name and Social Security Number in the designated fields. Ensure that you use full names as specified.
3. Fill in the Insured's address and telephone number accurately. This information is crucial for identification purposes.
4. Next, provide the Policyowner’s name and Policy Number. Double-check these details to avoid any processing delays.
5. Designate your Primary Beneficiary(ies) by filling out their names, dates of birth, addresses, Social Security Numbers, relationships to the insured, and benefit percentages. Remember to express proceeds as percentages rather than dollar amounts.
6. If applicable, check the box for Irrevocable Primary Beneficiary(ies) and ensure all required signatures are included.
7. Complete the Contingent Beneficiary(ies) section similarly to the Primary Beneficiary section if needed.
8. Finally, sign and date the form where indicated. If there are multiple signers (e.g., joint policyowners), ensure all signatures are collected before submission.

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