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5 dot (CXC CONTRACT 8 5 x 11)

5 dot (CXC CONTRACT 8 5 x 11) 2026

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The document is a Group Life and/or Accidental Death Claim Form provided by Unum Group for beneficiaries to claim life insurance or accidental death benefits. It includes detailed instructions for completing the form, sections for employer and beneficiary information, fraud warnings specific to various states, and guidelines on submitting necessary documentation such as death certificates and beneficiary designations. The form also outlines the process for payment of benefits and provides information about the Unum Retained Asset Account.

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Click ‘Get Form’ to open the 5 dot (CXC CONTRACT 8 5 x 11) in the editor.
Begin with the Employer Statement section. Fill in the employer's name, address, and contact information. Ensure to check all applicable types of coverage being claimed.
Next, complete the Accidental Death Statement if applicable. Provide details about the deceased, including their relationship to the employee and any relevant accident information.
Proceed to fill out the Substitute W-9 Form. Enter your taxpayer identification number and ensure all fields are accurately completed before signing.
Finally, review the Authorization section. Sign and date it to allow for necessary disclosures related to the claim process.

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Versions	Form popularity	Fillable & printable
2020	4.9 Satisfied (60 Votes)
2016	4.4 Satisfied (42 Votes)
2014	4.2 Satisfied (48 Votes)
2010	4.4 Satisfied (134 Votes)

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How many times can a government contract be extended?

The option provision may be exercised more than once, but the total extension of performance hereunder shall not exceed 6 months.

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Under the Option to Extend Services clause, the government may require continued performance of any services within the limits and rates specified in the contract. The total extension of performance exercisable under the clause must not exceed 6 months.

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