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Click ‘Get Form’ to open it in the editor.
Begin by entering your name and address at the top of the form. Ensure that you use complete names as specified in the instructions.
In the 'Primary Beneficiary' section, list each beneficiary's full name, relationship to you, percentage of benefit, address, date of birth, and Social Security number. Remember that percentages must total 100%.
If applicable, fill out the 'Contingent Beneficiary' section using the same format as above. This is important for ensuring that benefits are distributed according to your wishes.
Review optional provisions and check any boxes that apply to your situation. Be cautious with designations regarding deceased children.
Ensure all necessary signatures are included: yours, a witness (if required), and your spouse if applicable. If there are additional beneficiaries beyond two for either category, continue on a separate page.
Once completed, mail or fax the form to the provided address or number. Keep a copy for your records.
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