Death Benefit Proceeds Form for Individual Life and Annuities 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the policy number(s) under which you are making a claim in Section 1.
3. In Section 2, provide the deceased's information including their name, date of birth, and date of death. Ensure accuracy as this is crucial for processing.
4. Move to Section 3 to indicate your capacity as a beneficiary. Select from options such as Individual Beneficiary or Estate Executor, and fill in the required details accordingly.
5. In Section 5, choose your preferred payment option for the death benefit proceeds. Options include Lump Sum Check or Settlement Alternatives.
6. Complete Section 6 regarding tax withholding preferences. Make sure to check the appropriate boxes based on your situation.
7. Finally, sign and date in Section 7 to certify that all information provided is accurate and complete before submitting your form.

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