Ri 76 10 2026

1. Click ‘Get Form’ to open the ri 76 10 document in the editor.
2. Begin by filling out Section A, which requires information about the insured. Enter the name, date of birth, and Social Security Number. Indicate if the insured is an employee, retiree, or compensationer by placing an 'X' in the appropriate box.
3. In Section B, provide details about the assignee(s). Include their full names, Social Security Numbers, addresses, relationships to the insured, and ensure that the total percentage assigned equals 100%.
4. Proceed to Section C where both the insured and assignee must sign. Ensure that two witnesses also sign this section. This step is crucial for validating the assignment.
5. Finally, review all entries for accuracy. If any mistakes are found, start over with a new form as erasures or cross-outs are not acceptable.

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