Form 7265-2025

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The document is a Beneficiary Designation Form from Anthem Life Insurance Company, intended for policyholders to designate primary and contingent beneficiaries for life insurance benefits. It outlines the necessary information required for each beneficiary, including their relationship to the insured and social security numbers. The form also explains the distribution of benefits among beneficiaries and provides definitions for primary and contingent beneficiaries, along with instructions regarding minors as beneficiaries and settlement options.

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