Be sure to name in this form all persons you wish to designate as beneficiaries of any unpaid compensation payable at your death. Examples of Designations. 1. |
I, the undersigned, certify that the information contained in this report form and its annexes is accurate and in accordance with the facts. |
Attachment No 2: Template of the agreement with the Beneficiary. IDENTIFICATION CARD TO THE AGREEMENT WITH A BENEFICIARY. CONTRACT DATA. NAWA Decision number. |
I hereby certify that the above member, whose identity I have established to my own satisfaction, freely and voluntarily signed this beneficiary designation ... |
30 апр. 2020 г. · WIDOW OR WIDOWER AND DESIGNATED BENEFICIARIES DO NOT FILL IN PART C. All OTHERS MUST. Part C. 1. List below the name, social security number, ... |
For example, if you named three equal Primary Beneficiaries and one were to predecease you, the surviving Beneficiaries would receive the full value of your ... |
A properly completed form containing at least one (1) primary beneficiary and signed on page 2 by you (the member) and two (2) witnesses who. |
This affidavit is to be used if there is no surviving beneficiary designated by the above-named person. It is to be completed only. |
By signing below, I hereby revoke any previous designations, and I designate the person, people, or entity named herein as beneficiaries. Check if you are ... |
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