Beneficiary Change Details

If you have a change in your beneficiary designations after you have already completed your retirement plan paperwork, it is important to file a Beneficiary Change Form (often called a " beneficiaries designation form ") with the appropriate retirement plan administrator. This will ensure that your money goes to the right people when the time comes. The process for doing this may vary depending on the type of retirement plan you have, so be sure to check with your administrator for specific instructions. In most cases, however, you will need to provide the following information: name of beneficiary, relationship to account holder, and mailing address or other contact information for beneficiary.

You may find information regarding the type of form you need to complete in the table. It will show you how much time you will require to fill out beneficiary change form, exactly what fields you need to fill in and a few further specific facts.

QuestionAnswer
Form NameBeneficiary Change Form
Form Length3 pages
Fillable?Yes
Fillable fields94
Avg. time to fill out19 min 37 sec
Other namesbanner life beneficiary designation form, banner life change of beneficiary form, beneficiary change form, beneficiary change

Form Preview Example

Banner Life Insurance Company 3275 Bennett Creek Avenue Frederick, Maryland 21704 (800) 638-8428

BENEFICIARY CHANGE FORM

(Please Print Clearly)

Insured: _______________________________________________

Policy Number: ______________________________

1.The policy proceeds payable upon the death of the insured will be paid to the beneficiaries named herein. The rights of the beneficiary will be subject to the rights of any assignee on record. If no percentage is provided, proceeds will be divided equally among all surviving beneficiaries. All prior revocable designations of Primary and Contingent beneficiaries are hereby revoked.

Primary Beneficiary (If additional space is needed, please attach a separate page, signed and dated. SSN or Tax ID

# and Date of Birth are REQUIRED.)

Name ____________________________________________________

SSN or Tax ID # ___________________

Address___________________________________________________

Date of Birth ______________________

City, State __________________________________Zip ____________

Telephone # ______________________

Relationship to Proposed Insured_______________________________

% Share _________________________

Name ____________________________________________________

SSN or Tax ID # ___________________

Address___________________________________________________

Date of Birth ______________________

City, State _________________________________Zip _____________

Telephone # ______________________

Relationship to Proposed Insured_______________________________

% Share _________________________

Name ____________________________________________________

SSN or Tax ID # ___________________

Address___________________________________________________

Date of Birth ______________________

City, State __________________________________Zip ____________

Telephone # ______________________

Relationship to Proposed Insured_______________________________

% Share _________________________

Name ____________________________________________________

SSN or Tax ID # ___________________

Address___________________________________________________

Date of Birth ______________________

City, State _________________________________Zip _____________

Telephone # ______________________

Relationship to Proposed Insured_______________________________

% Share _________________________

Name ____________________________________________________

SSN or Tax ID # ___________________

Address___________________________________________________

Date of Birth ______________________

City, State __________________________________Zip ____________

Telephone # ______________________

Relationship to Proposed Insured_______________________________

% Share _________________________

LP-159 (7-12)

Contingent Beneficiary (If additional space is needed, please attach a separate page, signed and dated. SSN or Tax ID # and Date of Birth are REQUIRED.) A Contingent Beneficiary will receive the benefits in the event no Primary Beneficiary is living or exists at the time of the insured’s death.

Name ____________________________________________________

SSN or Tax ID # ___________________

Address___________________________________________________

Date of Birth ______________________

City, State _________________________________ Zip _____________

Telephone # ______________________

Relationship to Proposed Insured_______________________________

% Share _________________________

Name ____________________________________________________

SSN or Tax ID # ___________________

Address___________________________________________________

Date of Birth ______________________

City, State __________________________________ Zip ____________

Telephone # ______________________

Relationship to Proposed Insured_______________________________

% Share _________________________

Name ____________________________________________________

SSN or Tax ID # ___________________

Address___________________________________________________

Date of Birth ______________________

City, State _________________________________ Zip _____________

Telephone # ______________________

Relationship to Proposed Insured_______________________________

% Share _________________________

Name ____________________________________________________

SSN or Tax ID # ___________________

Address___________________________________________________

Date of Birth ______________________

City, State _________________________________ Zip _____________

Telephone # ______________________

Relationship to Proposed Insured_______________________________

% Share _________________________

2.No proceedings in bankruptcy or insolvency, voluntary or involuntary, are pending against the undersigned, nor is the under- signed under guardianship or any other legal disability. This designation shall be invalid if the person making it does not have the right to change the beneficiary under the policy specified. Any payment made by Banner Life Insurance Company in good faith pursuant to the foregoing designation shall fully discharge Banner Life Insurance Company of its liability under the policy.

Required Signatures:

____________________________________________

_______________________________________________

Print Policy Owner Name

 

Telephone Number

 

____________________________________________

_______________________________________________

Street Address

 

Email Address

 

____________________________________________

 

 

City, State, Zip

 

 

 

____________________________________________

_______________________________________________

Signature of Policy Owner / Title

Date

Additional Signature** (if necessary)

Date

For Massachusetts residents, state law requires that a disinterested adult who is not a party to the policy witness this request.

__________________________________________________

Signature of Witness (Massachusetts Only) Date

**AZ, CA, ID, LA, NV, NM, TX, WA, WI, and Puerto Rico are community property law states. These laws may apply depending on your current marital status, marital status at the time of policy issuance, state where your policy was issued, residence state at time of issuance, and residence state(s) since issuance. Consult with your legal or tax advisor to determine whether these laws apply to you and whether a spousal signature is required on this form. Banner Life Insurance Company disclaims any responsibility for determining the applicability of community property laws or the validity of the requested change.

LP-159 (7-12)

3.To process your request without delay, please make sure the following have been completed:

Did the Policy Owner(s) sign and date the form?

Did you provide the SSN or Tax ID #, Telephone # and Date of Birth for all beneficiaries?

Do the percentage totals equal 100%?

Did you include the spousal signature if applicable?

Did you include an additional signature if applicable?

If you designated more than 5 Primary or Contingent Benefi ciaries, did you attach an additional page signed and dated?

Did you enclose the title and signature page of trust if listed as a beneficiary?

BENEFICIARY DESIGNATION INFORMATION

The benefi ciary designation form is an IMPORTANT DOCUMENT concerning your life insurance coverage, please read the following carefully. If multiple Primary Benefi ciaries or Contingent Benefi ciaries are named and no percentage distribution is noted, then any proceeds payable to such benefi ciaries will be split equally. Unless otherwise specifi ed, if there is more than one Primary Beneficiary, and one predeceases the insured, benefi ts will be paid to the surviving Primary Benefi ciaries according to their respective interests. If no Primary Benefi ciaries survive the insured, benefi ts will be paid to the designated Contingent Benefi ciaries. In the event that no Primary or Contingent Benefi ciary survives the insured, benefi ts will be paid to any designated Tertiary Benefi ciary, or if none, as specified according to the terms of the policy. Benefi ciary designation changes may have legal or tax consequences, please consult your legal or tax advisor to discuss your individual needs. Once received, the benefi ciary designation will replace all prior designations for the indicated policy.

Examples of Frequently Used Beneficiary Designations

Proposed Beneficiary

One benefi ciary

All children (unnamed)

Minor children

Suggested Wording

Jane Jones Doe, wife.

To all my lawful children, in equal shares with rights of survivorship. (unless specified proceeds will be paid to all surviving lawful children).

John Smith, custodian for Mary Doe, a minor, under the Uniform Transfers to Minors Act (UTMA). [Benefi ts cannot be paid to minor children unless to a custodian under UTMA or a court appointed fi nancial guardian or guardian of the minor’s estate].

An existing trust

A trust under a last will and testament

Estate

Non-profi t organization

Children, per stirpes

Specifi ed secondary benefi ciary

The John Doe Irrevocable Trust, dated 1/1/2001, Eric Smith trustee.

Trustee under my last will and testament as shall be admitted to probate. [Should only be used if an appropriate trust has been set forth within the insured’s will].

To my Estate.

Name and address of the beneficiary organization.

To all my lawful children, per stirpes. (Surviving grandchildren of a pre-deceased child will equally share that child’s portion; this option could also be used for named children).

Jane Jones Doe, wife, if predeceased then Mary Ann Doe, sister. (Used to designate a Secondary Beneficiary rather than distribute a predeceasing Primary Beneficiary’s share to the remaining Primary Benefi ciaries, please provide Date of Birth and SSN or Tax ID # for the Secondary Benefi ciary in the Comments section).

Irrevocable benefi ciary

Jane Jones Doe, wife, irrevocable beneficiary.

Contact Information

 

 

Legal & General America

1-800-638-8428

(telephone)

Banner Life Insurance Company

1-301-294-6960

(fax)

3275 Bennett Creek Avenue

customerservice@bannerlife.com

Frederick, Maryland 21704

Faxed, email or mailed copies will be accepted.

LP-159 (7-12)

How to Edit Beneficiary Change Form

It's super easy to prepare the banner life insurance change of beneficiary form. Our software was intended to be allow you to fill out any document quickly. These are the four actions to go through:

Step 1: Choose the orange "Get Form Now" button on the website page.

Step 2: Once you have entered the banner life insurance change of beneficiary form edit page, you'll see all actions it is possible to take regarding your file within the upper menu.

You'll have to enter the following information if you want to fill in the document:

banner life beneficiary change empty spaces to fill in

The system will require you to complete the Name, Address, City, Telephone # ______________________, Relationship to Proposed Insured, Name, Address, City, Telephone # ______________________, Relationship to Proposed Insured, and Name area.

Entering details in banner life beneficiary change part 2

Be sure to point out the important particulars from the Address, City, Telephone # ______________________, Relationship to Proposed Insured, Name, Address, City, Telephone # ______________________, Relationship to Proposed Insured, and LP-159 (7-12) segment.

banner life beneficiary change Address, City, Telephone # ______________________, Relationship to Proposed Insured, Name, Address, City, Telephone # ______________________, Relationship to Proposed Insured, and LP-159 (7-12) blanks to fill

The area Contingent Benefi ciary (If, Name, Address, City, Telephone # ______________________, Relationship to Proposed Insured, Name, Address, City, Telephone # ______________________, and Relationship to Proposed Insured will be where to place all parties' rights and obligations.

banner life beneficiary change Contingent Benefi ciary (If, Name, Address, City, Telephone # ______________________, Relationship to Proposed Insured, Name, Address, City, Telephone # ______________________, and Relationship to Proposed Insured fields to fill

Check the sections Name, Address, City, Telephone # ______________________, Relationship to Proposed Insured, Name, Address, City, Telephone # ______________________, and Relationship to Proposed Insured and then fill them out.

Completing banner life beneficiary change part 5

Step 3: If you are done, click the "Done" button to upload your PDF form.

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