Beneficiary Change Life Form PDF Details

It is a common occurrence for individuals to change their wills or estate planning documents following a significant life event, such as the birth of a child, marriage, or the death of a spouse. However, what many people don't realize is that they may also need to update their beneficiary designations on certain accounts and investment plans. This can be especially important if you have changed your name due to marriage or divorce. Reviewing your beneficiary designations periodically is a good way to make sure that your assets are distributed according to your wishes.

QuestionAnswer
Form NameBeneficiary Change Life Form
Form Length6 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min 30 sec
Other nameslincoln financial beneficiary change form, beneficiary lincoln form, you beneficiary change online, change life lincoln form

Form Preview Example

 

 

 

 

Life Customer Service Contact Information

 

 

 

 

Mail: PO Box 21008, Greensboro, NC 27420-1008

 

 

 

 

Phone: 800-487-1485 Fax: 800-819-1987

 

 

 

 

Email: CustServSupportTeam@LFG.com

The Lincoln National Life Insurance Company

www.LincolnFinancial.com

Lincoln Life & Annuity Company of New York

 

First Penn-Pacific Life Insurance Company

 

(as in your contract and herein the “Company”)

 

Beneficiary Change for Life Policy

GENERAL INFORMATION (Please type or print clearly.)

This section must be completed or your request will be declined.

Policy/Certificate No.: ___________________________________________________________________________________

Issued by (the Company): ________________________________________________________________________________

INSURED INFORMATION

Full Legal Name (FIRST, MIDDLE, LAST): _______________________________________________________________________

Insured’s Mailing Address:________________________________________________________________________________

City: _______________________________________________________

State: _________ Zip:__________________

Social Security Number: _______________________________________

Date of Birth: ___________________________

Daytime Telephone Number: ____________________________________

 

Email Address:_________________________________________________________________________________________

OWNER INFORMATION (If different from Insured. Submit more pages as necessary.)

Full Legal Name (FIRST, MIDDLE, LAST): _______________________________________________________________________

Owner’s Mailing Address: ________________________________________________________________________________

City: _______________________________________________________

State: _________ Zip:__________________

Social Security Number/EIN*: ___________________________________

Date of Birth/Trust**:______________________

Daytime Telephone Number: ____________________________________

 

Email Address:_________________________________________________________________________________________

*The submission of a completed IRS Form W-9 may be required. Employer Identification Number for Trusts or Entities **The date the trust was established

Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affiliates.

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INSTRUCTIONS

Almost all beneficiary changes can be requested by using this form. However, if there is any question concerning the completion of the request or if a beneficiary designation is desired which cannot be requested on this form, contact your local representative or Agency which services your policy.

1.Complete a separate request for change of beneficiary for each policy to be changed, unless the owner and all information is the same for all policies.

2.A form which has been altered or on which there has been an erasure cannot be accepted unless the alteration or erasure is initialed by the policy owner(s).

3.This form is to be forwarded to the Company. A confirmation of the beneficiary change will be sent to you for your records.

4.This form is not to be used to elect an Optional Method of Settlement.

5.Irrevocable Beneficiaries: An irrevocable beneficiary is a designation that cannot be changed without the irrevocable beneficiary’s written consent. It is also a designation that for any change (i.e. withdrawal, ownership change, etc.) to the policy/contract, we will require the irrevocable beneficiary to sign and date the request. If you are naming an irrevocable beneficiary, contact our office for instructions.

6.Beneficiary Classes (unless otherwise specified in the designation):

•PRIMARY or the first person(s)/entity(ies) in line to receive the death proceeds after the insured is deceased.

•CONTINGENT or the second or subsequent person(s)/entity(ies) in line to receive the death proceeds after the insured is deceased and no surviving primary beneficiary(ies).

•SECOND CONTINGENT or the third or subsequent person(s)/entity(ies) in line to receive the death proceeds after the insured is deceased and no surviving primary or contingent beneficiary(ies).

7.If your beneficiary is a Trust, see page five.

Beneficiary Designation

Designations given in dollar amounts will not be accepted. However, designations given in percentages or fractions equal to 100% will be accepted.

If joint beneficiaries are named in any of the three classes (Primary, Contingent, or Second Contingent), the proceeds are to be paid equally to the survivors unless otherwise stated.

If you are adding beneficiaries but not changing existing beneficiaries, you must restate all existing beneficiaries.

Change beneficiaries on: (select one)

hBase policy

hChildren term rider(s)

hPrimary Insured Rider

hFirst to die rider

hLast to die rider

hOther Insured rider – on the life of ___________________________________________________________________

If you do not select one of the options, we will automatically change the beneficiaries on the base policy and the primary insured rider (if applicable).

For Trust and Custodian Designations see page 5.

If no fractions or percentages are given, proceeds will be paid equally to the survivor or survivors, if any in the class (ie: primary, contingent, or second contingent).

 

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Primary Beneficiary(ies) (Submit more pages as necessary.) This information is required in order to assist us in identifying and contacting your beneficiary(ies) in the event of a claim / distribution and ensure benefits are paid out appropriately. State regulations may require benefits be paid to the State if the beneficiary cannot be located in a timely manner. If your beneficiary is a Trust, see pg. 5.

The first person(s)/entities in line to receive the death proceeds after the insured is deceased.

Full Legal Name (FIRST, MIDDLE, LAST): _______________________________________________________________________

Beneficiary’s Mailing Address:_____________________________________________________________________________

City: _______________________________________________________

State: _________ Zip:__________________

Social Security Number/EIN*: ___________________________________

Date of Birth: ___________________________

Daytime Telephone Number: ______________________________________________________________________________

Email Address:_________________________________________________________________________________________

Relationship to Insured:__________________________________________________________________________________

Percentage or Fraction of Proceeds:__________

Full Legal Name (FIRST, MIDDLE, LAST): _______________________________________________________________________

Beneficiary’s Mailing Address:_____________________________________________________________________________

City: _______________________________________________________

State: _________ Zip:__________________

Social Security Number/EIN*: ___________________________________

Date of Birth: ___________________________

Daytime Telephone Number: ______________________________________________________________________________

Email Address:_________________________________________________________________________________________

Relationship to Insured:__________________________________________________________________________________

Percentage or Fraction of Proceeds:__________

Full Legal Name (FIRST, MIDDLE, LAST): _______________________________________________________________________

Beneficiary’s Mailing Address:_____________________________________________________________________________

City: _______________________________________________________

State: _________ Zip:__________________

Social Security Number/EIN*: ___________________________________

Date of Birth: ___________________________

Daytime Telephone Number: ______________________________________________________________________________

Email Address:_________________________________________________________________________________________

Relationship to Insured:__________________________________________________________________________________

Percentage or Fraction of Proceeds:__________

* The submission of a completed IRS Form W-9 may be required. Employer Identification Number for Trusts or Entities

 

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Contingent Beneficiary(ies) (Submit more pages as necessary.) This information is required in order to assist us in identifying and contacting your beneficiary(ies) in the event of a claim / distribution and ensure benefits are paid out appropriately. State regulations may require benefits be paid to the State if the beneficiary cannot be located in a timely manner.

The second or subsequent person(s)/entity(ies) in line to receive the death proceeds after the insured is deceased and no surviving primary beneficiary(ies).

Full Legal Name (FIRST, MIDDLE, LAST): _______________________________________________________________________

Beneficiary’s Mailing Address:_____________________________________________________________________________

City: _______________________________________________________

State: _________ Zip:__________________

Social Security Number/EIN*: ___________________________________

Date of Birth: ___________________________

Daytime Telephone Number: ______________________________________________________________________________

Email Address:_________________________________________________________________________________________

Relationship to Insured:__________________________________________________________________________________

Percentage or Fraction of Proceeds:__________

Contingent Beneficiary(ies) (Submit more pages as necessary.)

Full Legal Name (FIRST, MIDDLE, LAST): _______________________________________________________________________

Beneficiary’s Mailing Address:_____________________________________________________________________________

City: _______________________________________________________

State: _________ Zip:__________________

Social Security Number/EIN*: ___________________________________

Date of Birth: ___________________________

Daytime Telephone Number: ______________________________________________________________________________

Email Address:_________________________________________________________________________________________

Relationship to Insured:__________________________________________________________________________________

Percentage or Fraction of Proceeds:__________

Second Contingent Beneficiary(ies) (Submit more pages as necessary.)

The third or subsequent person(s)/entity(ies) in line to receive the death proceeds after the insured is deceased and no surviving primary or contingent beneficiary(ies).

Full Legal Name (FIRST, MIDDLE, LAST): _______________________________________________________________________

Beneficiary’s Mailing Address:_____________________________________________________________________________

City: _______________________________________________________

State: _________ Zip:__________________

Social Security Number/EIN*: ___________________________________

Date of Birth: ___________________________

Daytime Telephone Number: ______________________________________________________________________________

Email Address:_________________________________________________________________________________________

Relationship to Insured:__________________________________________________________________________________

Percentage or Fraction of Proceeds:__________

* The submission of a completed IRS Form W-9 may be required. Employer Identification Number for Trusts or Entities.

 

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Trust Designation (Submit more pages as necessary.) This information is required in order to assist us in identifying and contacting your beneficiary(ies) in the event of a claim / distribution and ensure benefits are paid out appropriately. State regulations may require benefits be paid to the State if the beneficiary cannot be located in a timely manner.

If the beneficiary is a Trust, complete the following, listing all Trustees.

h Primary Beneficiary

h Contingent Beneficiary

h Second Contingent

Full Legal Name(s): _____________________________________________________________________________________

Name of Trustee(s):_____________________________________________________________________________________

Trust Mailing Address: ___________________________________________________________________________________

City: _______________________________________________________

State: _________ Zip:__________________

Social Security Number/EIN*: ___________________________________

Date of Trust**:__________________________

Daytime Telephone Number: ______________________________________________________________________________

Email Address:_________________________________________________________________________________________

Percentage or Fraction of Proceeds:__________

*The submission of a completed IRS Form W-9 may be required. Employer Identification Number for Trusts or Entities ** The date the trust was established.

Custodian Designation (Submit more pages as necessary.)

If the beneficiary is a custodian on behalf of a minor, complete the following if applicable.

Note: Minor Beneficiaries—Any payment due to a minor beneficiary shall be made to the legally appointed guardian of the minor, unless otherwise permitted by law. If you are designating a minor beneficiary, we suggest you contact your legal advisor to consider doing so under the UNIFORM GIFTS TO MINORS ACT (UGMA), or UNIFORM TRANSFERS TO MINORS ACT (UTMA), whichever may be in effect in your state.

Name of Custodian (FIRST, MIDDLE, LAST):_____________________________________________________________________

Custodian’s Mailing Address: _____________________________________________________________________________

City: _______________________________________________________ State: _________ Zip:__________________

Daytime Telephone Number: ______________________________________________________________________________

Email Address:_________________________________________________________________________________________

As Custodian for:

Name of Minor (FIRST, MIDDLE, LAST): ________________________________________________________________________

under the UTMA/UGMA of the State of: _________________

Minor’s Mailing Address: _________________________________________________________________________________

City: _______________________________________________________

State: _________ Zip:__________________

Social Security Number: _______________________________________

Date of Birth: ___________________________

Daytime Telephone Number: ______________________________________________________________________________

 

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Authorizations and Signatures — Required

This page must be completed and returned or your request will be declined.

I certify that the information provided on this form is complete and correct:

X

 

___________________________

Owner’s Signature

 

Date*

_______________________________________________________________________

___________________________

Name (print or type)

 

Title*

X

 

___________________________

 

 

Owner’s Signature**

 

Date*

_______________________________________________________________________

___________________________

Name (print or type)

 

Title*

X

 

___________________________

 

 

Irrevocable Beneficiary Signature (if applicable; defined on page 2)

Date*

_______________________________________________________________________

___________________________

Name (print or type)

 

Title*

X

 

___________________________

 

 

Witness Signature** (Massachusetts Only)

Date*

_______________________________________________________________________

___________________________

Name (print or type)

 

Title*

* Required

 

 

** A witness signature of a disinterested party is required in the state of Massachusetts.

 

 

 

 

Signature Requirements

 

 

 

 

Owner

Signature(s) Required

 

Individual(s)

Signature of the Policyowner(s)

 

Power of Attorney (POA)

Signature of POA with title. We require a copy of the POA document to be on file with Lincoln.

 

If the POA is more than 3 years old, we require an affidavit that the POA is still current to

 

accompany the request. Signature Example: John Doe, Attorney-in-Fact for Jane Doe.

Conservator or Guardian

Signature of Conservator or Guardian with title. We require Letter(s) of Conservatorship or Letters

 

of Guardianship of the Estate to be on file with Lincoln.

 

Custodian of Minor

Signature of Custodian with title. We require a court order, or other documentation evidencing an

 

appointment as Custodian under a state Uniform Transfers [Gifts] to Minors Act, to be on file with

 

Lincoln.

 

 

 

Corporation, Bank or

Signature of one officer with title, and a corporate resolution which names all officers authorized

Financial Institution

to sign on behalf of the corporation; or two officer’s signatures, with title, without corporate

 

resolution.

 

 

 

Pension Plan

Signature of the Pension Plan Administrator and a copy of Plan documents naming the

 

Administrator.

 

 

 

Trust

Signature of all trustee(s) with title along with the completed Certification of Trustee Powers form.

 

 

Partnership or LLC

Signature of one general/managing partner with title and a copy of the Partnership agreement

 

for Partnerships OR one managing member’s signature with title and a copy of the operating

 

agreement for LLCs.

 

 

 

Signed by an “X”

Signature notarized, if the signor is unable to sign and must sign with an “X”.

 

 

 

Stamped signatures

We will not knowingly accept a stamped signature.

 

 

 

 

All other interested parties

Contact customer service to verify signature(s) needed.

 

 

 

Titles

If you are signing the form in any capacity other than as an individual an appropriate title is required.

 

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financial beneficiary change life completion process shown (step 1)

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