Form 40D PDF Details

Understanding the intricacies of the 40D form is essential for anyone engaged in contractual agreements with North American Company for Life and Health Insurance®. This document, central to ensuring that commissions owed are rightly directed in the event of one's unforeseen demise, acts as a safeguard for the financial benefits one accrues in their professional capacity. It meticulously outlines the procedure for designating a beneficiary, who, upon the contractor's death and upon providing the necessary documentation, such as a certified death certificate, becomes entitled to receive any unpaid commissions. The form's requirement for notarization underscores its significance and the seriousness with which it must be approached. It incorporates provisions for modifying the beneficiary detail, underscoring the flexibility intrinsic to the agent's evolving preferences or circumstances. Moreover, it addresses potential debt obligations with North American, delineating the priority of debt repayment from the commissions due before any disbursement to the beneficiary. This careful structuring ensures that both the agent's interests and the company's financial protocols are adhered to, providing a comprehensive framework within which agents and their beneficiaries can navigate their financial entitlements and obligations.

QuestionAnswer
Form NameForm 40D
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesnorth american company for life and health insurance beneficiary change form, north american life change of beneficiary form, north american company for life and health insurance change of beneficiary form, american company for life and health insurance beneficiary form

Form Preview Example

By signing below, I agree that under the terms of my contract with North American, any commission not yet paid to me at the time of my death shall be payable to the above-named beneficiary.
*FORM MUST BE NOTARIZED*
Dated at ___________________, ____________________, the

CLEAR FORM

BENEFICIARY DESIGNATION FORM

This form allows you to designate your beneficiary to receive vested commissions otherwise due to you in the event of your death. Once your beneficiary has provided us with a certified copy of your death certificate and the Deceased Agent Beneficiary Form, any commission will be payable to the beneficiary listed on file with us under the terms of the agreement set in your agent contract with North American Company for Life and Health Insurance® (North American). All payments will be made in accordance with the applicable contract with the company (copy available upon request). The beneficiary would also be responsible for any taxes incurred by payment of said commissions. In the event that you wish to change the designation of the beneficiary, the new designation would terminate the interest of all previous beneficiaries. In the event that you should have an indebtness with North American, commissions would be applied to the debt first, and then to the beneficiary.

BENEFACTOR INFORMATION (please print or type):

LAST NAMEFIRST NAMEMI SOCIAL SECURITY # AGENT #

ACTION TO BE TAKEN:

 

 

 

 

 

 

 

 

 

r Add Beneficiary

r Modify Beneficiary Information

 

r Change Beneficiary

BENEFICIARY INFORMATION:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FULL NAME (must be natural person or trust*)

 

 

SOCIAL SECURITY/TIN #

DATE OF BIRTH

 

 

 

 

 

 

 

 

ADDRESS

 

CITY, STATE

 

ZIP CODE

PHONE

AGENT SIGNATURE

DATE

*A copy of the trust must be provided.

Return completed form to:

North American Company for Life

and Health Insurance®, Annuity Service Center Attention: Commissions Department

4350 Westown Parkway West Des Moines, IA 50266 Fax: (866)322-7072

(state)(county)

__________ day of _______________________, 20________.

Signed and sworn to (or affirmed) before me by

__________________________________________________.

NAME(S) OF PERSON(S)

_________________________________________________________________

(sIGNATURE OF NOTARY)

STAMP/SEAL:

16367Z

PRT 05-12

How to Edit Form 40D Online for Free

Filling in north american company for life and health beneficiary form is a breeze. Our team developed our PDF editor to really make it user-friendly and uncomplicated and enable you to complete any form online. Listed below are steps you will want to stick to:

Step 1: The very first step is to press the orange "Get Form Now" button.

Step 2: You can see all the functions that it's possible to use on the file when you have accessed the north american company for life and health beneficiary form editing page.

If you want to prepare the file, type in the details the software will ask you to for each of the next areas:

entering details in north american company for life and health beneficiary change form step 1

Fill in the BENEFICIARY INFORMATION, FULL NAME must be natural person, SOCIAL SECURITYTIN, DATE OF BIRTH, ADDRESS, CITY STATE, ZIP CODE, PHONE, By signing below I agree that, FORM MUST BE NOTARIZED, AGENT SIGNATURE, DATE, A copy of the trust must be, Dated at the, and STATE fields with any particulars that is asked by the system.

Filling in north american company for life and health beneficiary change form stage 2

Step 3: In case you are done, press the "Done" button to export your PDF document.

Step 4: To prevent different difficulties down the road, you will need to prepare up to several copies of the file.

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