Form Cbc 12870 3 PDF Details

When federal employees consider the future and how to best protect their loved ones, managing life insurance benefits is a significant part of the planning process. One particular aspect of this planning involves the CBC 12870-3 form, a document specifically designed for Inter Vivos Trustee Designation for Federal Employees’ Group Life Insurance. This form plays a crucial role, as it allows employees to direct their life insurance proceeds to a trust, ensuring that such funds are managed according to their wishes during their lifetime. By completing this form, federal employees appoint trustees or successor trustees to handle the proceeds from the Federal Employees’ Group Life Insurance Program in the event of their passing. It outlines clear instructions on what should be done if the designated trustee fails to qualify or if the trust terminates before the employee's death, addressing the payee details, including name, address, relationship, and share of proceeds. Importantly, it outlines the responsibilities of the Office of Federal Employees’ Group Life Insurance (OFEGLI), emphasizing its limited role in the application or disposition of the insurance proceeds post-payment. Moreover, to uphold the document's validity and safeguard against unauthorized alterations, the form stipulates the necessity of signatures from the insured or assignee and two witnesses, underlining the process's seriousness and the need for transparency and accuracy. This form not only represents a critical step in financial and estate planning but also reflects the deeper care and concern federal employees hold for their beneficiaries' well-being, ensuring that their wishes are honored and their loved ones are financially secure.

QuestionAnswer
Form NameForm Cbc 12870 3
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesPage1, OFEGLI, cbc 12870 3, SSN

Form Preview Example

INTER VIVOS TRUSTEE DESIGNATION

FOR FEDERAL EMPLOYEES’ GROUP LIFE INSURANCE

(Trust That An Employee Establishes During His/Her Lifetime.)

This form is to be attached to and made part of designation of beneficiary dated _____________________.

Name of Insured:

SSN:

I request that the amount payable under the FEDERAL EMPLOYEES’ GROUP LIFE INSURANCE PROGRAM (Proceeds) to be paid to the Trustee(s) or Successor Trustee(s) as provided under (Name of Trust Agreement)

________________________________________________________________________________________

bearing the date of____________________________________________ executed by me.

I further request that in the case of the failure of said Trustee(s) to be appointed as such or to qualify as such for any reason, or the termination for any reason of the trust prior to my death that the Proceeds shall be paid to:

Name

Address

Relationship

Share

The Office of Federal Employees’ Group Life Insurance (OFEGLI) shall not be responsible for the application or disposition of the proceeds by said Trustee and the receipt by said Trustee shall fully discharge OFEGLI’s liability under the FEDERAL EMPLOYEES’ GROUP LIFE INSURANCE PROGRAM.

Signature of Insured/Assignee

(Only the Insure/Assignee may sign. Signatures by guardians, conservators or through a power of attorney are not acceptable.)

Date of execution (Month, day, year)

TWO WITNESSES TO SIGNATURE

(A WITNESS IS NOT ELIGIBLE FOR RECEIVE PAYMENT AS A BENEFICIARY)

Signature of witness

Number and street address

City, state and ZIP code

Signature of witness

Number and street address

City, state and ZIP code

RECEIPT BY EMPLOYING OFFICE

Date of Receipt:

Receiving Agency:

Received By:

PRIVACY ACT NOTICE. This document includes material covered by the Privacy Act of 1974 and should be viewed only by personnel having an official "need to know" the information contained herein.

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CBC 12870-3 (Rev 10/23/09)

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Part # 1 for filling out 1974

2. The next step is usually to fill out these fields: This form is to be attached to and, Date of execution Month day year, A WITNESS IS NOT ELIGIBLE FOR, TWO WITNESSES TO SIGNATURE, Signature of witness, Signature of witness, Number and street address Number, City state and ZIP code, City state and ZIP code, Date of Receipt Received By, RECEIPT BY EMPLOYING OFFICE, Receiving Agency, PRIVACY ACT NOTICE This document, and Page of CBC Rev.

TWO WITNESSES TO SIGNATURE, Date of execution Month day year, and PRIVACY ACT NOTICE This document inside 1974

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