The Sacl 201 form serves a critical function within the Diocese of Sacramento Lay Employees Pension Plan, specifically focusing on beneficiary designation for its participants. Integral to ensuring that pension plan benefits are distributed according to the wishes of the deceased employee, this document requires careful attention to detail in listing primary and secondary beneficiaries. With a stern reminder that a legally married employee’s primary beneficiary defaults to their spouse - a stipulation that cannot be overridden - the form underscores the importance of clear, deliberate beneficiary designation. The provisions within the form provide a framework for various scenarios, including divorce, remarriage, or if beneficiaries predecease the plan participant, ensuring that the plan's benefits are distributed smoothly and according to the employee’s wishes. Additionally, the form touches upon the event of both the employee and the beneficiary dying in a common accident, specifying that the plan participant will be considered to have died last for the purposes of benefit distribution. Moreover, instructions for designating non-relative beneficiaries and the distribution among multiple beneficiaries highlight the form's adaptability to cater to the unique circumstances of each employee. With a structure that also accommodates situations where the beneficiary is a minor or incapable of providing a valid receipt, the Sacl 201 form is comprehensive, anticipating various complexities that might arise in the administration of pension benefits.
| Question | Answer |
|---|---|
| Form Name | Form Sacl 201 |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | SACL201 diocese of sacramento lay employees pension plan form |
THE DIOCESE OF SACRAMENTO
LAY EMPLOYEES PENSION PLAN
BENEFICIARY DESIGNATION
When filed with the Plan Administrator prior to your death, this designation supersedes and replaces all previous designations under this Plan.
Name: ____________________________________ Parish/School/Agency: _____________________________
Social Security No. _____________________________ City: ________________________________ __________
IMPORTANT NOTICE
If you are legally married, your primary beneficiary is automatically your spouse. Neither you nor your spouse may elect otherwise.
If you are not married, your primary beneficiary is any person that you designate to receive death benefits under the plan, if any are payable.
Regardless of your marital status, it is important to designate a beneficiary B and to keep your designation
Should your spouse or other beneficiary fail to survive you by at least 30 days B or if you and your beneficiary die in a common accident or disaster B you will have been deemed to have died last.
Beneficiary designation. See page two for sample designations. Attach a separate page if more space is necessary.
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Beneficiary Address ___________________________________________________________________
Street Address
__________________________________________________________ _________
City |
State |
Zip |
Use separate page if more than one address and indicate name of each addressee.
EMPLOYEE SIGNATURE
I hereby make the above designation, revoking and replacing all previous designations under this plan. I understand if I am legally married at my death, my spouse has priority over any other claim presented.
Signature of Employee ________________________________ Date ___________________
ADMINISTRATOR=S RECORD OF RECEIPT
Date Received: ____________________________ Initials: _______________
Original To: Office of Lay Personnel |
Copy To: Employee / Retiree |
SACL 201 (10/06)
INSTRUCTIONS
1.Use this form to designate or change your primary and/or secondary beneficiary.
2.When your relationship to your beneficiary is other than by blood, show your relationship as Anonrelative@.
3.Where more than one primaryand/or secondarybeneficiaryis designated, the amountto be paid to each beneficiarymust be clearly set forth by designating fractions or portions to be received.
4.Your secondarybeneficiarywill receive a benefit onlyif (a) your primarybeneficiarydies before you, or (b) your spouse dies before receiving the total survivor benefit.
5.CommonAccident or Disaster: The plan provides that if you and your spouse or other beneficiarydies ina commonaccident or disaster, you will be deemed to have died last.
6.If you death occurs and a minor is designated, or your beneficiaryis incapable of giving valid receipt, the Plan Administrator may direct that payment be made to the person or institution responsible for the care and maintenance of such individual.
7.The proper wording for typical nominations of beneficiary is shown below. In the event none of the following nominations provide4 the disposition desired, you should consult your attorney.
Designations in bold type mean your spouse <
is your primary beneficiary
Type of Beneficiary
1.Estate.
2.One Primary Beneficiary.
3.Two Primary Beneficiaries.
4.4. Three or More Primary Beneficiaries.
5.5. One Primary Beneficiary and One Secondary Beneficiary.
6.One Primary Beneficiary and Two Secondary Beneficiaries.
7.One Primary Beneficiary and Three or more Secondary Beneficiaries.
8.One Primary Beneficiary and Unnamed Children as Secondary Beneficiaries.
9.Two Primary Beneficiaries and One Secondary Beneficiary.
10.Two Primary Beneficiaries in Unequal Beneficiary.
11.Trustee or Business Partner.
12.Revocable Inter Vivos Trust.
Language To Be Used
1.Estate.
2.Peter Jones, father.
3.3. Peter Jones, father and Anna Jones,
mother, equally, or the survivor.
4.Peter Jones, father, Anna Jones, mother, and Mary Jones, daughter, or the
survivors, equally or the survivor.
5.Dorothy Q. Jones, spouse, if living, otherwise Mary Jones, daughter.
6.Dorothy Q. Jones, spouse, if living, otherwise
Mary Jones, daughter, Quincy Jones, son, equally, or the survivor.
7.Dorothy Q. Jones, spouse, if living, otherwise Mary Jones, Quincy Jones, and Edna Jones,
children, or the survivor or survivors, equally.
8. Dorothy Q. Jones, spouse, if living, otherwise the children born of the marriage of the designator and said wife, or the survivor, or the survivors, equally.
9. Peter Jones, father, and Anna Jones, mother, equally, or the survivor, if either survives; otherwise Mary Jones, daughter.
10.Peter Jones, father, as to the
11.____________ (trustee or business partner)
12.Surviving Trustee(s) under the Trust
Agreement Establishing the (Name of trust,
such as APeter and Dorothy Jones |
Revocable |
Trust@) dated [date trust agreement |
signed]. |
Designations in bold type means your spouse is your primary beneficiary
PLAN ADMINISTRATOR=S ADDRESS
Benefit Manager
Diocese of Sacramento
2110 Broadway
Sacramento, CA
(916)
SACL 201 (10/06)