Mutual Omaha Ownership Form PDF Details

The Mutual Omaha Ownership Form plays a crucial role in the process of changing ownership of life insurance policies, specifically excluding cases where policies are assigned for loans. This procedure, often undertaken with the intent of making a gift or for valuable consideration, allows current policy owners to transfer their rights, titles, and interests to new owners under specific terms and conditions. It's important to note that such a change may have tax implications, advising the consultation of a tax advisor before proceeding. The form meticulously outlines the requirements for transferring ownership, whether to an individual or a trust, and necessitates detailed information about both the current and new owners or trustees. Additionally, it distinguishes between the assignments made as a gift versus those for valuable consideration, clearly indicating that the transfer is unconditional and irrevocable once executed. The document also covers the essential aspect of beneficiary changes, which must be requested through a separate Beneficiary Change Request Form and highlights that the policy will only regard the beneficiaries of record for the death benefit, unless altered by the new owner(s) or trustee(s). Lastly, the presence of signatures from all parties involved, including any applicable legal spouses due to community property laws, is imperative to affirm the change, emphasizing that no modification is valid until recorded by Companion Life Insurance Company. This comprehensive form underscores the importance of meticulous attention to detail and legal requirements in the significant act of transferring life insurance policy ownership.

QuestionAnswer
Form NameMutual Omaha Ownership Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesmutual omaha ownership, mutual omaha change ownership, s ies donee online, change ownership donee form

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Change of Ownership Form – Life Insurance

(For Change of Ownership of Life Insurance Policies Only –

COMPANION

OF NEW YORK

Do Not Use This Form When Assigning a Policy for a Loan)

Note: The change of ownership of a life insurance policy may have tax consequences. We recommend that you consult your tax advisor with any questions you may have prior to making this change of ownership.

Policy Number ________________________________________ Current Owner(s)______________________________________

Current Insured _______________________________________

■The Current Owner(s) referred to hereafter as the Donor(s), hereby transfer(s) the ownership of the above Policy with the intention of making a gift. The Donor(s) hereby transfer(s) and assign(s) all right, title and interest in the above Policy to the New Owner(s) shown below, referred to hereafter as the Donee(s), subject to all of the terms and conditions of the Policy. The Donor(s) further waive(s) all rights, on behalf of himself/herself or his/her estate, to receive any benefits whatsoever under the terms of said Policy and direct(s) that if, in the event such benefits do become payable either to himself/herself or his/her estate under the terms of the Policy, that said benefits be paid to the estate of the Donee(s) thereunder.

■For valuable consideration received, the Current Owner(s) hereby transfer(s) the ownership of the above Policy, and hereby sell(s) and assign(s) all right, title and interest in the above Policy, to the New Owner(s) shown below, subject to all of the terms and conditions of the Policy.

1.NEW OWNER* (Note: If the New Owner is a Trust, skip to

Paragraph 3. below.)

Name __________________________________________

Relationship ____________________________________

Address ________________________________________

City __________________ State ______ ZIP ________

Tax ID/Social Security No. ________________________

( )

Telephone _______ ______________________________

Age ________ Date of Birth _______________________

*If multiple new owners, the policy will be owned as joint tenants with rights of survivorship and not as tenants in common.

3.NEW OWNER–TRUST

Name of Trust __________________________________

Date of Trust ____________________________________

Name of Trustee ________________________________

Name of Co-Trustee ______________________________

2.NEW JOINT OWNER

Name __________________________________________

Relationship ____________________________________

Address ________________________________________

City __________________ State ______ ZIP ________

Tax ID/Social Security No. ________________________

( )

Telephone_______ ______________________________

Age ________ Date of Birth _______________________

Trustee Address ________________________________

City __________________ State ______ ZIP ________

( )

Telephone_______ ______________________________

Tax ID/Social Security No. ________________________

(Attach the above information for any Co-Trustee)

If the Current Owner is a Trust, please send a copy of the pages showing that the Trust has been executed and identifying the Trustee(s) and Successor Trustee(s).

Companion Life Insurance Company is not responsible for the sufficiency or validity of this Change of Ownership. No Change of Ownership shall be binding on us until we receive and record it at the Company’s Home Office. This Change of Ownership is unconditional and irrevocable, and the New Owner(s) shall have the power to exercise all rights of ownership under said Policy.

Y6501_0503

Please see reverse side

Signed at _____________________________________________ this__________ day of _______________________________.

X ________________________________________________

X ________________________________________________

Personal Signature of Current Owner/Trustee/Donor

Personal Signature of Spouse of Current Owner/Current Donor residing in a

 

community property state (CA, AZ, ID, LA, NM, NV, PR, TX, WA, and WI)

X________________________________________________

Personal Signature of Current Joint Owner (if any)/Joint Trustee (if any)/ Joint Donor (if any)

X________________________________________________

Personal Signature of Spouse of Current Joint Owner (if any)/Current Joint Donor (if any), residing in a community property state (CA, AZ, ID, LA, NM, NV, PR, TX, WA, and WI)

X ________________________________________________

X ________________________________________________

Personal Signature of New Owner/Trustee/Donee

Personal Signature of New Joint Owner (if any)/Co-Trustee (if any)/Joint Donee (if any)

____________________________________________

Date _______________________________________

Personal Signature of Irrevocable Beneficiary(ies) (if applicable)

 

Received and Recorded by: Companion Life Insurance Company

Date _______________________________________

Notice

The death benefit of the Policy is payable to the Beneficiary(ies) of record. If the New Owner(s)/Trustee(s)/ Donee(s) desire(s) the Beneficiary(ies) to be changed, the New Owner(s)/Trustee(s)/Donee(s) must request this change in accordance with the policy provisions. The Beneficiary Change Request Form below may be used to change the Beneficiary(ies).

Beneficiary Change Request Form

Companion Life Insurance Company is authorized to change, and hereby changes, the Beneficiary(ies) of Policy Number

_____________________ to the person(s)/entity(ies) shown below:

Primary Beneficiary(ies) ______________________________

Tax ID/Social Security No. __________________________

(use Attachment if necessary)

 

Relationship to Insured ______________________________

Relationship to New Owner(s) ______________________

Contingent Beneficiary(ies) ___________________________

Tax ID/Social Security No. __________________________

(use Attachment if necessary)

 

Relationship to Insured ______________________________

Relationship to New Owner(s) ______________________

No Beneficiary Change shall be binding on us until we receive and record it at the Company’s Home Office. Unless you direct us otherwise, payment of the death benefit will be shared equally by all Primary Beneficiaries who survive the insured. If no Primary Beneficiaries survive the Insured, payment will be shared equally by all Contingent Beneficiaries who survive the insured.

This change of Beneficiary hereby revokes all previous Beneficiary designations. The New Owner(s)/Trustee(s)/ Donee(s) reserve(s) the right to further change the Beneficiary(ies).

■Irrevocable Beneficiary(ies): If this Box is checked, this Policy will be endorsed to show that the Beneficiary(ies) named above is/are irrevocable, and that no changes to the Policy, including a change of Beneficiary(ies), may be made by the Owner(s)/Trustee(s)/Donee(s) without the consent of the Beneficiary(ies) shown above.

Date:_________________ New Owner(s)/Trustee(s)/Donee(s) Signatures: X ________________________________________

X ________________________________________

Instructions: Complete this form and return it to:

Companion Life Insurance Company: 1-800-733-0662

3316 Farnam Street

Omaha, NE 68175-1100

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Completing section 1 in mutual ownership form insurance

2. Soon after filling out this section, go on to the next stage and fill out the necessary details in all these fields - NEW OWNERTRUST, Name of Trust, Trustee Address, Date of Trust, City State ZIP, Name of Trustee, Telephone, Name of CoTrustee, Tax IDSocial Security No Attach, If the Current Owner is a Trust, Companion Life Insurance Company, and Please see reverse side.

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3. This 3rd section should be pretty uncomplicated, Signed at this day of, Personal Signature of Current, Personal Signature of Current, Personal Signature of Spouse of, Personal Signature of Spouse of, Personal Signature of New, Personal Signature of New Joint, Personal Signature of Irrevocable, Date, Received and Recorded by Companion, Date, Notice The death benefit of the, and Beneficiary Change Request Form - these fields has to be filled out here.

Tips to fill out mutual ownership form insurance portion 3

As to Received and Recorded by Companion and Beneficiary Change Request Form, be certain that you get them right in this current part. These two could be the most important fields in the document.

4. The subsequent subsection needs your details in the following parts: Beneficiary Change Request Form, Primary Beneficiaryies use, Tax IDSocial Security No, Relationship to Insured, Relationship to New Owners, Contingent Beneficiaryies use, Tax IDSocial Security No, Relationship to Insured, Relationship to New Owners, No Beneficiary Change shall be, This change of Beneficiary hereby, and Irrevocable Beneficiaryies If this. Be sure to type in all of the requested info to go forward.

mutual ownership form insurance conclusion process explained (step 4)

5. The document must be wrapped up by filling in this area. Here you will notice a detailed set of fields that require appropriate information to allow your document usage to be faultless: Date New OwnersTrusteesDonees, Instructions Complete this form, and Companion Life Insurance Company.

Filling out part 5 of mutual ownership form insurance

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