Tsp 17 Fillable Form – Fill Out and Use This PDF

The Form TSP-17, Information Relating to Deceased Participant, is an integral document for handling the Thrift Savings Plan (TSP) accounts of deceased members, applicable to both uniformed services members and civilians. This form is designed to identify potential beneficiaries and ensure the accurate distribution of the deceased's TSP assets, replacing the previous editions and variants such as Form TSP-U-17. It's crucial for individuals managing the affairs of the deceased TSP participant to fill out and submit this form alongside the required documentation, including the death certificate, to the TSP Death Benefits Processing Unit.

To start the process of submitting information about a deceased participant's potential beneficiaries, click the button below.

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Tsp 17 Fillable Form PDF Details

Understanding the intricacies and the vital role of Form TSP-17, Information Relating to Deceased Participant, is crucial for those navigating the process of assigning beneficiaries for the Thrift Savings Plan (TSP) accounts of a deceased participant. This form, which consolidates the previous Form TSP-U-17 and other iterations, serves as a key document for both uniformed service members and civilians. Its primary function is to compile essential information about potential beneficiaries of one or multiple TSP accounts. A distinctive feature of this form is its capacity to apply information uniformly across separate accounts, streamlining an otherwise complicated process. Should a deceased participant have a valid Form TSP-3, Designation of Beneficiary, on file, that document will take precedence in determining the distribution of the account. However, Form TSP-17 also allows for the updating of beneficiary information, improving the accuracy and efficiency of the TSP's record-keeping. Completing the form requires diligence—every section must be filled out with the most accurate information available, and it must be accompanied by a death certificate that specifies the cause or manner of death. Additionally, the form outlines a statutory order of precedence for potential beneficiaries, illuminating the hierarchy established by law to guide the distribution of assets should explicit beneficiaries not be designated. This critical document ensures that the participant's TSP account is managed and distributed with respect to their legacy and the welfare of their potential beneficiaries.

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Form Name	Tsp 17 Fillable Form
Form Length	9 pages
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Avg. time to fill out	2 min 15 sec
Other names	tsp 17 form, tsp 17 fillable form, 17 tsp fillable, tsp form 17

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This Form TSP-17, Information Relating to Deceased Participant,

replaces Form TSP-U-17 and previous editions of Form TSP-17.

Form TSP-U-17 and previous editions of Form TSP-17, Information Relating to Deceased Participant, are no longer available. They have been combined into a single Form TSP-17.

This version of Form TSP-17 should be used both by members of the uniformed services and by civilians. (Scroll down to view form.)

Thrift Savings Plan

Form TSP-17

Information Relating

to Deceased Participant

March 2015

INFORMATION AND INSTRUCTIONS

GENERAL INFORMATION

Use this form to provide information about potential beneﬁciaries of a deceased participant’s Thrift Savings Plan (TSP) account or accounts. If the participant had multiple accounts with the TSP, the information here will be applied to each account separately. If a valid Form TSP-3, Designation of Beneﬁciary, is on ﬁle with the TSP recordkeeper for the account, payment of the account will be made according to the designation(s). In that case, the information provided on this form may be used to update beneﬁciary information (e.g., addresses) on ﬁle with the recordkeeper.

Type or print all information on this form. Make a copy for your records and mail the original form to: TSP Death Benefits Processing Unit, P.O. Box 4450, Fairfax, VA 22038-4450.

For overnight delivery, send the form to: ATTN: TSP Death Benefits Processing Unit, 12210 Fairfax Town Center, Unit 906, Fairfax, VA 22033.

Or fax the completed form to: 1-703-592-0170.

If you have questions, call the toll-free ThriftLine at 1-TSP-YOU-FRST (1-877-968-3778) or the TDD at

1-TSP-THRIFT5 (1-877-847-4385). Outside the U.S. and Canada, please call 404-233-4400 (not toll free).

I. INFORMATION ABOUT DECEASED PARTICIPANT

Complete all items in this section. This information is needed to identify the deceased participant’s account(s). You MUST include a copy of the participant’s death certiﬁcate with this form. The death certiﬁcate must state the cause or manner of death. (Note: Some states do not routinely include cause or manner of death on death certiﬁcates, so you may have to request speciﬁcally a death certiﬁcate with cause or manner of death included.)

II. INFORMATION ABOUT YOU

Complete all items in this section.

•

If you are not a potential beneficiary, you may leave Item 11 (Social Security number) and Item 12 (Date of Birth) blank.

If you are an executor or administrator of the deceased participant’s estate, enter “Executor” or “Adminis- trator” in Item 18. Note: If there is not a valid Form TSP-3, Designation of Beneﬁciary, on ﬁle and there is no spouse, child, or parent of the deceased participant, you must provide the estate’s Taxpayer Identi- fication Number (TIN) in Item 11 if payment is expected to be made to the estate. In this case, you must attach a copy of your court appointment along with a copy of the TIN. You do not need to provide the requested information again in Section IV.

III. INFORMATION ABOUT POTENTIAL BENEFICIARIES

If the participant was married at the time of death (i.e., you answered “Yes” to Item 19), proceed to Section IV; information about other potential beneﬁciaries is not required. Otherwise, answer all of the remaining ques- tions in this section before proceeding to Section IV.

Beneﬁciaries will be determined using the following statutory order of precedence:

1.To your spouse;

2.If none, to your child or children equally, and to descendants of deceased children by representation;

3.If none, to your parents equally or to the surviving parent;

4.If none, to the appointed executor or administrator of your estate; or

5.If none, to your next of kin who would be entitled to your estate under the laws of the state in which you resided at the time of your death.

	In this order of precedence, a child includes a natural child (even if the child was born out of wedlock) and
	a child adopted by the participant; it does not include a stepchild or a foster child who was not adopted.
	Note: If your natural child was adopted by someone other than your spouse, that child is not entitled to a
	share of your TSP account under the statutory order of precedence. “By representation” means that if a child
	of yours dies before you do, that child’s share will be divided equally among his or her children. “Parent” does
	not include a stepparent unless the stepparent adopted you.
	In Item 20, if you know that the participant had children but you are uncertain as to the number of children,
	please provide your best estimate of the number of children and check the adjoining box.
	If you are applying on behalf of the participant’s estate, please provide the court papers appointing executor
	or administrator and a copy of the Estate EIN number on IRS letterhead.
Page 2 of 8	Form TSP-17 (3/2015)
	PREVIOUS EDITIONS OBSOLETE

THRIFT SAVINGS PLAN

TSP-17

INFORMATION RELATING

TO DECEASED PARTICIPANT

Use this form to provide information about potential beneﬁciaries of a deceased Thrift Savings Plan (TSP) participant. Read the instructions for each section before completing the form. A copy of the participant’s death certificate must accompany this form.

INFORMATION ABOUT DECEASED PARTICIPANT

1.Name of Deceased Participant

LastFirstMiddle

–

Date of Birth (mm/dd/yyyy)

Date of Death (mm/dd/yyyy)

Social Security Number

5.Legal Residence at Time of Death

Street Address

6.	City	7.		8.
			State/Country		Zip Code
9.		Check here to indicate that you have attached a copy of the death certiﬁcate (as required).

II.

INFORMATION ABOUT YOU

10.Name

LastFirstMiddle

11.			–		–			12.	/	/
	Social Security Number (or TIN if estate)								Date of Birth (mm/dd/yyyy)
13.	Address
		Street Address or Box Number
14.	City							15.		16.
									State/Country		Zip Code
17.	Daytime Phone			(		)	–	18.
				Area Code and Number					Relationship to Deceased Participant

III.

INFORMATION ABOUT POTENTIAL BENEFICIARIES

19.Participant’s Spouse—Was the participant married at the time of death?

Yes

Don’t Know

If “Yes,” skip to Section IV; if “No” or “Don’t Know,” complete questions 20 – 22 below.

20.Participant’s Children—

A. Were there any living children of the participant at the time of death?

Yes

Don’t Know

If “Yes,” how many? _______

Check here if the number of children you identiﬁed is an estimate.

B.Were there any children of the participant who died before the participant died?

Yes

Don’t Know

If “Yes,” please complete the following:

1.How many children died before the participant? _______

you identiﬁed is an estimate.

Check here if the number of children

2.Were there any descendants of those deceased children (i.e., the participant’s grandchildren) living at the time of the participant’s death?

Yes

Don’t Know If “Yes,” how many? _______

of children you identiﬁed is an estimate.

Check here if the number

21.Participant’s Parents—Did the participant have at least one living parent at the time of death?

Yes

Don’t Know

22.Executor or Administrator of Participant’s Estate—Is there an executor or administrator for the estate of the participant? If yes, please provide the court documentation appointing the executor or administrator and a copy of the Taxpayer Identiﬁcation Number (TIN).

Yes

Don’t Know

☞If you answered “Yes” or “Don’t Know” to any of the questions in 20 – 22, complete the rest of this form. If you an- swered “No” to every question in Section III, skip to Section VII; you may be contacted for additional information.

Form TSP-17 (3/2015)

PREVIOUS EDITIONS OBSOLETE

Page 3 of 8

INFORMATION AND INSTRUCTIONS

IV. DETAILED INFORMATION ABOUT POTENTIAL BENEFICIARIES

The information in this section will be used to locate potential beneﬁciaries. Be sure to ﬁll in the deceased participant’s name and Social Security number at the top of the page. If you need to list more than four per- sons, make as many photocopies of the page as you need. Check the box at the bottom of the page and indicate the number of additional pages attached.

If you cannot provide all of the requested information, provide as much information as you can. Write “Don’t Know” on any line for which you do not have information. If the information that you are able to provide is not enough to contact the potential beneﬁciary (that is, if you cannot provide a full address or telephone number) or if you only have information about some of the beneﬁciaries, complete Section V also.

When providing information about a potential beneﬁciary who was living at the time of the participant’s death but who died after the participant, be sure to provide the date of death for that person.

If you are providing information about children of the participant, be sure to include natural children (including those who were born out of wedlock) and those who were adopted by the participant. Do not provide infor- mation for natural children who were adopted by someone other than the participant’s spouse.

In the following (correctly ﬁlled-out) example, the participant was not married at the time of death, but the participant had two living children, a deceased child who had a son, and a surviving father. Because the participant was not married at the time of death, the applicant provided information about the participant’s living children and the grandchild (from the participant’s deceased child) identiﬁed in Item 20. There was no need to provide information about the deceased child identiﬁed in Item 20B because that child predeceased the participant. There was also no need to provide information about the surviving parent, because the living children and the grandchild will be the beneﬁciaries according to the statutory order of precedence.

Example

III.

INFORMATION ABOUT POTENTIAL BENEFICIARIES

19.Participant’s Spouse—Was the participant married at the time of death?

Yes

✓ No

Don’t Know

If Yes, skip to Section IV; if “No” or “Don’t Know,” complete questions 20 – 22 below.

20.Participant’s Children—

A. Were there any living children of the participant at the time of death?

✓ Yes	No	Don’t Know
If “Yes,” how many? __2__		Check here if the number of children you identiﬁed is an estimate.

B.Were there any children of the participant who died before the participant died?

✓ Yes	No	Don’t Know
If “Yes,” please complete the following:
1. How many children died before the participant? __1__			Check here if the number of children
you identiﬁed is an estimate.

2.Were there any descendants of those deceased children (i.e., the participant’s grandchildren) living at the time of the participant’s death?

✓ Yes	No	Don’t Know If “Yes,” how many? __1__	Check here if the number
of children you identiﬁed is an estimate.

21.Participant’s Parents—Did the participant have at least one living parent at the time of death?

✓Yes

Don’t Know

✓Yes

Don’t Know

☞If you answered “Yes” or “Don’t Know” to any of the questions in 20 – 22, complete the rest of this form. If you an- swered “No to every question in Section III, skip to Section VII; you may be contacted for additional information.

IV.

Name

Stanek

Brad

Scott

Son

DETAILED

Last

First

Middle

Relationship to Deceased Participant

INFORMATION

123 Main Street

Chicago

60612

ABOUT

Address

POTENTIAL

Street Address or Box Number

City

State/Country

Zip Code

312

) 555

1985

912 – 34

– 5678

02 / 24 / 1970

BENEFICIARIES

Phone (

–

Check one:

✓Daytime

Evening

Social Security Number

Date of Birth (mm/dd/yyyy)

If this person died after the participant, provide the date of death.

mm dd

yyyy

Name

Jones

Linda

Leslie

Daughter

Last

First

Middle

Relationship to Deceased Participant

Address

13 H Street

Pottstown

19464

Street Address or Box Number

City

State/Country

Zip Code

Phone ( 610

Check one:

)555

Daytime

– 9432	923 – 45 – 6789	08 / 18 / 1972
		Date of Birth (mm/dd/yyyy)
✓Evening	Social Security Number

If this person died after the participant, provide the date of death.		/	/
	mm	dd	yyyy


Name	Stanek	omas	Arthur			Grandson
Last		First	Middle		Relationship to Deceased Participant
Address	921 North Avenue	Gaithersburg		MD			20878
	Street Address or Box Number	City		State/Country			Zip Code

Phone ( 301

Check one:

)555

✓Daytime

–	1980		934	–	56	–	7890		Don't/	Know/
Evening		Social Security Number						Date of Birth		(mm/dd/yyyy)
Evening

If this person died after the participant, provide the date of death.		/	/
	mm	dd	yyyy

Page 4 of 8	Form TSP-17 (3/2015)
	PREVIOUS EDITIONS OBSOLETE

Deceased Participant’s Name		SSN	–	–

IV.	If the participant was married at the time of death, provide the requested information for the deceased par-
DETAILED	ticipant’s spouse only. Otherwise, provide the requested information for all living children of the participant,
INFORMATION	all children who died after the participant, and all living children of deceased children whom you identiﬁed in
ABOUT	Item 20 in Section III. (You do not need to provide this information for any children identiﬁed in Item 20B who
ABOUT

	POTENTIAL	died before the participant.) When providing a phone number for a person living outside the United States or
	POTENTIAL	Canada, enter the number exactly as you would if you were calling it from the United States.
	BENEFICIARIES
	BENEFICIARIES
		If you answered “No” to all questions related to the spouse and children, provide the requested information
		for parent(s) of the participant identiﬁed as living in Item 21. If there were no living parents, provide informa-
		tion about the executor or administrator identiﬁed in Item 22.

☞

Name

LastFirstMiddle Relationship to Deceased Participant

Address

Street Address or Box Number

City

State/Country

Zip Code

Phone

(

)

–

Date of Birth

(mm/dd/yyyy)

Check one:

Daytime

Evening

Social Security Number

If this person died after the participant, provide the date of death.

yyyy

Name

Last

First

Middle

Relationship to Deceased Participant

Address

Street Address or Box Number

City

State/Country

Zip Code

Phone

(

)

–

Date of Birth

(mm/dd/yyyy)

Check one:

Daytime

Evening

Social Security Number

If this person died after the participant, provide the date of death.

yyyy

Name

Last

First

Middle

Relationship to Deceased Participant

Address

Street Address or Box Number

City

State/Country

Zip Code

Phone

(

)

–

Check one:

Daytime

Evening

Social Security Number

Date of Birth

(mm/dd/yyyy)

If this person died after the participant, provide the date of death.

yyyy

Name

Last

First

Middle

Relationship to Deceased Participant

Address

Street Address or Box Number

City

State/Country

Zip Code

Phone

(

)

–

Check one:

Daytime

Evening

Social Security Number

Date of Birth

(mm/dd/yyyy)

If this person died after the participant, provide the date of death.

yyyy

Check here if additional pages are used. Number of additional pages

Form TSP-17 (3/2015)

PREVIOUS EDITIONS OBSOLETE

Page 5 of 8

INFORMATION AND INSTRUCTIONS

V. REFERRAL FOR INFORMATION

If you answered “Don’t Know” about potential beneﬁciaries in Section III, or you cannot provide a name, address, or telephone number for any individual you identiﬁed in Section IV, provide in this section the name, address, and telephone number of anyone else whom the TSP can contact to obtain this information. If you cannot provide the address and telephone number, provide any information that you can.

VI. ADDITIONAL INFORMATION

You can use this section to expand upon or clarify any information provided on this form. You can also use this space to provide additional information not covered elsewhere on this form which is relevant to the disposition of the deceased participant’s account. (If you need additional space, continue on a blank sheet of paper.)

VII. CERTIFICATION

You must sign and date this form in Items 23 and 24.

Page 6 of 8	Form TSP-17 (3/2015)
	PREVIOUS EDITIONS OBSOLETE

Deceased Participant’s Name		SSN	–	–

V.	Complete this section if:
REFERRAL	• You cannot provide a current address or telephone number for a potential beneﬁciary whom you listed in
FOR	Section IV.
INFORMATION	• There is no spouse and you believe there may be additional children about whom you have limited

knowledge.

•You answered “Don’t Know” about potential beneﬁciaries in Section III.

Please refer us to someone who may be able to provide this information. (For more space, use Section VI.)

Name

(

)

–

Daytime Phone

Address

City

State

Zip Code

Relationship to Participant

To which potential beneﬁciary(ies) does this referral apply?

VI.	Use this space to provide any information that may be relevant to the disposition of the deceased participant’s
ADDITIONAL	account and that you did not furnish elsewhere on this form.
INFORMATION

VII.	I certify that the information I have provided is true and complete to the best of my knowledge. Warning: Any
CERTIFICATION	intentional false statement in this form or willful misrepresentation concerning it is a violation of law that is
	punishable by a ﬁne or imprisonment for as long as 5 years or both (18 U.S.C. 1001).
	23.		24.
		Your Signature		Date Signed

PRIVACY ACT NOTICE. We are authorized to request this information under

5 U.S.C. chapter 84. We are authorized by Executive Order 9397 to ask for the de- ceased participant’s Social Security number and your Social Security number and by 26 U.S.C. 6109 to ask for Taxpayer ID Numbers. We will use the information you provide on this form to identify the deceased participant’s account(s) and to process death beneﬁt payments from that account. This information may be shared with other Federal agencies for statistical, auditing, or archiving purposes. In addition, we may

Form TSP-17 (3/2015)

PREVIOUS EDITIONS OBSOLETE

share the information with law enforcement agencies investigating a violation of civil or criminal law, or agencies implementing a statute, rule, or order. It may be shared with congressional ofﬁces, private sector audit ﬁrms, spouses, former spouses, and ben- eﬁciaries, and their attorneys. We may also disclose relevant portions of the informa- tion to appropriate parties engaged in litigation. You are not required by law to provide this information, but if you do not provide it, we will not be able to process this form or make payment.

Page 7 of 8

Remember to attach a copy of the participant’s death certificate when you submit this form.

The death certificate must state the cause or manner of death.

Page 8 of 8	Form TSP-17 (3/2015)
	PREVIOUS EDITIONS OBSOLETE

How to Edit Tsp 17 Fillable Form Online for Free

tsp form 17 can be filled in online very easily. Just make use of FormsPal PDF tool to get it done right away. To make our tool better and easier to use, we continuously develop new features, taking into consideration suggestions coming from our users. To get the ball rolling, consider these easy steps:

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government form tsp 17 writing process explained (part 1)

2. Immediately after this selection of blanks is completed, go on to type in the relevant details in these - III INFORMATION ABOUT POTENTIAL, Participants SpouseWas the, Yes, Dont Know, If Yes skip to Section IV if No or, Participants Children, A Were there any living children, Yes, Dont Know, If Yes how many, Check here if the number of, B Were there any children of the, Yes, Dont Know, and If Yes please complete the.

Step # 2 for submitting government form tsp 17

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government form tsp 17 conclusion process outlined (stage 3)

4. To go ahead, the next form section will require typing in a couple of form blanks. These comprise of Deceased Participants Name, SSN, IV DETAILED INFORMATION ABOUT, If the participant was married at, If you answered No to all, Name, Last, Address, First, Middle, Relationship to Deceased, Street Address or Box Number, City, StateCountry, and Zip Code, which are vital to going forward with this particular PDF.

Writing part 4 of government form tsp 17

It is easy to make an error when filling in the Name, thus be sure you go through it again before you send it in.

5. This pdf has to be finalized by dealing with this segment. Below one can find a full set of fields that need to be completed with correct details in order for your document usage to be faultless: Check one, Daytime, Evening, If this person died after the, yyyy, Name, Last, Address, First, Middle, Relationship to Deceased, Street Address or Box Number, City, StateCountry, and Zip Code.

Writing part 5 of government form tsp 17

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