ANNUITY CLAIMANT'S STATEMENT
This form must be executed before a WITNESS by the person or persons to whom . 3) Name: Birth Date. -. -. Relationship. TIN/SSN. Percentage. %. Address
Environmental Protection Agency § 1039.245
total hydrocarbon (THC) emissions. In- dicate in your application for certifi- cation if you are using this option. If you do, measure THC emissions
PREAUTHORIZED CHECK PLAN
Name. Relationship to the Insured/Annuitant Birth Date. %. □ *Irrevocable
Form TSP-3
Form TSP-3 (10/2007). PREVIOUS EDITIONS OBSOLETE. Use this form to designate a beneficiary or beneficiaries to receive your civilian Thrift Savings Pla
*DRSD112*
DRS D 112 (R 11/11). *DRSD112* . Completion of this form revokes any prior designations I have made. Signature Please complete all sections of this form
7 CFR Ch. II (1–1–11 Edition) § 250.11
Mar 17, 2011 the distributing agencies' responsibil- ities to the Department for overall management and control of the dis- tribution program shall