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HEALTH AND SECURITY PLAN DC CHANGE OF BENEFICIARY FORM PLEASE READ THE INSTRUCTIONS ON THE BACK BEFORE COMPLETING THIS FORM PRINT OR TYPE IN BLACK INK AND IN CAPITAL LETTERS 125 Barclay St. New York NY 10007 2179 Telephone 212 815 - 1234 PID OR MEMBER S SOCIAL SECURITY MEMBER S LAST NAME MEMBER S FIRST NAME MI This beneficiary designation is effective on the date this form is received at the DC 37 Health and Security Plan Office. Your signature on the Change of Beneficiary Form must be...
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DC 37 beneficiary refers to the designated person or persons who will receive benefits from the DC 37 trust funds in the event of the member's death.
All members of DC 37 who are eligible for benefits and want to designate a beneficiary must file DC 37 beneficiary form.
To fill out the DC 37 beneficiary form, you need to provide the required information such as your name, address, date of birth, social security number, and the name and relationship of the designated beneficiary.
The purpose of DC 37 beneficiary designation is to ensure that your benefits from the DC 37 trust funds are distributed according to your wishes in the event of your death.
The DC 37 beneficiary form requires information such as your personal details (name, address, date of birth, social security number), as well as the details of your designated beneficiary (name, relationship).
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