Unum CS-1110 2009 free printable template

BENEFICIARY DESIGNATION FORM GROUP LIFE AND GROUP ACCIDENTAL DEATH DISMEMBERMENT INSURANCE Unum Life Insurance Company of America Provident Life and Accident Insurance Company The Paul Revere Insurance Company Instructions Please complete sign and date this form to designate your bene ciary ies or to change your existing bene ciary ies. Return the completed form to your employer. SECTION 1 Employee Information Name Last Name Suf x First Name MI Employer Name Social Security Number Check the...

How to fill out Unum CS-1110

How to fill out Unum CS-1110

1. Gather all necessary personal information, such as your name, address, and Social Security number.
2. Review the instructions on the form carefully before starting to fill it out.
3. Complete Section A by providing basic identification details.
4. In Section B, indicate the type of benefits you are applying for and any related dates.
5. Fill out Section C by listing any dependents or beneficiaries.
6. Provide details in Section D about your employment history and relevant income.
7. Review all entries for accuracy before submitting the form.
8. Sign and date the form at the designated area.

Who needs Unum CS-1110?

1. Individuals who are filing for disability benefits.
2. Employees seeking coverage under Unum insurance policies.
3. Dependents or beneficiaries of an insured individual who are applying for benefits.

Instructions and Help about Unum CS-1110

Hi I'm Jenna I'm here to assist you in filling out the beneficiary change form from pensions and benefits USA this form is used for making changes in the selection of beneficiaries who receive proceeds from insurance plans offered by pensions and benefits these may include coverage provided for you by P and B such as the pensioners' death benefit plan the pastor's life insurance plan or additional plans in which you are enrolled this document allows P and B in our insurance underwriter Aetna to expedite the disposition of funds after your passing as insurance proceeds payments to beneficiaries from these sources bypass probate in most cases this allows proceeds to be distributed fairly quickly speaking of speeding at the process to help expedite claims we recommend you complete one beneficiary designation change form for each plan in which you are enrolled it is important to review them periodically as there are changes in your life such as marriage birth divorce death and so on before we begin here are a few guidelines that will benefit you and help us number one please type or print your responses in ink and make sure your handwriting is easily read this is a legal document, and it's important that everyone who deals with it can clearly understand your wishes number two if you make a mistake just start over with a new form they're available in fillable forms at PB USA org and are easily printed out on your own printer the use of liquid paper are marking through a mistake gives the appearance of a change and might result in your wishes being questioned you want to avoid the appearance that anyone other than you completed this form number three be sure to sign and date your form before returning it to us an unsigned undated form is not a legal document also be aware that typically the insurance company won't approve a form which is signed by a power of attorney in number four if you wish to list a will estate or trust as a beneficiary this is not the correct form for you in such case email us that help at PB USA org in preparing to complete this form here are a few things to consider before you start number one give careful thought to whom you choose to be aware there is no legally binding requirement that would compel the beneficiary of your proceeds to carry out your wishes even if you have a prior agreement with them for instance if you choose to make a friend the beneficiary with the understanding he will use the money to care for your infant children that person may choose to honor or disregard your wishes without legal consequences so be careful about whom you select number two minor children should not be listed as beneficiaries an insurance company cannot pay a benefit to a minor child doing this would result in cumbersome legal procedures that could cost time and money in most cases it's best to leave the benefits to your spouse and let him or her take care of the children number three do not list yourself it's important that you don't...

People Also Ask about

How do I fill out a beneficiary form?

Write only one beneficiary on each line. Make sure that you write the full names of all beneficiaries. For example, if you name you children as beneficiaries, DO NOT merely write “children” on one of the lines; instead write the full names of each of your children on separate lines.

How do I fill out a beneficiary form?

General Instructions Write only one beneficiary on each line. Make sure that you write the full names of all beneficiaries. For example, if you name you children as beneficiaries, DO NOT merely write “children” on one of the lines; instead write the full names of each of your children on separate lines.

What is a Life Insurance beneficiary form?

Use this form to name the persons or entities you want to receive your life insurance proceeds after your death.

How do I write a beneficiary designation letter?

Most beneficiary designations will require you to provide a person's full legal name and their relationship to you (spouse, child, mother, etc.). Some beneficiary designations also include information like mailing address, email, phone number, date of birth and Social Security number.

What does beneficiary form mean?

The beneficiary designation forms allow you to name primary and secondary beneficiaries. Your “primary beneficiaries” are the first people or entities that you want to receive your benefit after you die.

What is a beneficiary form?

Your original designation remains in force whether it still reflects your wishes or not, until you submit another form to cancel prior designations or to designate a new beneficiary. A designation of beneficiary form outlines your desire to have the funds due upon your death paid out in a particular way.

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What is Unum CS-1110?

Unum CS-1110 is a specific form used for reporting certain types of financial information related to insurance or benefits provided by Unum Group.

Who is required to file Unum CS-1110?

Individuals or entities that are beneficiaries of Unum Group's insurance or benefits programs and are required to report detailed financial information must file Unum CS-1110.

How to fill out Unum CS-1110?

To fill out Unum CS-1110, accurately complete all sections of the form, providing required information such as personal identification, financial details, and any other relevant data. Ensure that all entries are legible and double-check for accuracy before submission.

What is the purpose of Unum CS-1110?

The purpose of Unum CS-1110 is to collect and report financial information necessary for processing claims or benefits related to Unum Group's insurance services, ensuring compliance with regulatory requirements.

What information must be reported on Unum CS-1110?

The information that must be reported on Unum CS-1110 includes personal identification details, the nature of the insurance or benefits claimed, financial data such as income or expenses related to the claim, and any other relevant documentation as specified by Unum Group.