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DBN-001 Rev. 6/13 Death Benefits Beneficiary Designation Use this form to designate the beneficiary or beneficiaries to receive death benefits (Salary Continuation Benefit) payable at your death.

How to fill out death benefits beneficiary designation

How to Fill Out Death Benefits Beneficiary Designation:

1. Start by obtaining the necessary forms from your employer or the insurance company providing the death benefits. These forms may also be available online.
2. Begin by providing your personal information, including your full name, address, and contact details. Make sure all the information is accurate and up to date.
3. Identify the specific death benefits plan to which you are making the beneficiary designation. This could be a life insurance policy, a retirement account, or any other plan that offers death benefits.
4. Indicate whether you want to name a primary beneficiary or multiple primary beneficiaries. A primary beneficiary is the person who will receive the death benefits upon your passing. You may also have the option to name secondary or contingent beneficiaries who would receive the benefits if the primary beneficiary is unable to.
5. Clearly write the full name of each beneficiary, along with their relationship to you (e.g., spouse, child, sibling). It's crucial to provide accurate and complete information to ensure the benefits reach the intended recipients.
6. Include the social security number or other identifying information of each beneficiary. This helps prevent any confusion or errors when processing the beneficiary designation.
7. Specify the percentage or amount of the death benefits that each beneficiary should receive. You can distribute the benefits equally among all designated individuals or allocate different percentages based on your preferences.
8. Sign and date the beneficiary designation form. Depending on the requirements, you may need to have your signature witnessed or notarized. Follow the instructions provided to ensure your form is valid.

Who Needs Death Benefits Beneficiary Designation:

1. Anyone who has death benefits coverage through an employer-sponsored plan, personal life insurance, or retirement account should consider designating beneficiaries. This ensures that the benefits are distributed according to their wishes and helps avoid legal complications.
2. Individuals who have dependents or loved ones who rely on them financially may find it especially important to designate beneficiaries. It provides a financial safety net for their family members if something were to happen to them.
3. Even if you don't have any dependents, designating beneficiaries can still be crucial. It allows you to determine who will receive your death benefits, whether it's close family members, friends, or charitable organizations that are important to you.

Remember to review and update your beneficiary designations periodically, especially following significant life events such as marriage, divorce, the birth of a child, or the death of a beneficiary.

For pdfFiller’s FAQs

What is death benefits beneficiary designation?

Death benefits beneficiary designation is a form that allows an individual to specify who will receive their death benefits in the event of their passing.

Who is required to file death benefits beneficiary designation?

Any individual who has death benefits as part of their insurance policy, retirement plan, or other financial account is required to file a death benefits beneficiary designation form.

How to fill out death benefits beneficiary designation?

To fill out a death benefits beneficiary designation form, one must provide their personal information, the name and contact information of the beneficiary, and specify the percentage of the death benefits they will receive.

What is the purpose of death benefits beneficiary designation?

The purpose of death benefits beneficiary designation is to ensure that the policyholder's death benefits are distributed according to their wishes, avoiding potential disputes among family members.

What information must be reported on death benefits beneficiary designation?

The information that must be reported on a death benefits beneficiary designation form includes the policyholder's name, date of birth, social security number, the beneficiary's name and contact information, and the percentage of benefits they will receive.

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