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Part 1 Primary Beneficiary ies In Equal Shares or as Designated Below Relationship to Insured of Proceeds Phone Number Social Security Number Birthdate as shall then be living and if no such beneficiary is then living 274597 2016 RiverSource Life Insurance Company. Spouse Name Date Signed Spouse Signature Part 4 Disclosures and Signatures Change of Beneficiary The undersigned hereby revokes any and all prior beneficiary designations and/or elections by the Owner s of a method of settlement...
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