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Please list additional beneficiaries along with percentages they are to receive on a separate page if needed. Indicate whether Beneficiary the additional beneficiary ies is/are primary or secondary beneficiary ies. I waive the requirement that this pre-retirement death benefit be paid in the form of a QPSA and if applicable Waiver of QPSA Signature X DID YOU REMEMBER TO Sign the form Initial any changes Use whole numbers Have your spouse s signature notarized 30 Scranton Office Park...
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