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Section D Applicant signature I revoke all previous Tier One/Tier Two Program beneficiary designations. I designate a specific person s and/or charity ies as my beneficiary ies. Complete Section C. I designate my estate as my beneficiary 100 designation. Instructions 11410 SW 68th Parkway Tigard OR 97223 Mailing Address PO Box 23700 Tigard OR 97281-3700 Toll free 888-320-7377 fax 503-598-0561 Website http //oregon.gov/pers Tier One or Tier Two Pre-Retirement Beneficiary Designation...
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