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WWW.gleaner life.org 5200 West U.S. Highway 223 P.O. Box 1894, Adrian, Michigan 49221 p 800.992.1894 f 517.265.7745 gleaner life. Additional BENEFICIARY ATTACHMENT Certificate Number(s) Insured/Annuitant
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How to fill out beneficiary change request 1

01
To fill out beneficiary change request 1, follow the steps below:
02
Obtain the beneficiary change request form from the concerned department.
03
Fill in your personal information such as your name, date of birth, address, and contact information.
04
Provide details of the existing beneficiary, including their name, relationship to you, and contact information.
05
Specify the reason for the beneficiary change request and provide any supporting documentation if required.
06
Clearly state the details of the new beneficiary, including their name, relationship to you, and contact information.
07
Review the form and ensure all information is accurate and complete.
08
Sign and date the beneficiary change request form.
09
Submit the completed form to the appropriate department or individual as instructed.

Who needs beneficiary change request 1?

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Beneficiary change request 1 is needed by individuals who want to update the designated beneficiary for a specific purpose such as insurance policies, retirement plans, or investment accounts. This request is typically used when the original beneficiary is no longer the preferred choice, or if there is a change in circumstances that warrants a change in the designated beneficiary.
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