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Reset Impersonal ACCIDENT INSURANCE Beneficiary Designation Footprint Policy: 677639Mail, email or fax completed form to: SAMBA, 11301 Old Georgetown Road, Rockville, MD 208522800 insurance SambaPlans.com
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How to fill out SAMBA Beneficiary Designation Form

01
Obtain the SAMBA Beneficiary Designation Form from the SAMBA website or your employer.
02
Read the instructions carefully to understand the requirements.
03
Fill in your personal information, including your name, address, and contact details.
04
Designate your primary beneficiary by providing their full name, relationship to you, and their contact information.
05
If desired, designate any contingent beneficiaries and provide their information as well.
06
Review your designated beneficiaries to ensure accuracy.
07
Sign and date the form to validate your designations.
08
Submit the completed form according to the provided instructions, whether by mail or electronically.

Who needs SAMBA Beneficiary Designation Form?

01
Individuals who have or are eligible for a SAMBA retirement account or insurance plan.
02
Participants in SAMBA-sponsored benefits programs who wish to designate beneficiaries.
03
Anyone wanting to ensure their assets are distributed according to their wishes upon their passing.
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The SAMBA Beneficiary Designation Form is a document used by members of the SAMBA (Service Appropriate Medical Benefits Administration) to designate individuals who will receive benefits upon the member's death.
All SAMBA members who wish to designate beneficiaries for their insurance benefits are required to file the SAMBA Beneficiary Designation Form.
To fill out the SAMBA Beneficiary Designation Form, a member must provide personal information, including their name and identification details, as well as the names, relationships, and contact information of the beneficiaries being designated.
The purpose of the SAMBA Beneficiary Designation Form is to legally establish who will receive the member's insurance benefits after their death, ensuring that benefits are distributed according to the member's wishes.
The SAMBA Beneficiary Designation Form must report the member's personal information, the names and relationships of the beneficiaries, their contact details, and any specific allocation percentages for the benefits.
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