Form Eb-0214-0809 - Designation Of Beneficiary Form - State Of New Jersey printable pdf download

EB-0214-0809

NEW JERSEY DIVISION OF PENSIONS AND BENEFITS

PO BOX 295, TRENTON, NJ 08625-0295

DESIGNATION OF BENEFICIARY

Designations of Beneficiary can now be submitted online when using the Member Benefit Online System (MBOS).

Log on to MBOS or, if you are a new user, register today at:

ABOUT THE DESIGNATION OF BENEFICIARY FORM

THIS FORM WILL REPLACE ALL PRIOR DESIGNATIONS OF BENEFICIARY.

The Designation of Beneficiary form allows a member of a New Jersey State-administered retirement system to nominate

a beneficiary, or beneficiaries, for benefits payable upon the death of that member. This form applies to both the group life

insurance and pension benefit for active and retired members.

GROUP LIFE INSURANCE

This designation is for any group life insurance benefit payable at the time of your death. Group life insurance does not apply

to retirees with less than 10 years of service credit, retirees of the Consolidated Police and Firemen's Pension Fund

(CPFPF) or Prison Officers Pension Fund (POPF), or members who enrolled at age 60 or older and failed to prove insur-

ability.

PENSION BENEFIT

This designation is for any and all pension benefits remaining at the time of your death.

Active Members

For Public Employees’ Retirement System (PERS) and Teachers’ Pension and Annuity Fund (TPAF) members, the pension

benefit is the return of member contributions paid in a lump sum to the designated beneficiary.

For Police and Firemen’s Retirement System (PFRS), State Police Retirement System (SPRS), and Judicial Retirement

System (JRS) members, the pension benefit is a monthly pension determined by the governing statutes of those funds

regarding surviving spouses, civil union partners, eligible domestic partners, minor children, and dependent parents.

Retired Members

For PERS, TPAF, and JRS* members:

Maximum Option - The beneficiary designated will be entitled to the pension allowance due for the month in which

you pass away.

Option 1 Benefit - The balance of the reserve established at retirement, if any, will be paid to this beneficiary.

Option A, B, C, D, 2, 3, or 4 Benefit - The beneficiary named as the recipient of a monthly pension at retirement can-

not be changed. However, should your beneficiary predecease you, a new beneficiary can be designated to receive

ONLY the pension allowance due for the month in which you pass away.

For PFRS, SPRS, and JRS members, the pension benefit is a monthly pension determined by the governing statutes of

those funds regarding surviving spouses, civil union partners, eligible domestic partners, minor children, and dependent

parents.

*JRS members: In addition to the statutory monthly survivor benefits for a spouse, civil union partner, eligible domestic partner, and/or dependent chil-

dren, you may also elect one of the eight voluntary pension options that provide a pension benefit to a named beneficiary of your choice.

PRIMARY AND CONTINGENT BENEFICIARIES

Please be sure to designate both primary and contingent beneficiaries. In the event of your death, the primary beneficiary,

or beneficiaries, will receive any death benefits that are payable. The contingent beneficiary, or beneficiaries, will receive

death benefits ONLY if all primary beneficiaries have predeceased you. Unless otherwise stated, all beneficiaries will share

and share alike. If no primary or contingent beneficiaries survive you, all death benefits will be paid to your estate.

You may nominate any of the following as your primary or contingent beneficiary:

A person or persons;

An institution, charity, or corporation;

Your estate (upon your death a court ordered surrogate certificate will be required).

If you choose a distribution of benefits other than the standard "share and share alike", or if you are naming a minor, using

a trust agreement, acting as a power of attorney for the member, or nominating a civil union partner or domestic part-

ner, please refer to Fact Sheet #68, Designating a Beneficiary , before completing this form. You may obtain this fact sheet

by visiting our Web site at: , or by calling the Office of Client Services at (609) 292-7524.

Form Eb-0214-0809 - Designation Of Beneficiary Form - State Of New Jersey

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