Designation Of Beneficiary Form

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DESIGNATION OF BENEFICIARY
In the event of your death, the Plan provides that your account balance will be paid to your Designated
Beneficiary.
Your Designated Beneficiary can be any person, trust fund, or your estate. You can name a single
Designated Beneficiary to receive all of your benefits, or two or more Designated Beneficiaries to split
the value of your benefits in the percentages which you specify. In addition, you may name Contingent
Beneficiary(ies), who receive your death benefits if your Primary Beneficiary dies before you do.
If you are married at the time of your death, your spouse will automatically be the beneficiary of your
death benefit, unless you have specifically elected otherwise. In order for such an election to be valid,
your spouse must irrevocably consent to the election. The designation must specify the nonspouse
beneficiary or beneficiaries, and your spouse's consent must be witnessed by a Notary Public or by a Plan
representative.
You may then change your beneficiary back to your spouse at a later time, or you may designate a
different beneficiary at a later time if you again obtain the required spousal consent.
If you are not married at the time of your death and you do not designate a beneficiary, your death benefit
will be paid to your estate.
Important note: your beneficiary under this Plan cannot be designated in your will. You must specify
your Designated Beneficiary using the Designation of Beneficiary form for the Plan.
Enclosed is a Designation of Beneficiary form which you should complete and return to the Plan
Administrator. Please be sure to keep a copy for your records. It is also a good idea to supply your
Designated Beneficiaries with a copy for their records.
Please inform the Plan Administrator of any change in your marital status. Any questions regarding your
death benefits or completion of this form should also be directed to the Plan Administrator.

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