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Pbgc Form 707 - Designation Of Beneficiary For Benefits Owed At Death - Virginia - 2013 Page 2

Designation of Beneficiary for Benefits Owed at Death

(Currently Receiving Pension Benefits)

Form 707, page 2 of 2

PBGC may owe you payments at the time of your death. Generally, this will happen if your

3. Designation of Beneficiary

–

estimated benefit is too low. If your benefit will continue to be paid to another person after your death (as with a joint-and-survivor or

certain-and-continuous annuity), the person receiving those continuing benefits will also receive any payments due to you at the time

of your death. If there are no continuing benefits, PBGC will make any payments due to you at the time of your death to the person

you designate in this section. If yo u do not designate anyone, or if the beneficiary you name dies before you , PBGC will pay the

amount we owe you in this order: your spouse, your children, your parents, your estate, and your next of kin.

- I

name the following person as my beneficiary. This designation replaces any previous designation and will only

Beneficiary

be effective when PBGC receives it.

Last Name

First Name

Middle Name

Other Name(s) Used

Social Security Number

Date of Birth

Gender



MALE



FEMALE

Mailing Address

Apartment / Route Number

City

State

Zip Code

Country

Email (optional)

Daytime Phone

Evening Phone

XTENSION

(

)

(

)

Relationship to me, if any (e.g., spouse, granddaughter, friend)

Pbgc Form 707 - Designation Of Beneficiary For Benefits Owed At Death - Virginia - 2013 Page 2