Designation Of Beneficiary For Retirees Who Elected A Guarantee Period Option Form (Page 2 of 2) in pdf

RMS-5.3 (Page 2)

INSTRUCTIONS FOR DESIGNATING A BENEFICIARY

UNDER A GUARANTEE OPTION

Please type or print in black or blue ink. This form must be properly notarized.

One primary and any number of contingent beneficiaries may be named. The same person cannot be designated as both

primary and contingent beneficiary. We can make payment to a contingent beneficiary(ies) only if your primary beneficiary

dies before you do. If you survive all of the beneficiaries named, we would pay your estate.

Any alterations to this form must be initialed. Stipulations or attachments to your designation are not acceptable.

If you desire more beneficiaries than can fit on one form, you must use an additional designation form, each clearly marked

as “form 1 of 2” and “form 2 of 2,” etc. Each form must be signed, notarized, and submitted at the same time. Additional

forms can be acquired from the System.

New beneficiary forms filed will supersede any previous designation. Therefore, if you want to add a beneficiary, for example

a new child, you must include on the new form all beneficiaries you wish to designate.

If you designate persons:

•

List full names (e.g., Mary Smith not Mrs. John Smith). Unborn children may not be named.

•

Provide complete information requested for each beneficiary.

•

Beneficiaries should be listed separately (not Mr. and Mrs. on one line).

If you designate your estate (you may not name your estate as your primary beneficiary):

•

Use the words “My Estate” on the name line in the contingent beneficiary area of the form. Before naming your

estate as beneficiary, we suggest you contact the IRS or your tax advisor to determine the tax impact of such a

designation.

If you designate the trustee of an Intervivos Trust (you may not name a trust as your primary beneficiary):

•

The trustee must be a person or a corporation and a true copy of the trust instrument, or a Certificate of Trust,

containing the names and addresses of the trustee and successor trustee must be submitted with your designation.

•

The following language must be used on the name line in the contingent beneficiary area of the form: “(name

of trustee), (address of trustee), as trustee of a trust created by instrument, dated (date of instrument), a true

copy of which is annexed hereto.”

If you designate the trustee of a Testamentary Trust (you may not name a trust as your primary beneficiary):

•

The will under which the trust is established must be your will.

•

The following language must be used on the name line in the contingent beneficiary area of the form: “The

trustee of the testamentary trust established by paragraph (number) of my will, dated (date of your will).”

10. If you designate a custodian for a minor:

•

The following sentence must be written in the space provided for the beneficiary’s name and address on the front of

this form: “(name of custodian) as Custodian for (name of minor) under the New York Uniform Transfers to Minors Act.”

The gender, relationship and date of birth refer to the minor, not the custodian.

BENEFICIARY DESIGNATION CHECKLIST

Did you indicate your Social Security number in the appropriate box on the reverse?

Did you designate a primary beneficiary?

Did you initial any changes, whiteouts, or erasures you may have made?

Is your designation form signed and notarized?

In order for your new designation to be acceptable, it must be completed properly,

notarized, signed and received by the System. If you have questions when

completing this form, please call us at (800) 356-3128, Ext. 6150.

Designation Of Beneficiary For Retirees Who Elected A Guarantee Period Option Form Page 2

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