Pbgc Form 707 - Designation Of Beneficiary Forbenefits Owed At Death (Page 2 of 2) in pdf

Pbgc Form 707 - Designation Of Beneficiary Forbenefits Owed At Death Page 2

Designation of Beneficiary for Benefits Owed at Death

Form 707, page 2 of 2

(Currently Receiving Pension Benefits)

Plan Number: FX.PrismCase.CaseIdNmbr.XF

Participant Name : FX.PrismCust.FullName.XF

3. Designation of Beneficiary

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PBGC may owe you money at the time of your death. Typically, this happens if your final

benefit is higher than the estimated benefit we had been paying. If another person continues to receive your benefit after your death

(as with a joint-and-survivor or certain-and-continuous annuity), PBGC will pay any money owed to that person. If there are no

continuing benefits or the person designated to receive continuing benefits dies before you, PBGC will pay any money owed you at

the time of your death to the person(s) and/or entity(ies) (such as a trust, church, estate or other organization) that you designate in

this section. If you do not make a designation, or if the beneficiary is a person and dies before you, PBGC will pay the money in this

order to: your spouse, your children, your parents, your estate, or your next of kin.

I name the following as my beneficiary(ies). This designation replaces any previous designation and will only be effective when

PBGC receives it.

Beneficiary(ies)

Social Security Number*

Date of Birth*

Relationship

Percentage**

Name _______________________________________

Address ______________________________________

_____________________________________________

Daytime Tel. No:_______________________________

Name _______________________________________

Address ______________________________________

_____________________________________________

Daytime Tel. No:_______________________________

Name _______________________________________

Address ______________________________________

_____________________________________________

Daytime Tel. No:_______________________________

* Complete if person

** Not necessary to provide; if provided, must total 100%

Pbgc Form 707 - Designation Of Beneficiary Forbenefits Owed At Death Page 2