Designation Of Beneficiary And Waiver Of Pre-Retirement Survivor Annuity printable pdf download

DESIGNATION OF BENEFICIARY and

WAIVER OF PRE-RETIREMENT SURVIVOR ANNUITY

Married Participants

In the event of your death before you have been paid your benefits, the Plan provides that your account balance

will be used to purchase a survivor annuity for your spouse. This annuity will provide your spouse with monthly

payments for the rest of his or her life based on the value of your death benefit.

However, beginning with the first day of the Plan Year in which you attain age 35 (or upon your termination of

employment if you are under age 35), you may elect to waive the requirement that your death benefits be paid to

your spouse in the form of an annuity. In order for such an election to be valid, your spouse must irrevocably

consent to the election. The designation must specify the non-spouse beneficiary or beneficiaries, and your

spouse's consent must be witnessed by a Notary Public or by a Plan representative.

You may revoke the waiver any time before your death, and if you desire, make a new election. For example, if

you decide to waive the requirement that your death benefits be paid to your spouse in the form of an annuity and

your spouse has consented to this election, the death benefit will be paid to your Designated Beneficiary. You

may 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.

Unmarried Participants

In the event of your death before you have been paid your benefits, the Plan provides that your account balance

will be paid to your Designated Beneficiary.

All Participants

Your Designated Beneficiary can be any person, trust fund, or 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 a Contingent Beneficiary, who receives

your death benefits if your Primary Beneficiary dies before you do.

Your death benefit will be paid to your estate in the following circumstances:

You are not married at the time of your death, and you have not designated a beneficiary.

All of your designated beneficiaries have predeceased you.

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.

Making Elections

Attached is a form which you should complete and return to the Plan Administrator. This form can be used for

any of the following:

To waive the pre-retirement survivor annuity and have the death benefits paid in a lump sum.

To designate the beneficiary to receive your death benefits under the Plan, whether they are paid in a

lump sum or as a survivor annuity.

To obtain the required spousal consent to the above elections, as applicable.

Please keep a copy of this form for your records. You should also supply your beneficiaries with a copy for their

records.

It is important to 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.

Designation Of Beneficiary And Waiver Of Pre-Retirement Survivor Annuity