Fillable Va Form 29-336 - Designation Of Beneficiary - Government Life Insurance (Page 2 of 2) in pdf

DEPARTMENT OF VETERANS AFFAIRS GOVERNMENT LIFE INSURANCE

IMPORTANT INFORMATION AND INSTRUCTIONS FOR NAMING BENEFICIARIES

In order to protect your beneficiary(ies), it is important to keep your Beneficiary Designation up to date. A properly completed, current

designation filed with your insurance records will ensure that your insurance will be paid to the person(s) you want to get it. The

information and instructions on this page are provided to help you complete the Beneficiary Designation on the reverse side of this form.

1. You have the right to change the beneficiary(ies) at any time without the knowledge or consent of the prior beneficiary(ies). A state

court order or divorce decree cannot restrict this right and is not binding on you.

2. You may name as beneficiary(ies) any person, firm, corporation or other legal entity including your estate.

3. This designation will cancel and replace all previous designations for all of your policies. Any policies you wish to be excluded from

this designation must be listed in Item 5, "Remarks" on the designation form.

4. When inserting a beneficiary's name, please provide the first name, middle initial, and last name. For example, use John J. Smith. For

married persons, use Mary K. Smith, not Mrs. John J. Smith.

5. DO NOT DELAY SENDING THIS DESIGNATION if you do not have a beneficiary's social security number handy. Your

designation is still valid even if you do not know the social security number, so send this designation right away. Having the beneficiary's

social security number will help us locate the beneficiary.

6. If you name more than one principal or contingent beneficiary, please show the share, in fractions such as 1/2 or 1/3, etc. which each is

to receive and make certain that the shares total "1". Equal shares will be paid unless you designate otherwise.

7. The "LUMP SUM" preprinted in the "option for each" block means that the beneficiary(ies) may choose to receive the insurance in

one lump sum or in monthly payments. For information on monthly payment options call our toll-free number below.

8. The preprinted phrase "or to survivor(s)" means that the share of a beneficiary(ies) who dies before you will be paid to the surviving

beneficiaries. For example, if you name three principal beneficiaries and one dies before you, the share will be paid to the other two

principal beneficiaries, not to any contingent beneficiaries. For information about alternatives to the automatic survivorship clause, please

call our toll-free number below.

9. By law, if a designated principal beneficiary does not file a claim for payment within two years of the date of your death, then payment

may be made to the beneficiary(ies) next entitled. If no claim for payment is received from any designated beneficiary within four years

of the date of your death, your insurance will be paid in accordance with 38 U.S.C. 1917(f). If you do not designate a beneficiary, your

insurance will be paid to your estate or to your heirs.

10. MAILING INSTRUCTIONS - Send the form promptly upon completion to the address below. A copy will be mailed to you as

evidence of receipt by VA. The address is:

VARO & IC (B&O)

P.O. BOX 8638

PHILADELPHIA, PA 19101

IF YOU HAVE ANY QUESTIONS CONCERNING YOUR GOVERNMENT LIFE INSURANCE, PLEASE FEEL FREE TO

CALL OUR TOLL-FREE NUMBER 1-800-669-8477.

NOTE: THIS FORM IS NOT TO BE USED FOR SERVICEMEMBERS' OR VETERANS GROUP LIFE INSURANCE.

PRIVACY ACT NOTICE: The VA will not disclose information collected on this form to any source other than what has been

authorized under the Privacy Act of 1974 or Title5, Code of Federal Regulations 1.576 for routine uses identified in the VA System of

records, 36VA00, Veterans and Armed Forces Personnel U.S. Government Life Insurance Records - VA, published in the Federal

Register. Your obligation to respond is voluntary, but your failure to provide us the information could impede processing. Giving us your

SSN account information is voluntary. Refusal to provide your SSN by itself will not result in the denial of benefits. The VA will not

deny any individual benefits for refusing to provide his or her SSN unless the disclosure of the SSN is required by a Federal Statute of

law in effect prior to January 1, 1975, and still in effect. The responses you submit are considered confidential (38 U.S.C. 5701).

RESPONDENT BURDEN: We need this information to determine, establish or verify your eligibility for VA Insurance benefits

(38 U.S.C. 5902). Title 38, United States Code, allows us to ask for this information. We estimate that you will need an average of 10 minutes

to review the instructions, find the information, and complete this form. VA cannot conduct or sponsor a collection of information unless a

valid OMB control number is displayed. You are not required to respond to a collection of information if this number is not displayed. Valid

OMB control numbers can be located on the OMB Internet page at If desired, you

can call 1-800-827-1000 to get information on where to send comments or suggestions about this form.

VA FORM 29-336, SEP 2014

Va Form 29-336 - Designation Of Beneficiary - Government Life Insurance Page 2

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