Beneficiary Designation Form - Lincoln Financial Group Page 2
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1
2COMPLETING YOUR BENEFICIARY DESIGNATION FORM
1.
At the top of the form, fill in the information regarding your employer and yourself.
2.
Next complete the information regarding who will be your primary and contingent beneficiaries. A primary beneficiary will be
the person/people that you want to receive the life insurance benefit. The contingent beneficiary or beneficiaries will only receive
the life insurance benefit if the primary beneficiary(ies) is no longer living. Indicate the percentage of the benefit amount that the
beneficiary will receive. Do not use dollar amounts. Percentages must add up to 100%.
3.
If you live in a community property state, are married and naming someone other than your spouse as the primary beneficiary, you
should have your spouse sign this form to avoid any delays at claim time.
4.
Sign and date the form.
Below is an example of how to complete the beneficiary designations:
PRIMARY BENEFICIARY(IES)
Social Security
Relationship
Date of
Percentage:
Primary Beneficiary’s Name and Address
Number
to You
Birth
Must equal 100%
Name:
Jill Doe
xxx-xx-xxxx
Wife
xx/xx/xx
100%
Address:
123 Main St, Anytown, NE 00000
Name:
Address:
Name:
Address:
CONTINGENT BENEFICIARY(IES):
Contingent beneficiaries will only receive benefit if there are no surviving primary beneficiaries.
Social Security
Relationship
Date of
Percentage:
Contingent Beneficiary’s Name and Address
Number
to You
Birth
Must equal 100%
Name:
John Doe Sr
xxx-xx-xxxx
Father
xx/xx/xx
50%
Address:
456 Main Ln, Anytown, NE 00000
Name:
Mary Doe
xxx-xx-xxxx
Sister
xx/xx/xx
25%
Address:
789 Main Rd, Anytown, NE 00000
Name:
Jack Doe Irrevocable Trust, Jill Doe TTEE UTA 1/04
xxx-xx-xxxx
Trust
25%
Address:
123 Main St, Anytown, NE 00000
FREqUENTLY ASkED qUESTIONS
Should I name a minor child as a beneficiary?
You may name a minor child as a beneficiary, however please be aware that we cannot make payment of a claim directly to a minor. If
a claim is incurred we would need to make payment to the guardian of the minor’s financial estate or pay the funds into a Secureline
Minor Account.
How would I name a Charitable Organization as a beneficiary?
A charitable organization that is not your employer may be named as a beneficiary. You will need to indicate the name of the charitable
organization, a contact for the organization, their tax identification number, and the percentage of the benefit that would be payable to them.
How do I name my Estate as the beneficiary?
You may name your estate as a beneficiary. To name your estate as the beneficiary indicate “My Estate” as the beneficiary. If you
know who will be the executor or administrator of your estate you should also include that person’s name. For example: My Estate, John
Doe Executor.
How do I name a Trust as the beneficiary?
You may designate a trust as a beneficiary. To name a trust as a beneficiary, indicate Trustee (show Name and address) under Trust
Agreement Dated (show date). If the trust has a tax identification number that will need to be supplied in place of the social security
number. For example: Jack Doe Irrevocable Trust, Jill Doe TTEE UTA 1/1/04.
Page 2 of 2
GLC-02170
10/08
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