Form Cs06893 - Beneficiary Change For Life Policy - Comal Isd
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4Customer Service Contact Information
PO Box 21008
Greensboro, NC 27420-1008
Toll Free: 1-800-487-1485
Fax: 336-335-2054
BENEFICIARY CHANGE FOR LIFE POLICY
GENERAL INFORMATION (To avoid processing delay, type or print clearly.)
This section must be completed.
See page 4 for required signature(s) and paperwork if applicable.
Policy/Certifi cate No.: ________________________________________ Issued by (the Company): __________________________
Insured’s Name: _____________________________________________________________________________________________
Owner(s) Name: _____________________________________________________________________________________________
Owner(s) Social Security Number/TIN: ___________________________________________________________________________
Owner(s) Address: ___________________________________________________________________________________________
City, State, Zip: ______________________________________________________________________________________________
Daytime Telephone No.: ____________________________Email Address: ______________________________________________
Check here if new address
INSTRUCTIONS
Almost all benefi ciary changes can be requested by using this form. However, if there is any question concerning the completion of the
request or if a benefi ciary designation is desired which cannot be requested on this form, contact your local representative or Agency
which services your policy.
1. Complete a separate request for change of benefi ciary for each policy to be changed, unless the owner and all information is the same
for all policies.
2. A form which has been altered or on which there has been an erasure cannot be accepted unless the alteration or erasure is initialed
by the policyowner.
3. This form is to be forwarded to the Company. A confi rmation of the benefi ciary change will be sent to you for your records.
4. This form is not to be used to elect an Optional Method of Settlement.
5. Irrevocable Benefi ciaries: An irrevocable benefi ciary is a designation that cannot be changed without the irrevocable benefi ciary’s written
consent. It is also a designation that for any change (i.e. withdrawal, ownership change, etc.) to the policy/contract, we will require the
irrevocable benefi ciary to sign and date the request. If you are naming an irrevocable benefi ciary, contact our offi ce for instructions.
6. Benefi ciary Classes (unless otherwise specifi ed in the designation):
PRIMARY or the fi rst person(s)/entity(ies) in line to receive the death proceeds after the insured is deceased.
CONTINGENT or the second or subsequent person(s)/entity(ies) in line to receive the death proceeds after the insured is deceased
and no surviving primary benefi ciary(ies).
SECOND CONTINGENT or the third or subsequent person(s)/entity(ies) in line to receive the death proceeds after the insured is
deceased and no surviving primary or contingent benefi ciary(ies).
BENEFICIARY DESIGNATION
Designations given in dollar amounts will not be accepted. However, designations given in percentages or fractions equal to 100% will
be accepted.
If joint benefi ciaries are named in any of the three classes (Primary, Contingent, or Second Contingent), the proceeds are to be paid
equally to the survivors unless otherwise stated.
If you are adding benefi ciaries but not changing existing benefi ciaries, you must restate all existing benefi ciaries.
Change benefi ciaries on: (select one)
Base policy
Children term rider(s)
Primary Insured Rider
First to die rider
Other Insured rider--on the life of the __________________
Last to die rider
If you do not select one of the options, we will automatically change the benefi ciaries on the base policy and the primary insured rider
(if applicable).
Lincoln Financial Group is the marketing name for Lincoln National Corporation and its affi liates.
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