Form Tsp-3 - Designation Of Beneficiary - Thrift Savings Plan

ADVERTISEMENT

TSP-3
THRIFT SAVINGS PLAN
DESIGNATION OF BENEFICIARY
Use this form to designate a beneficiary or beneficiaries to receive your civilian Thrift Savings Plan (TSP) account after your death.
Read the instructions on the back to assist you in completing this form. Type or print the information requested. Do not alter
this form or the information you enter; if you need to make a correction or change your entries, start over on a new form. If you
have a uniformed services TSP account, you will need to make a separate TSP beneficiary designation for that account on Form
TSP-U-3.
I.
INFORMATION
1.
Name
Last
First
Middle
ABOUT YOU
2.
3.
/
/
4.
(
)
Social Security Number
Date of Birth (mm/dd/yyyy)
Daytime Phone (Area Code and Number)
5.
Address
Street address or box number
6.
7.
8.
City
State/Country
Zip Code
II.
Indicate in whole percentages or fractions the share of your TSP account to be paid to each beneficiary.
DESIGNATING
1.
Share:
YOUR
Beneficiary Name (Last)
(First)
(Middle)
BENEFICIARIES
Street address or box number
City
State/Country
Zip Code
/
/
Social Security Number/EIN
Date of Birth (mm/dd/yyyy)
Relationship
2.
Share:
Beneficiary Name (Last)
(First)
(Middle)
Street address or box number
City
State/Country
Zip Code
/
/
Social Security Number/EIN
Date of Birth (mm/dd/yyyy)
Relationship
3.
Share:
Beneficiary Name (Last )
(First)
(Middle)
Street address or box number
City
State/Country
Zip Code
/
/
Date of Birth (mm/dd/yyyy)
Social Security Number/EIN
Relationship
Check here if additional pages are used. Number of additional pages
(See back of form.)
III.
Sign and date this section. Your signature must be witnessed in Section IV.
YOUR
SIGNATURE
Participant’s Signature
Date Signed
IV.
This form is valid only if it is witnessed by two persons. The witnesses must be age 21 or older. (A witness
cannot be a beneficiary of any portion of this TSP account.) By signing below, the witnesses affirm that the
WITNESSES TO
participant: (a) signed Section III in their presence, or (b) informed them that the signature in Section III is
SIGNATURE
the participant’s own signature.
Witness 1
Typed or Printed Name of First Witness
Signature of First Witness
Witness 2
Typed or Printed Name of Second Witness
Signature of Second Witness
Form TSP-3 (10/2005)
EDITIONS PRIOR TO 8/02 OBSOLETE

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Legal
Go
Page of 4