BENEFICIARY DESIGNATION

BENEFICIARY DESIGNATION 

I, [INSERT NAME], being of full age and sound mind and memory, residing at [INSERT ADDRESS] hereby make the following beneficiary designation to be effective upon my death regardless of any other provisions of my estate planning documents. This designation revokes all prior beneficiary designations I may have made for the account/policy.

  • ACCOUNT/POLICY NAME: [INSERT ACCOUNT/POLICY NAME]

Primary Beneficiaries

Beneficiary No. 1

  • [Full Name of the primary beneficiary]
  • [Relationship to you, e.g., spouse, child, sibling]
  • Address: [insert address] Date of Birth: [insert date of birth]
  • [Percentage of the account/policy to be distributed to the primary beneficiary, e.g., 50%]

Beneficiary No. 2

  • [Full Name of the primary beneficiary]
  • [Relationship to you, e.g., spouse, child, sibling]
  • Address: [insert address] Date of Birth: [insert date of birth]
  • [Percentage of the account/policy to be distributed to the primary beneficiary, e.g., 50%]

If any of the above-named beneficiaries shall not survive me or is unable to receive the designated percentage of my account/policy for any reason, I designate the following contingent beneficiaries to receive the full amount equally: 

Contingent Beneficiary No. 1

  • [Full Name of the contingent beneficiary]
  • [Relationship to you, e.g., spouse, child, sibling]
  • [Address: [insert address] 

 

  • [Date of Birth: [insert date of birth]
  • [Percentage of the account/policy to be distributed to the primary beneficiary, e.g., 50%]

Contingent Beneficiary No. 2

  • [Full Name of the contingent beneficiary]
  • [Relationship to you, e.g., spouse, child, sibling]
  • [Address: [insert address] 
  • [Date of Birth: [insert date of birth]
  • [Percentage of the account/policy to be distributed to the primary beneficiary, e.g., 50%]

PER STIRPES 

If any primary or contingent beneficiary named herein should predecease me, the remaining interest shall be divided per stirpes and added to the surviving beneficiary’s share.

SUCCESSOR BENEFICIARY

  1. If any of the primary or contingent beneficiaries named herein should predecease me, the interest in the account/policy shall be paid to [SUCCESSOR BENEFICIARY/BENEFICIARIES’ NAME] residing at [SUCCESSOR BENEFICIARY/BENEFICIARIES’ ADDRESS] divided per stirpes.

 

  1. In the absence of valid written designation or a Surviving Designated Beneficiary, my account/policy shall be paid to my estate in accordance with applicable law.

This designation shall be binding on my heirs, executors, administrators, assigns and anyone else claiming an interest in the account or assets. I understand that I have the right to change my beneficiary designation at any time by completing and submitting a new beneficiary designation form.

 

Signed and dated:

……………………………………………….. 

[Your Signature]             [Date of signing]

 

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