Fillable Beneciary Designation Before Retirement (City of Plano)

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Beneciary Designation Before Retirement (City of Plano)

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MEMBER INFORMATION
Please type or use only black or blue ink and do not highlight. Any corrections must be initialed.
Member’s Name (first, middle, last) TMRS ID Number (not required) Social Security Number
Mailing Address City State Zip Daytime Phone Number
MARITAL STATUS (must check one): q Married q Not married (If married, see Spousal Consent section
y
below.)
PRIMARY BENEFICIARY DESIGNATION Limit 3 Please read instructions carefully. If desired, alternate beneciary designations may be
completed on page 2. For more information about designating custodians for minors (under 21), please see the attached instructions.
Beneficiary’s Full Name (first, middle, last) Social Security Number
q Male q Female • Relationship: q Spouse q Non-Spouse
Date of Birth (MM/DD/YYYY)
Custodian’s Name if beneficiary age under 21 (optional) Custodian’s Relationship to Beneficiary
Beneficiary’s Full Name (first, middle, last) Social Security Number
q Male q Female • Relationship: q Spouse q Non-Spouse
Date of Birth (MM/DD/YYYY)
Custodian’s Name if beneficiary age under 21 (optional) Custodian’s Relationship to Beneficiary
Beneficiary’s Full Name (first, middle, last) Social Security Number
q Male q Female • Relationship: q Spouse q Non-Spouse
Date of Birth (MM/DD/YYYY)
Custodian’s Name if beneficiary age under 21 (optional) Custodian’s Relationship to Beneficiary
MEMBER SIGNATURE REQUIRED
Making false or misleading statements on any form submitted to TMRS is a violation of State law and has criminal and potential civil liability. I hereby revoke all prior beneficiary designa-
tions. I direct TMRS to pay, if I die before retirement, all of my TMRS benefits (including Supplemental Death Benefit (SDB), if any) to the beneficiary(ies) listed on this form. If I am not
currently vested, I understand that when I vest, this designation becomes invalid and I must resubmit a new beneficiary designation form with TMRS (even if I do not
change my beneficiary(ies). If a beneficiary dies, or I divorce a beneficiary, then this designation becomes void for that person. If I name more than one beneficiary, my benefits will
be divided equally among surviving primary beneficiaries, unless otherwise stated. BY SIGNING THIS FORM, I CERTIFY THAT I HAVE READ THE ATTACHED INSTRUCTIONS, MY MARITAL STATUS IS
CORRECT, AND ALL OF THE INFORMATION I HAVE PROVIDED IS CORRECT.
Member’s Signature Date Signed (MM/DD/YYYY)
SPOUSAL CONSENT only to be completed for certain cases, see below
Your spouse must complete this section in front of a notary only if you are vested and married, and if your spouse is not designated as your only primary
beneciary. See the instructions on the following page for more clarication.
I understand that my consent is required before my spouse can designate anyone other than me as primary beneficiary. I hereby consent to the beneficiary(ies) designated above.
Spouse’s Printed Name Spouse’s Signature
State of County of
This instrument was acknowledged before me on the day of
, 20 ,
by
Name of Spouse
Notary Public, State of
(Name of State)
Please read the information provided on the following pages.
TMRS • P.O. Box 149153 • Austin, Texas 78714-9153 • 800.924.8677 • 512.476.7577 • FAX 512.476.5576 • www.tmrs.com
*TMRSBENE*
TMRS -BENE • Revised 5-2017
TMRS • Page 1
(SEAL
)
u
v
w
x
y
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Beneficiary Designation Before Retirement
®
PURPOSE
This form allows you, as a not-vested or vested member, to make or change your beneficiary designation for a non-retired membership. Please
visit MyTMRS at www.tmrs.com to see if you are eligible to make or change your beneficiary designation online.
■
You are vested with TMRS if you have 5 or more years of service (some cities require 10 years to vest). Once you are vested, you may
leave your account balance with TMRS until you become eligible for retirement, even if you terminate employment covered by TMRS.
If you do not know if you are vested please contact TMRS directly.
■
If you have not retired and have worked for more than one city, the beneficiary designation on this form applies to benefits at all cities.
■
If you are Vested, your designated beneficiary is entitled to receive
retirement benefits, if you die prior to retirement. If you have not
designated a beneficiary after you vest, retirement benefits will be
paid in the following manner:
■
To your surviving spouse; or
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To your surviving children if there is no spouse; or
■
To your last valid beneficiary designated with TMRS if there
are no surviving children; or
■
To your estate if there is no prior valid beneficiary designated
with TMRS.
SPOUSAL CONSENT
Spousal Consent for this non-retired membership is only needed if you are vested, and you are married, and your spouse is not desig-
nated as your only primary beneficiary.
HOW LONG IS THE BENEFICIARY DESIGNATION VALID?
The designation on this form is valid until:
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You submit another valid beneficiary designation selection; or
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You apply for retirement and designate a beneficiary; or
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If not vested, once you become vested (at which time your designation on this form may become inoperative); you will need to
submit this form again.
DESIGNATING YOUR BENEFICIARY
■
You may designate up to three primary beneficiaries and up to three alternate beneficiaries.
■
Unless directed otherwise in writing on this form, your benefits will be paid equally to the surviving primary beneficiaries, or equally to
the surviving alternate beneficiaries, only if the designation with respect to each primary beneficiary is revoked by divorce (if designated
as a spouse on the form) or death. Contact TMRS for instructions on how to provide for unequal distributions.
■
If you desire to designate alternate beneficiaries, you must complete pages 1 and 2 of this form and submit both pages. TMRS will not
accept page 2 without page 1.
PRESELECTING A RETIREMENT OPTION – Only for Vested Members
If you are a vested member, you may choose to pre-select a retirement option for your beneficiary if you die prior to retirement. However, you are
not required to pre-select an option. If you die prior to retirement and have not pre-selected an option, your beneficiary designated on this form
would have the choice of receiving:
■
Monthly payments for life (if only one person is designated); or
■
Monthly payments for 15 years (reduced to 5 years for Estates and some Trusts — see below); or
■
A lump-sum refund of your account balance at the time of death.
If you choose to pre-select an option, you will need to complete the Vested Option Selection form.
Please contact TMRS directly for assistance.
T his beneficiary designation only applies to a not-vested or vested membership that has not been retired. If your membership has been
retired, please use the Beneficiary Designation – After Retirement form.
NOT-VESTED VESTED
If you are Not-Vested, your designated beneficiary is entitled to re-
ceive your account balance if you die prior to retirement. If you have
not designated a beneficiary and you are not vested, your account
balance will be paid to your estate.
SPECIAL INSTRUCTION: Completion of this section is optional. If completed, page 2 must accompany
page 1 when submitted to TMRS.
MEMBER INFORMATION • Please type or use only black or blue ink and do not highlight. Any corrections must be initialed.
Member’s Name (first, middle, last) TMRS ID Number (not required) Social Security Number
DESIGNATING AN ALTERNATE BENEFICIARY LIMIT 3 Please read instructions before completing. Unless otherwise specied, benets will
be divided equally among surviving alternate beneciaries, only if the designation with respect to each primary beneciary designated on page 1 of this form is revoked
by reason of divorce (if designated as a spouse on the form) or death.
Beneficiary’s Full Name (first, middle, last) Social Security Number
q Male q Female • Relationship: q Spouse q Non-Spouse
Date of Birth (MM/DD/YYYY)
Custodian’s Name if beneficiary age under 21 (optional) Custodian’s Relationship to Beneficiary
Beneficiary’s Full Name (first, middle, last) Social Security Number
q Male q Female • Relationship: q Spouse q Non-Spouse
Date of Birth (MM/DD/YYYY)
Custodian’s Name if beneficiary age under 21 (optional) Custodian’s Relationship to Beneficiary
Beneficiary’s Full Name (first, middle, last) Social Security Number
q Male q Female • Relationship: q Spouse q Non-Spouse
Date of Birth (MM/DD/YYYY)
Custodian’s Name if beneficiary age under 21 (optional) Custodian’s Relationship to Beneficiary
MEMBER SIGNATURE REQUIRED
If you complete any part of page 2, your signature is required on both pages 1 and 2.
I acknowledge that I am signing this form again, on this page 2, because I have elected to name an alternate beneficiary(ies) in addition to my primary beneficiary(ies). If I name
more than one primary or alternate beneficiary, my benefits will be paid to the surviving primary beneficiaries in equal shares (unless I have otherwise directed on this form) or
in equal shares to the surviving alternate beneficiaries if I am not survived by any primary beneficiary(ies). If a beneficiary dies, or I divorce a beneficiary, then this designation
becomes void for that person. BY SIGNING THIS FORM, I CERTIFY THAT I HAVE READ THE ATTACHED INSTRUCTIONS, MY MARITAL STATUS IS CORRECT, AND ALL OF THE INFORMATION I
HAVE PROVIDED IS CORRECT.
Member’s Signature Date Signed (MM/DD/YYYY)
z
{
|
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⊲
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Alternate Beneficiary Section (optional)
Please read the information provided on the following pages.
TMRS • P.O. Box 149153 • Austin, Texas 78714-9153 • 800.924.8677 • 512.476.7577 • FAX 512.476.5576 • www.tmrs.com
TMRS -BENE • Revised 5-2017
TMRS • Page 2
ESTATE, TRUST, AND CHARITY DESIGNATIONS
■
If you wish to designate your estate as beneficiary, please write only the word “ESTATE” in the space provided for the name of
the beneficiary.
■
If you wish to designate a charity as beneficiary, please write the name of the charity (i.e., American Heart Association) in the space
provided for the name of the beneficiary.
■
If you wish to designate a trust, please write “Trustee of the (enter name of trust here)” in the space provided for the name of the
beneficiary. Please ensure that you have a legal trust agreement in place prior to designating a “Trust” on this form.
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TMRS will accept the designation of a Trust. However, we cannot assure that if and when a benefit becomes payable from TMRS,
the designation will be legally valid. In other words, if the trustee does not accept or has died, or if the trust has been
revoked, or if for any other reason the designation is not legally sucient at the time of the member’s death, the benefit due
from TMRS will be paid in accordance with the provisions of the TMRS Act as if no trust/trustee had been designated.
■
A trust having more than one beneficiary may not receive benefits for which multiple designated beneficiaries are not eligible.
A trust that may be revoked is not a ‘designated beneficiary’ under the Internal Revenue Code, and may not receive retirement
system benefit payments for a period longer than 5 years.
IMPORTANT: SUPPLEMENTAL DEATH BENEFITS (SDB)
■
If your employer provides Supplemental Death Benefits (SDB) and you die while employed, TMRS will pay a one-time lump sum
payment approximately equal to one year’s salary based on the 12 months prior to death.
■
If eligible, your beneficiary(ies) will only receive one Supplemental Death Benefit based on your status as an active employee or
a retired member at the time of your death.
■
The SDB payment will be paid to the beneficiary(ies) designated on this form, even if you have previously designated a dierent
SDB beneficiary.
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If you wish to designate a dierent beneficiary(ies) other than the person(s) designated on this form to receive the SDB payment,
you will need to complete and submit the Supplemental Death Benefits Beneficiary Designation form at the same time or after
you submit this form.
RULES FOR DESIGNATING MINOR CHILDREN
Chapter 141 of the Texas Property Code is the Texas Uniform Transfers to Minors Act (TUTMA), which allows you to nominate a “custodian” to
receive TMRS benefits on behalf of your minor beneficiary. If you wish to designate a minor (under 21) child, please write the full name and all
information pertaining to the minor child in the “Primary Beneficiary” or “Alternate Beneficiary” section of the form. Then complete the custodian
information next to each child’s name.
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Only adults at least 21 years of age, financial institutions, corporations, or other legal entities may serve as custodians.
■
You cannot nominate two or more custodians to serve jointly for a single beneficiary. However, you may nominate a substitute
custodian to serve in the event the first nominated custodian dies before any payment is made, declines, or is ineligible to serve.
Please contact TMRS for instructions on how to nominate a substitute custodian.
■
If the same custodian is named for all minors, that custodian would receive separate benefit payments for each minor.
■
When the minor beneficiary reaches age 21, the custodianship for that beneficiary is terminated and any TMRS benefits that become
payable will be paid directly to that beneficiary.
■
The designated custodian can select any benefit option that the minor could select if the minor were an adult.
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The minor’s Social Security number is used for IRS reporting purposes.
TMRS WILL NOT ACCEPT
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Attachments (listing additional beneficiaries)
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Alterations without being initialed
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An incomplete form or any attempt to change its pre-printed provisions
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An unacceptable designation
GOVERNING LAW
In the event of an irreconcilable conflict between the terms of this form and the terms of the laws and rules governing TMRS, the laws and rules
shall control.
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Beneciary Designation Before Retirement (City of Plano)

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Completed 4 August 2020

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