Fillable Beneficiary Designation Common

Fill Online, Printable, Fillable, Blank Beneficiary Designation Common Form

Use Fill to complete blank online OTHERS pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Beneficiary Designation Common

On average this form takes 21 minutes to complete

The Beneficiary Designation Common form is 2 pages long and contains:

  • 0 signatures
  • 8 check-boxes
  • 82 other fields

Country of origin: OTHERS
File type: PDF

BROWSE OTHERS FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
307B R11-20Page 1 of 2
Thrivent ID
Beneficiary Designation
Common
Section 1 - General Information
Contract number 1 Contract number 2 Contract number 3 Contract number 4 Contract number 5 Contract number 6
Name of insured/annuitant/payee (print first, middle, last name and suffix, as applicable) (One name only)
Select all coverages to be included in this designation below.
If no box is selected, this beneficiary designation will apply to all coverages and riders under the contract number(s) listed
above.
Base Coverage Child Rider (one designation applies for all children under a child rider)
Term Life Insurance Rider Secondary Coverage (spouse rider, joint life/annuity contract)
Section 2 - Primary and Contingent Beneficiary
Select the class for each beneficiary. If a class is not selected, it will be deemed that the named beneficiary is a
primary beneficiary.
Per stirpes:
If per stirpes is desired, select the box for each beneficiary you would like per stirpes. Per Stirpes means if a named
beneficiary is deceased, his/her portion of proceeds are paid equally to his/her surviving children. "Surviving children" means all children
born or legally adopted, and does not include step-children. *Per stirpes may not be used for spouse and/or parent relationships.
Percentages: Percentages are only needed if the beneficiaries are to receive an unequal amount, and must equal 100%.
Trusts: If a beneficiary is a living (Inter Vivos) trust, provide the exact name of the trust and the date the trust was established or
Tax Identification number.
UTMA (Uniform Transfers to Minor Act): An individual named as a primary beneficiary should not also be named as a custodian
for a contingent beneficiary.
Additional beneficiaries: If there is not enough room on this form to list all beneficiaries, continue on a separate sheet that
includes 1.) contract number(s) 2.) all beneficiary information requested on this form 3.) the owner's signature and date.
Name of beneficiary/entity (one name only) Relationship to insured
Beneficiary class (select one)
Primary First contingent
Select if applicable* (see above)
Per stirpes for this beneficiary
Percentage (if not equal)
Address of beneficiary/entity City State ZIP code
Social Security/Tax Identification number Date of birth/trust
Phone
Name of UTMA custodian if beneficiary is a minor (one name only) UTMA state
Name of beneficiary/entity (one name only) Relationship to insured
Beneficiary class (select one)
Primary First contingent
Select if applicable* (see above)
Per stirpes for this beneficiary
Percentage (if not equal)
Address of beneficiary/entity City State ZIP code
Social Security/Tax Identification number Date of birth/trust
Phone
Name of UTMA custodian if beneficiary is a minor (one name only) UTMA state
307B R11-20Page 2 of 2
Name of beneficiary/entity (one name only) Relationship to insured
Beneficiary class (select one)
Primary First contingent
Select if applicable* (see above)
Per stirpes for this beneficiary
Percentage (if not equal)
Address of beneficiary/entity City State ZIP code
Social Security/Tax Identification number Date of birth/trust
Phone
Name of UTMA custodian if beneficiary is a minor (one name only) UTMA state
Name of beneficiary/entity (one name only) Relationship to insured
Beneficiary class (select one)
Primary First contingent
Select if applicable* (see above)
Per stirpes for this beneficiary
Percentage (if not equal)
Address of beneficiary/entity City State ZIP code
Social Security/Tax Identification number Date of birth/trust
Phone
Name of UTMA custodian if beneficiary is a minor (one name only) UTMA state
Section 3 - Agreements and Signatures
All contract owners must sign. By signing this form, I certify that I have read and agree to all the provisions on form 28887.
This beneficiary designation is effective and revokes all previous beneficiary designations upon submission to and approval
by Thrivent.
Signature of owner/controller
X
Date signed
Name of owner/controller
Signature of joint owner/controller
X
Date signed
Name of joint owner/controller
Address of owner/controller City State ZIP code
Print name and code number of representative (optional)
X
Date signed
Signature of witness (Required in MA. Optional in all other states.)
Signature of spouse (See form 28887 for more information)
X
Date signed
Thrivent approval (Internal use only)
Mail completed form to:
Thrivent
PO Box 8075
Appleton, WI 54912-8075
Fax:
800-225-2264
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Beneficiary Designation Common

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 29 November 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document