Fillable College Investing Plan Successor Designation (Fidelity Investments)

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College Investing Plan Successor Designation (Fidelity Investments)

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1.718992.108 033170201
Page 1 of 2
Questions? Go to Fidelity.com/college or call 800-544-1914.
Successor Designation — 529 College Savings Plan
Use this form to designate a Successor and/or Contingent Successor for your 529 College Savings Plan (“529 Plan”). Do NOT use this
form for an UGMA/UTMA 529 Plan account or a Trust 529 Plan account. Type on screen or fill in using CAPITAL letters and black ink. If
you need more room for information or signatures, make a copy of the relevant page.
Helpful to Know
• Complete a Successor Designation form for each 529
College Savings Plan (“529 Plan”) account, if you have
more than one.
• In the event of your death, your designated Successor
(or Contingent Successor in the event you and your
Successor both die) will replace you as the Participant in
the 529 Plan.
• Before completing this form, carefully review the
Successor Designation Agreement provided to you
when you opened the account(s). The agreement
governs this form.
• This form will replace all previous Successor and
Contingent Successor designations you have made for
the account.
• Your Successor and/or Contingent Successor Participant
must be 18 years of age or older and a U.S. citizen or
resident alien.
• Consult your personal tax and estate planning
professional if you have questions about how the
Successor Designation Agreement may apply to your
specific situation.
1. Account Information
Participant (Owner)/Authorized Individual Name Account Number
6
Beneficiary Name
2. Successor Designation
I hereby designate the person or trust named below as Successor to receive the assets remaining in the account
listed in Section 1 upon my death:
First Name Middle Name Last Name
Trust Name Enter full trust name as evidenced by the trust document.
Date of Birth or Trust MM DD YYYY Social Security or Taxpayer ID Number Relationship to Account Owner
3. Contingent Successor Designation Optional
I hereby designate the person or trust named below as Contingent Successor to receive the assets remaining in the
account listed in Section 1 upon my death and the death of the Successor Participant listed in Section 2.
First Name Middle Name Last Name
Trust Name Enter full trust name as evidenced by the trust document.
Date of Birth or Trust MM DD YYYY Social Security or Taxpayer ID Number Relationship to Account Owner
Enter full first and last
name as evidenced by
a government-issued,
unexpired document
(e.g., driver’s license,
passport, permanent
resident card).
Enter full first and last
name as evidenced by
a government-issued,
unexpired document
(e.g., driver’s license,
passport, permanent
resident card).
Form continues on next page.
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4. Signature
By signing below, you:
• Hereby designate the person(s) and/or
trust(s) named above as Successor or
Contingent Successor to receive the assets
remaining in the account listed in Section
1 upon your death and/or the death of the
Successor Participant listed on this form.
• Certify that you have received and read
a copy of the Fidelity Brokerage Services
LLC College Investing Form Successor
Designation Agreement (“Agreement”).
• Agree to be bound to the terms and con-
ditions set forth in the Agreement, of which
this Form is a part, as it may be amended
from time to time.
• Understand that the designations made
herein, and any future changes to those
designations, will be effective only when
accepted by Fidelity Brokerage Services
LLC (“Fidelity”) in accordance with the
terms of the Agreement. When accepted
by Fidelity, the designations in this Form
will replace any earlier designations you
have made.
• Hereby consent to the Agreement and to
the Successor and Contingent Successor
you have designated on this Form.
• Understand that the Agreement and its
enforcement are governed by the laws
of the Commonwealth of Massachusetts,
except with respect to its conflict-of-law
provisions and except as superseded by
federal law. The Agreement shall be effec-
tive for the benefit of Fidelity’s successors
and assigns, whether by merger, consoli-
dation, or otherwise. Fidelity may transfer
your account to its successors and assigns,
and this Agreement shall be binding upon
your heirs, executors, administrators, suc-
cessors, and assigns.
PRINT OWNER NAME
OWNER SIGNATURE DATE MM DD YYYY
SIGN
X X
Page 2 of 2
1.718992.108 033170202
On this form, “Fidelity” means Fidelity Brokerage Services LLC and its affiliates. Brokerage services are
provided by Fidelity Brokerage Services LLC, Member NYSE, SIPC. 374710.4.0 (06/20)
Did you sign the form? Send the ENTIRE form to Fidelity Investments.
Questions? Go to Fidelity.com/college or call 800-544-1914.
Regular mail
Fidelity Investments
Attn: CPSC
PO Box 770001
Cincinnati, OH 45277-0015
Overnight mail
Fidelity Investments
Attn: CPSC
100 Crosby Parkway KC1K
Covington, KY 41015
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College Investing Plan Successor Designation (Fidelity Investments)

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Completed 19 July 2020

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