Fillable Tiaa Cref Account Beneficiary Update F11136 1106.qxp (Southern Utah University)

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Tiaa Cref Account Beneficiary Update F11136 1106.qxp (Southern Utah University)

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TA MB
F11136 (11/06)
DESIGNATING BENEFICIARIES
P.O. Box 1259
Charlotte, NC 28201
PAGE 1 OF 3
Important: Please use a pen with blue or black ink and print in capital letters. If you have questions, call us toll-free
at 800 842-2776 Monday to Friday from 8 a.m. to 10 p.m. and Saturday from 9 a.m. to 6 p.m. (ET) or visit us online
at www.tiaa-cref.org.
YOUR PERSONAL INFORMATION
First Name MI Last Name
#
Social Security Number/Tax Identification Number Date of Birth (mm/dd/yyyy)
Daytime Telephone Number Evening Telephone Number
Your Country of Citizenship is
Your U.S. State
of Residence is: OR Your Country of Residence is:
PROVIDE YOUR ANNUITY/ACCOUNT NUMBERS
Important: This form is for funds in TIAA-CREF retirement accounts through employers' plans not subject to ERISA, from
plans that have no spousal rights provisions, or are not part of employers' plans like IRAs. This form does not cover mutual
fund accounts not part of a retirement plan, life insurance contracts, and contracts through which you are currently receiving
retirement income. If you have questions or need a form for these situations, call us or visit us online.
Check either A or B below. Check the first box (A) if you want the same beneficiary designation(s) for all your applicable
TIAA-CREF annuities. Check the second box (B) if you want the beneficiary designation(s) applied to specific annuities. If you
have additional annuities for which the designation(s) apply, check the box below and attach a signed and dated page listing your
additional annuity numbers.
A. These beneficiary designations will apply to all of your TIAA and accompanying CREF annuity numbers,
which are described on Page 1 of “Designating Beneficiaries for Your TIAA-CREF Accounts.”
OR
B. These designations of beneficiaries are to apply only to the following TIAA and accompanying
CREF annuity numbers.
Check this box and attach a signed and dated page to list additional annuity numbers.
TIAA Numbers CREF Numbers
————
//——
*MNTID01*
TA MB
F11136 (11/06)
DESIGNATING BENEFICIARIES
PAGE 2 OF 3
CHOOSE YOUR BENEFICIARIES
Tell us who should receive any payments due after you die. Unless you specify otherwise, your benefits will be allocated equally
among your beneficiaries. The total allocation to the beneficiaries of each class must equal 100%.
Check this box and attach either the optional page(s) provided with this form, or a signed and dated page, to list
additional primary and/or contingent beneficiaries, a trust, or to provide additional instructions.
PRIMARY BENEFICIARY (CLASS I) -
First Name MI Last Name
#1
Social Security Number/Tax Identification Number Date of Birth (mm/dd/yyyy) Gender (M or F)
Percentage Relationship
First Name MI Last Name
2
Social Security Number/Tax Identification Number Date of Birth (mm/dd/yyyy) Gender (M or F)
Percentage Relationship
CONTINGENT BENEFICIARY (CLASS II) - First Name MI Last Name
#1
Social Security Number/Tax Identification Number Date of Birth (mm/dd/yyyy) Gender (M or F)
Percentage Relationship
First Name MI Last Name
2
Social Security Number/Tax Identification Number Date of Birth (mm/dd/yyyy) Gender (M or F)
Percentage Relationship
//——
//——
//——
//——
*MNTBN01*
TA MB
F11136 (11/06)
DESIGNATING BENEFICIARIES
PAGE 3 OF 3
DESIGNATING PAYMENT TO CHILDREN OF A DECEASED CHILD OF MINE/BENEFICIARY
If you want to apply the Payment to children of a deceased child of mine/Payment to children of a deceased beneficiary
designations, complete A and/or B as appropriate. If you don’t select a class of beneficiaries for a provision, we will apply
this provision to your primary beneficiary(ies). See “Making Beneficiary Designations” on Page 2 of “Designating Beneficiaries
for Your TIAA-CREF Accounts” for more information on these provisions.
A. Apply the provision “Payment to children of a deceased child of mine” to my
Primary (Class I) beneficiaries Contingent (Class II) beneficiaries.
AND/OR
B. Apply the provision “Payment to children of a deceased beneficiary” to my
Primary (Class I) beneficiaries Contingent (Class II) beneficiaries.
YOUR AGREEMENT
Please provide your signature and the date below. Also be sure to complete the following pages which request
information about your marital status as required by your plan. Please mail this completed form to TIAA-CREF, P.O. Box 1259,
Charlotte, NC 28201.
I, the undersigned, agree that:
• All prior beneficiary designations and methods of payment requested for the annuities indicated on this “Designating
Beneficiaries” form will be revoked, and any benefits due by reason of my death will be payable to the beneficiary(ies)
named on this form.
• I understand that this “Designating Beneficiaries” form is subject to all of the terms and conditions of the annuities and
as described in "Designating Beneficiaries for Your TIAA-CREF Accounts" provided with this form.
• I request that any provision that requires the annuities to be submitted for endorsement of this change be waived.
• I reserve the right to make further changes to my beneficiary designations. However, if I previously named an
irrevocable beneficiary for any benefits, I will need to obtain a consent or release from the beneficiary before a change
can be made.
• I understand that if I elect to have this designation apply to all my referenced annuities, it will apply to those issued as
of the date this form is accepted by TIAA-CREF.
Your Signature Date (mm/dd/yyyy)
)
200//
*MNTSG01*
TA MB
F11136 (11/06)
DESIGNATING A TRUST
OPTIONAL - FOR DESIGNATING A TRUST
YOUR PERSONAL INFORMATION
First Name MI Last Name
#
Social Security Number/Tax Identification Number
NAME OF TRUST
#
Tax Identification Number Date Trust was established (mm/dd/yyyy)
Additional Information
//——
——
*MNTTR01*
TA MB
F11136 (11/06)
DESIGNATING BENEFICIARIES
OPTIONAL - FOR DESIGNATING ADDITIONAL BENEFICIARIES
YOUR PERSONAL INFORMATION
First Name MI Last Name
#
Social Security Number/Tax Identification Number
PRIMARY BENEFICIARY (CLASS I) - First Name MI Last Name
#3
Social Security Number/Tax Identification Number Date of Birth (mm/dd/yyyy) Gender (M or F)
Percentage Relationship
First Name MI Last Name
4
Social Security Number/Tax Identification Number Date of Birth (mm/dd/yyyy) Gender (M or F)
Percentage Relationship
CONTINGENT BENEFICIARY (CLASS II) - First Name MI Last Name
#3
Social Security Number/Tax Identification Number Date of Birth (mm/dd/yyyy) Gender (M or F)
Percentage Relationship
First Name MI Last Name
4
Social Security Number/Tax Identification Number Date of Birth (mm/dd/yyyy) Gender (M or F)
Percentage Relationship
//——
//——
//——
//——
——
*MNTB201*
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Tiaa Cref Account Beneficiary Update F11136 1106.qxp (Southern Utah University)

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Completed 21 July 2020

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