| |
 |
| |
|
|
- Remember to complete all areas of the form.
- We require the original copy.
- Remember to get it witnessed.
- If you make any changes to the form please initial.
- If the account name is not the same as the designated beneficiary, please provide an explanation or the form will not be accepted.
|
|
If you have questions or require further information, call our Customer Service Center at
1-800-387-2747 and ask to speak with a Claims Analyst. |
|
|
|
