Follow the steps to conveniently complete your form online

1. Press the ‘Get Form’ button to access the claimant's statement for death benefit form.
2. In Section 1, provide the required information about the deceased. This includes their full name, any other names they may have used (e.g., maiden name or nickname), their resident address, policy number(s), date of death, city, state, zip code, social security number, and date of birth.
3. Proceed to Section 2 to fill in details about the beneficiary. Enter the beneficiary's name, indicate if they are not a U.S. citizen, and provide their mailing address along with the resident address if it differs. Include the beneficiary's phone number, date of birth, and social security number. If applicable, specify their relation to the insured or indicate if the beneficiary is a trust or estate by listing the taxpayer ID number.
4. Complete the certification statement, ensuring that you check the appropriate boxes regarding backup withholding requirements. Note that if notified by the IRS about backup withholding, you must cross out the second item.
5. In Section 3, select your preferred settlement option. You can choose between lump sum, periodic installments, or the interest option. Depending on your selection, complete any additional information required, such as the contract number.
6. If you opt for electronic funds transfer (EFT), complete Section 4 by providing your financial institution's information, account owner's name, checking account number, city/state, and routing/transit number. Remember to attach a void check to validate the account information.
7. After reviewing all sections for accuracy, save your changes, then download, print, or share the filled form as needed.

Complete your documents online today to ensure a smooth submission process.