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Rank, title or grade Social Security Number DET 3 CO A, 3300 DIVISION STREET, EVANSVILLE, IN 47715 INARNG 400,000 Duty Location Branch of Service Current Amount of SGLI 2. About Your Coverage I am completing this form to: (Check all that apply) Coverage is available in increments of $50,000 up to a maximum of $400,000 Name or update my SGLI bene ciary. You must complete sections 3 & 5. Increase or restore my SGLI coverage to $ . You must complete sections 3,.

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