Get Pai 100 1006

Filling out the Pai 100 1006 form is an essential step in designating your beneficiaries for group accident, health, and life insurance. This guide will provide you with a detailed, step-by-step approach to completing the form accurately and effectively.

Follow the steps to complete the Pai 100 1006 form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. In Section 1, enter the organization name, phone number, county, city, address, state, and zip code of the organization under which you are covered.
3. Proceed to Section 2 and fill in your personal details, including your date of birth, full name (last name, suffix, first name, middle initial), and social security number. Be sure to check the appropriate coverage(s) this form applies to: Accident & Health (A&H), Group Life, Accidental Death & Dismemberment (AD&D), or all.
4. In Section 3, list your primary beneficiary(ies). Provide each person’s name, address, relationship to you, social security number, date of birth, and the percentage of benefits each should receive. Remember, the total percentages must equal 100%.
5. Next, move to Section 4 and name your contingent beneficiary(ies). Fill in the same details as required for primary beneficiaries, ensuring that the total percentages also equal 100%.
6. Finally, in Section 5, sign and date the form. This signature indicates your consent and understanding that this form cancels all prior beneficiary designations.
7. You can then save changes, download, print, or share the completed form as needed.

Ready to proceed? Start filling out your Pai 100 1006 form online today.