Get F83345sa 2

The F83345sa 2 form is essential for designating beneficiaries for your insurance policy. This guide will walk you through the steps required to complete the form accurately and submit it effectively.

Follow the steps to fill out the F83345sa 2 form online.

1. Click ‘Get Form’ button to access the F83345sa 2 and open it in your browser for completion.
2. Begin by entering the employer name: 'Retirees for Brevard Public Schools.' This identifies the organization related to your insurance policy.
3. Fill in the insured's name by providing the last name, followed by the first name and middle initial, ensuring accurate spelling.
4. Input the policy number, which is '34303,' to associate your beneficiary designation with the correct insurance policy.
5. Enter the employee ID or the last four digits of your Social Security Number for identification purposes.
6. Provide the current address, including street, city, state, and zip code, to ensure correspondence reaches the correct location.
7. Fill in the insured's date of birth to confirm the identity of the insured individual on the policy.
8. Designate the primary beneficiaries by entering their full names, dates of birth, addresses, phone numbers, Social Security Numbers, relationships to the insured, and share percentages. Ensure the total share percentages equal 100%.
9. If applicable, include contingent beneficiaries under the same fields as primary beneficiaries, also ensuring their share percentages total 100%.
10. Sign and date the completed form at the designated signature line to confirm your declarations.
11. Finally, save your changes, download a copy for your records, and share or return the completed form to the specified address or fax it to 651-665-4827.

Complete and submit your F83345sa 2 form online for efficient management of your beneficiary designations.