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Get Beneficiary Designation Form - Www3 Austincc

Widow/ Widower City, State, Zip Code Status D ivorced Full-Time Faculty Adjunct Faculty Full-Time Staff Married Part-Time Staff Hourly SECTION B: B ENEFITS PAYABLE This Beneficiary Designation applies to benefits payable by Austin Community College District. Check all that apply: Lump Sum Vacation and/or Sick Leave Salaries Due/Reimbursable Expenses SECTION C: PRIMARY BENEFICIARY(IES) Pay benefits to the named beneficiary(ies) as follows: Pay the person listed (100%).

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