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Ry Designation(s) OR Change of all prior beneficiary designation(s) I hereby revoke any previous beneficiary designation(s), if any, for my group term life insurance and/or accidental death and dismemberment (AD&D) insurance issued to this group or employer and direct that the insurance proceeds payable under the policy be paid as indicated below. Member Name (Enter Full Legal Member Name) Social Security Number Member Address Telephone Number Policyholder/Employer ATLANTA FEDERATION OF.
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Keywords relevant to (Click To Clear All Fields) Clear Form
- undersigned
- designation
- DISMEMBERMENT
- revoke
- payable
- contingent
- beneficiary
- proceeds
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