Er side. Please keep a copy for your records. Group Policyholder Name Group Policy Number 877187 University of Pittsburgh Employee/Retiree Name and Address Employee/Retiree Social Security Number Subject to the terms of the above numbered Group Policy(ies), I request that any sum becoming payable by reason of my death be payable to the following beneficiary(ies). It is my understanding that this designation shall operate so as to revoke all designations of beneficiary and all elections of o.
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How to fill out the Antea BMS-015 online
Filling out the Antea BMS-015 form is an essential step in designating a beneficiary for your life insurance policy. This guide provides clear, step-by-step instructions to ensure that you complete the form accurately and efficiently.
Follow the steps to fill out the Antea BMS-015 form online.
- Press the ‘Get Form’ button to access the Antea BMS-015 document and open it in your browser.
- Begin by filling in the group policyholder name and group policy number as indicated at the top of the form. Ensure that this information is accurate to avoid any issues with processing.
- Enter your name and address in the fields provided for the employee/retiree. Include your social security number to verify your identity.
- Designate your beneficiaries by entering their names, addresses, and social security numbers in the designated sections. Use the checkboxes to specify whether they are primary or contingent beneficiaries.
- If there are multiple primary beneficiaries, indicate their percentage shares. Make sure the total does not exceed 100%.
- Complete the spousal consent section only if you reside in a community property state and are naming a beneficiary other than your spouse. This is not mandatory.
- Review the conditions listed on the reverse side of the form thoroughly to ensure compliance and understanding of your designation.
- Sign and date the form at the bottom where indicated. If required, your spouse should also sign the spousal consent section.
- Once you have completed the form, save your changes. You can then download, print, or share the document as necessary.
Start completing your Antea BMS-015 form online today for a hassle-free experience.
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