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Get Assurant KC3136A 2006-2023

Of insured Former name PLEASE READ THE FOLLOWING INFORMATION BEFORE COMPLETING THIS FORM. 1. Give FULL names and relationships of each beneficiary. If beneficiary is not related, also provide date of birth and Social Security number. 2. If your designation does not fit into the arrangements below (designations such as wills, estates, trustees), please contact your HR representative or Assurant Employee Benefits for assistance. PRIMARY BENEFICIARY(IES): All beneficiaries named in this section w.

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