Beneficiary Designation Form Sample Clauses

Beneficiary Designation Form. You may designate a primary beneficiary and a secondary beneficiary. You can name more than one person as a primary or secondary beneficiary. For example, you may wish to name your spouse as primary beneficiary and your children as secondary beneficiaries. Your secondary beneficiary(ies) will receive nothing if any of your primary beneficiaries survive you. All primary beneficiaries will share equally unless you indicate otherwise. The same rule applies for secondary beneficiaries. Designate Your Beneficiary(ies): Primary Beneficiary(ies): Secondary Beneficiary(ies): I certify that my designation of beneficiary set forth above is my free act and deed. Name of Employee Employee’s Signature (Please Print) Date
Beneficiary Designation Form. “Beneficiary Designation Form” shall mean the form established from time to time by the Bank and the Administrator, which an Insured completes, signs and returns in order to designate one or more Beneficiaries.
Beneficiary Designation Form. With respect to the Trustee Deferred Compensation Agreement (the “Agreement”) by and between the undersigned and the Invesco Funds: I hereby revoke any prior designation of beneficiary(ies), if applicable, and make the following beneficiary designations:4
Beneficiary Designation Form. The form attached hereto as Exhibit 1.9, or such other substantially similar form as the Plan Administrator acknowledges in writing as an acceptable substitute, which is duly executed by the Participant and received by the Company or the Plan Administrator prior to the Participant’s death.
Beneficiary Designation Form. As an Executive participating in a Supplemental Executive Retirement Agreement with Tompkins Financial Corporation, I hereby designate my spouse to receive any death benefits that may become payable under the Agreement. I understand and acknowledge no death benefit will be paid under the Agreement (a) if the below-designated Spouse is not a “Surviving Spouse” as defined in the Agreement, or (b) if I do not return this Spousal Benefit Designation Form, completed and executed, to the Committee on or before my Retirement Date, as defined in the Agreement. Spouse’s Name: ___________________________________ Social Security Number: _____________________________ Date of Birth: ______________________________ Home Address: ____________________________________________________________ Executive’s Signature: ______________________________ Witness’ Signature: ______________________________
Beneficiary Designation Form. I, Michael A. Fornof, designate as my Beneficiary to benefits under this Agreement, . If my designated Beneficiary shall not survive me, I designate as my Contingent Beneficiary to benefits under this Agreement. I understand that the only way that I can change my Beneficiary or Contingent Beneficiary under this Agreement is to complete a revised Beneficiary Designation Form to this Agreement and communicate such revised form to the Company. Michael A. Fornof Witness: FIRST AMENDMENT TO THE CLARION COUNTY CONNUMITY BANK SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN AGREEMENT For the benefit of Michael A. Fornof This First Amendment is adopted this 30th day of January, 2020, by and between Clarion County Community Bank (the “Company”) and Michael A. Fornof (the “Participant”).
Beneficiary Designation Form. BONUS YEAR Pursuant to the provisions of the “Executive Deferred Compensation Agreement, Phantom Stock Account—____ Bonus Year” by and between United States Cellular Corporation, a Delaware corporation (the “Company”), and the undersigned Executive (the “Executive”), the Executive hereby revokes all prior beneficiary designations made with respect to such agreement and designates the following person(s) or entity(ies) to receive any payment to be made pursuant to paragraph 3(e) thereof. Name Address % PRIMARY1 SECONDARY2 1 If you are married and name someone other than your spouse (e.g., a child) as a primary beneficiary, the designation is invalid unless your spouse consents by signing the statement below in the presence of a Notary Public. 2 Your secondary beneficiary(ies) will receive no payment if any of your primary beneficiaries survives you.
Beneficiary Designation Form. The Grantee has been awarded an option (“Option”) pursuant to one or more option award agreements (the “Award Agreement(s)”). In the event of the Grantee’s death, the Grantee hereby designates the Beneficiary(ies) identified below to receive any vested Option granted to the Grantee under the Award Agreement(s). Such Option shall be transferred to the Beneficiary(ies) identified below and shall be subject to all the terms and conditions of the applicable Award Agreement(s).
Beneficiary Designation Form. The form established from time to time by the Plan Administrator that a Participant completes, signs and returns to the Plan Administrator to designate one or more Beneficiaries.
Beneficiary Designation Form the form prescribed by the Committee upon which a Participant may designate a Beneficiary.