Common use of Primary Beneficiary Clause in Contracts

Primary Beneficiary. The Employee hereby designates the person(s) ------------------- named below to be his primary beneficiary and to receive the balance of any unpaid benefits under the Agreement. ================================================================================ Name of Percentage of Primary Beneficiary Mailing Address Death Benefit -------------------------------------------------------------------------------- % -------------------------------------------------------------------------------- % ================================================================================

Primary Beneficiary. The Employee Executive hereby designates the person(s) ------------------- named below to be his or her primary beneficiary and to receive the balance of any unpaid benefits Benefits under the Agreement. ================================================================================ Name of Percentage of Primary Beneficiary Mailing Address Percentage of Death Benefit -------------------------------------------------------------------------------- % -------------------------------------------------------------------------------- % ================================================================================---------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------

Primary Beneficiary. The Employee hereby designates ------------------- the person(s) ------------------- named below to be his primary beneficiary and to receive the balance of any unpaid benefits under the Agreement. ================================================================================ : Name of Percentage of Primary Beneficiary Mailing Address Death Benefit -------------------------------------------------------------------------------- ------------------- --------------- ------------- % -------------------------------------------------------------------------------- % ================================================================================%

Primary Beneficiary. The Employee hereby designates the person(s) ------------------- named below to be his primary beneficiary and to receive the balance of any unpaid benefits under the Agreement. : ================================================================================== Name of Mailing Address Percentage of Primary Beneficiary Mailing Address Death Benefit -------------------------------------------------------------------------------- ---------------------------------------------------------------------------------- % -------------------------------------------------------------------------------- ---------------------------------------------------------------------------------- % ==================================================================================

Primary Beneficiary. The Employee hereby designates the person(s) ------------------- named below to be his primary beneficiary and to receive the balance of any unpaid benefits under the Agreement. =====: =========================================================================== Name of Mailing Address Percentage of Primary Beneficiary Mailing Address Death Benefit -------------------------------------------------------------------------------- --------------------------------------------------------------------------- % -------------------------------------------------------------------------------- --------------------------------------------------------------------------- % ================================================================================

Primary Beneficiary. The Employee Executive hereby designates the person(s) ------------------- named below to be his or her primary beneficiary and to receive the balance of any unpaid benefits Benefits under the Agreement. ================================================================================ Name of Percentage of Primary Beneficiary Mailing Address Percentage of Death Benefit -------------------------------------------------------------------------------- % -------------------------------------------------------------------------------- % ================================================================================------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------

Primary Beneficiary. The Employee hereby designates the person(s) ------------------- named below to be his primary beneficiary and to receive the balance of any unpaid benefits under the Agreement. : ================================================================================== Name of Percentage of Primary Beneficiary Mailing Address Death Benefit -------------------------------------------------------------------------------- ---------------------------------------------------------------------------------- % -------------------------------------------------------------------------------- ---------------------------------------------------------------------------------- % ==================================================================================

Primary Beneficiary. The Employee hereby designates the person(s) ------------------- named below to be his primary beneficiary and to receive the balance of any unpaid benefits under the Agreement. ================================================================================ Name of Percentage of Primary Beneficiary Mailing Address Death Benefit -------------------------------------------------------------------------------- % -------------------------------------------------------------------------------- % ================================================================================

Primary Beneficiary. The Employee hereby designates the person(s) ------------------- named below to be his primary beneficiary and to receive the balance of any unpaid benefits under the Agreement. ================================================================================ Name of Percentage of Primary Beneficiary Mailing Address Death Benefit Benefit: -------------------------------------------------------------------------------- % -------------------------------------------------------------------------------- % ================================================================================= Employment Agreeement Payment Election Form Page 3

Primary Beneficiary. The Employee hereby designates the person(s) ------------------- named below to be his primary beneficiary and to receive the balance of any unpaid benefits under the Agreement. ================================================================================ : ----------------------------- --------------------------- --------------------- Name of Mailing Address Percentage of Primary Beneficiary Mailing Address Death Benefit -------------------------------------------------------------------------------- ----------------------------- --------------------------- --------------------- % -------------------------------------------------------------------------------- ----------------------------- --------------------------- --------------------- % ================================================================================----------------------------- --------------------------- ---------------------

Primary Beneficiary. The Employee hereby designates the person(s) ------------------- named below to be his her primary beneficiary and to receive the balance of any unpaid benefits under the Agreement. ================================================================================ : ----------------------------- --------------------------- --------------------- Name of Mailing Address Percentage of Primary Beneficiary Mailing Address Death Benefit -------------------------------------------------------------------------------- ----------------------------- --------------------------- --------------------- % -------------------------------------------------------------------------------- ----------------------------- --------------------------- --------------------- % ================================================================================----------------------------- --------------------------- ---------------------