Change of Beneficiary "*" indicates required fields Client Name*(Submit one workflow seed per client. If joint account only one workflow seed needed)Advisor/Agent Name:* Casey Short Tony Rizzo Jay Beerley David McEntire Dan Thomas Which type of beneficiary is changing?Please click all that apply New Primary Beneficiary New Contingent Beneficiary Removing a Beneficiary without replacement Complex (requires a letter of instruction) New Primary Beneficiary(s)Click on the plus button to the right to add more beneficiaries.NameAddressDate of BirthPercentageRelationship Add RemoveNew Contingent Beneficiary(s)Click on the plus button to the right to add more beneficiaries.NameAddressDate of BirthPercentageRelationship Add RemoveWhat beneficiary is being removed?Please include the name or names of any primary or contingent beneficiaries that are being removed from an existing accountNotesWhich accounts need this EXACT change?Click on the plus button to the right to add more accountsCustodianAccount TypeLast 4 of account/policy number Add RemoveAre there any other accounts requiring a different beneficiary structure? Yes No Please click all that apply to this different beneficiary structure New Primary Beneficiary New Contingent Beneficiary Removing an Existing Beneficiary without replacement Complex (requires letter of instruction) New Primary Beneficiary(s): For any beneficiary already entered on this form, leave address, DOB & relationship blankClick on the plus button to the right to add more beneficiaries.NameAddressDate of BirthPercentageRelationship Add RemoveNew Contingent Beneficiary(s): For any beneficiary already entered on this form, leave address, DOB & relationship blankClick on the plus button to the right to add more beneficiaries.NameAddressDate of BirthPercentageRelationship Add RemoveWhat beneficiary is being removed?Please include the name or names of any primary or contingent beneficiaries that are being removed from an existing accountNotesWhich accounts need this EXACT change?Click on the plus button to the right to add more accountsCustodianAccount TypeLast 4 of account/policy number Add RemoveAnything else? Δ « Back to Workflow Seeds
