review their beneficiary designations - AccessAllstate

LIFE ESSENTIALS
You take care of them now –
take care of them later too.
REVIEW YOUR BENEFICIARY DESIGNATIONS TODAY
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Things change. Have your
beneficiaries changed, too?
Make sure you’re providing for the ones you love.
Review your list of designated beneficiaries now, to
ensure you’re providing for those you leave behind.
There are many events that may require a change in your
beneficiaries. For example:
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n
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A change in your marital status
The birth of children or grandchildren
A death in the family
n Marriage or divorce of beneficiaries 1
n
Change of support for a nonprofit or charitable organization
The worksheet on the following page is provided for your
convenience. After listing potential beneficiaries, discuss it with
your financial professional to help ensure that your life insurance
will be there for the people who count on you the most. It’s one of
the most thoughtful things you can do.
A few reminders
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Your beneficiaries will divide
the proceeds equally unless you
specify percentages.
If you plan to name minor
children as your beneficiary,
consider designating a custodian.
Under a state's Uniform Transfer
to Minors Act (UTMA), payment
may be expedited and may
eliminate the need for a courtappointed
guardian. 2
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Consider adding a secondary
beneficiary, in case your primary
beneficiary predeceases you.
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Adding a contingent beneficiary
other than your estate may help
you avoid probate.
Please note that completion of this questionnaire does not change your current beneficiaries.
It is necessary to complete and send to the Home office a Change of Beneficiary form for
acceptance to make a beneficiary change.
1 Some states revoke spouses as beneficiaries at time of divorce. Please consult a legal
professional.
2 In South Carolina and Vermont, referred to as Uniform Gifts to Minors Act (UGMA).
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Lincoln Benefit Life Company
THIS FORM NOT TO BE USED WITH SECTION 401 OR 403(b) CONTRACTS P.O. Box 80469, Lincoln, NE 68501-0469
TEL: 1-800-525-9287
Use ball point pen when completing form
FAX: (Annuities) 1-877-525-2689 (Life) 1-866-525-5433
STEP 1 - CONTRACT/POLICY INFORMATION (ALL FIELDS MUST BE COMPLETED). Only one policy number
and Insured/Annuitant per change form. Submit a separate change of beneficiary form for each policy.
Owner’s Name Owner’s SSN/TIN Contract/Policy #
Joint Owner’s Name (if applicable)
Insured or Annuitant’s Name
Name and Date of Trust
Name of Current Trustee
Trust Tax ID Number
Joint Owner’s SSN/TIN
Insured or Annuitant’s SSN/TIN
STEP 2 - PRIMARY BENEFICIARY (IES) – If more than 2 Primary Beneficiaries, please use a separate sheet of paper and
attach to this form. Percentages must add up to 100%.
If the Contract Owner is the TRUST then the Beneficiary should also be the TRUST.
A. Individual, Corporation or Estate
Name of Primary Beneficiary #1
Name of Primary Beneficiary #2
NOTE: Please use WHOLE Percentages ONLY
NOTE: Please use WHOLE Percentages ONLY
Street Address
Street Address
City/State/Zip
City/State/Zip
SSN/TIN
Date of Birth (MM/DD/YYYY) SSN/TIN
Date of Birth (MM/DD/YYYY)
Relationship
Relationship
B. Trust as Primary Beneficiary (NOT Under Last Will)
Street Address City State Zip
C. Trust as Primary Beneficiary (Trust Within Last Will)
To the trustee of the trust created pursuant to the Last Will and Testament of ____________________________ as admitted
Name
to probate provided the trustee submits a written claim within six months of the death of the person that triggered payment
under the policy. If no such claim is made by the trustee, the proceeds shall be paid to _______________________________.
Name
STEP 3 - CONTINGENT BENEFICIARY(IES) – If more than 2 Contingent Beneficiaries, please use a separate sheet
of paper and attach to this form. Percentages must add up to 100%.
Name of Contingent Beneficiary #1
Name of Contingent Beneficiary #2
NOTE: Please use WHOLE Percentages ONLY
NOTE: Please use WHOLE Percentages ONLY
Street Address
Street Address
City/State/Zip
City/State/Zip
SSN/TIN
Date of Birth (MM/DD/YYYY) SSN/TIN
Date of Birth (MM/DD/YYYY)
Relationship
Relationship
FIC77LBL-2 Page 4 of 5 (08/09)
Review your beneficiaries.
Name and relationship
of beneficiary
Are they currently a
beneficiary? How much
will they receive?
What do you hope
this person will do
with the proceeds? 3
Is action needed?
Example:
Connie Johnson
Wife of 20 years
Yes
$400,000
Pay off all debts and
put the kids through
college, without having
to work full time.
Yes. Based on our
current expenses, I
need to increase her
share of the proceeds
to $550,000.
If you answered anything other than 'No' in this column, then action is needed.
Make an appointment with your financial professional today to
discuss how to help protect your loved ones in the future.
REQUEST FOR
CHANGE OF BENEFICIARY (PAYEE)
❑ Equally OR ❑ Percentage %
❑ Equally OR ❑ Percentage %
Use our Change of Beneficiary form (FIC77LBL)
to update the beneficiaries on your LBL policies.
❑ Equally OR ❑ Percentage %
❑ Equally OR ❑ Percentage %
3 Beneficiaries may use proceeds for any purpose and are under no contractual obligation to carry out the owner's desires.
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The Strength of Lincoln Benefit Life
For more than 70 years, Lincoln Benefit Life Company (Lincoln Benefit Life) has been an
innovator in bringing insurance and annuity products to policyholders nationwide. Lincoln
Benefit Life was acquired in 1984 by Allstate Life Insurance Company (Allstate Life).
Lincoln Benefit Life and Allstate Life have more than 120 years of combined experience and
are subsidiaries of the Allstate Corporation, a Fortune 100 company that provides insurance
protection to approximately 17 million U.S. families.
Lincoln Benefit Life prides itself on strength, stability and integrity, as well as its ability to
provide product solutions and professional assistance to help you and your family achieve
your lifelong dreams.
800-525-9287
n Not FDIC, NCUA/NCUSIF insured n Not insured by any federal government agency n Not a deposit n Not guaranteed by the bank or credit union n May go down in value
Please note that neither Lincoln Benefit Life Company nor its agents or representatives can give legal or tax advice.
This information is provided for general consumer educational purposes by Lincoln Benefit Life Company (Lincoln Benefit Life), Home Office, Lincoln, NE, and
is not intended to provide legal, tax or investment advice. Lincoln Benefit Life issues fixed and variable insurance products that are sold through agreements
with affiliated or unaffiliated broker-dealers or agencies. Lincoln Benefit Life’s variable products are sold by registered representatives, investment advisors,
and agents or bank employees who are licensed insurance agents. ALFS, Inc., serves as principal underwriter of SEC-registered contracts for Lincoln Benefit
Life. ALFS, Inc., and Lincoln Benefit Life are subsidiaries of Allstate Life Insurance Company, Home Office, Northbrook, IL.
Date of first issue: 03/10
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©2010 Allstate Insurance Company