Account Beneficiary Card

Account Beneficiary Card

The beneficiaries will receive all the funds from your account in the event of the death of the account owner.

Member Name

Joint Owner Name

Account Number

Date

Please add/change the following beneficiary(ies) to my/our account:

Beneficiary One

Name

SSN

Address

City

State

ZIP

Phone

Date of Birth

Relationship

Beneficiary Two

Name

SSN

Address

City

State

ZIP

Phone

Date of Birth

Relationship

Beneficiary Three

Name

SSN

Address

City

State

ZIP

Phone

Date of Birth

Relationship

Beneficiaries cannot withdraw unless: (1) all persons creating the account die, and (2) the beneficiary is then living. If two or more beneficiaries are named and survive the death of all persons creating the account, such beneficiaries will own this account in equal shares, without right of survivorship. The person(s) creating the beneficiaries reserves the right to change beneficiaries at any time.

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Your legal name

Your email address

Please Confirm full name and signature.

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Timestamp

Audit

September 8, 2021 4:35 pm PDT

Account Beneficiary Card Uploaded by Adam McGee - [email protected] IP 69.4.146.122