Annuity Contract Beneficiary Change Document
Contract Number:
Owner Name(s):
Owner Address:
Annuitant Name(s):
Current Beneficiary(ies)
Name
Relationship
Share %
New Primary Beneficiary(ies)
Name
Relationship
Share %
New Contingent Beneficiary(ies)
Name
Relationship
Share %
Special Instructions / Notes:
Owner Signature:
Date:
Joint Owner Signature (if applicable):
Date:
Witness or Notary (if required):