Using Form CO-783
Example 3 - Designate a Beneficiary
Evelyn has designated Jane Smith as her primary beneficiary and Elizabeth Doe as her contingent beneficiary. Elizabeth will receive Evelyn's account balance if Jane Smith dies before Evelyn.
| Section D - Beneficiary Designation (Beneficiary(ies) must be a person, estate or other legal entity) | |||||||
| ***Contingent Beneficiaries only become effective in the event all primary beneficiaries die prior to the death of the participant.*** | |||||||
| Primary Beneficiary(ies) | Contingent Beneficiary(ies) | ||||||
| Name | Soc Sec No | Relationship | % | Name | Soc Sec No | Relationship | % |
| Jane Smith | 123-44-1111 | Daughter | 100 | Elizabeth Doe | 111-22-3333 | Sister | 100 |
| Name | Soc Sec No | Relationship | % | Name | Soc Sec No | Relationship | % |