708 Designation of Beneficiary (Not currently receiving bene

	Designation of Beneficiary (Not Currently Receiving Pension Benefits)		PBGC Form 708 Approved OMB 1212-0055 Expires 08/31/08
Pension Benefit Guaranty Corporation. P.O. Box 151750 Alexandria Virginia 22315-1750		For assistance, call 1-800-400-7242

Plan Name: «PrismCase.CaseTitle»

Plan Number: «PrismCase.CaseIdNmbr»

Participant Name: «PrismCust.FullName»

Date Printed: 02/06/2021

INSTRUCTIONS: Use this form to designate your beneficiary. Please print clearly with dark ink. To begin receiving benefits, or for other information, call our Customer Contact Center at 1-800-400-7242.

1. General information about you

Last Name

First Name

Middle Name

Other Name(s) Used

Social Security Number

-

-

Mailing Address

Apartment / Route Number

City

State

Zip Code

Country

Email (optional)

Daytime Phone

Extension

Evening Phone

(

)

-

x

(

)

-

2. Designation of Beneficiary – If there are payments owed to you at the time of your death, PBGC will pay them to the person you designate below. If you do not name anyone, or if the beneficiary you name dies before you, PBGC will pay the underpayment in this order: your spouse, your children, your parents, your estate, and your next of kin.

Beneficiary information that you provide when you apply for your benefits will supercede the information on this form.

CONTINUE

Designation of Beneficiary (Not Currently Receiving Pension Benefits) Form 708, page 2 of 2
	Plan Number: «PrismCase.CaseIdNmbr»	Participant Name: «PrismCust.FullName»

Beneficiary – I name the following person as my beneficiary for amounts owed to me at my death. This replaces any previous designation and will only be effective when PBGC receives it.

Last Name

First Name

Middle Name

Other Name(s) Used

Social Security Number

Date of Birth

Gender

male 

-

-

/

/

female 

Mailing Address

Apartment / Route Number

City

State

Zip Code

Country

Email (optional)

Daytime Phone

Extension

Evening Phone

(

)

-

x

(

)

-

Relationship to me, if any (e.g., spouse or granddaughter, friend)

3. Signature – You must sign and date this form.

signature

date

SIGN & DATE BEFORE SUBMITTING. THANK YOU.