708 Designation of Beneficiary

Locating and Paying Participants

Form 708

Locating and Paying Participants

OMB: 1212-0055

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Designation of Beneficiary

(Not Currently Receiving Pension Benefits)


PBGC Form 708

Approved OMB 1212-0055

Expires

Pension Benefit Guaranty Corporation.
P.O. Box
151750, Alexandria, Virginia 22315-1750

For assistance, call 1-800-400-7242


Plan Name: FX.PrismCase.CaseTitle.XF

Plan Number: FX.PrismCase.CaseIdNmbr.XF Participant Name: FX.PrismCust.FullName.XF

Date Printed: 02/04/2021

Date of Plan Termination: FX.PrismCase.DOPT.XF

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


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. Signature Sign and date this document. Knowingly and willfully making false, fictitious or fraudulent statements to the Pension Benefit Guaranty Corporation is a crime punishable under Title 18, Section 1001, United States Code.


I declare under penalty of perjury that all of the information I have provided on this form is true and correct.


signature



date





CONTINUE



Designation of Beneficiary

(Not Currently Receiving Pension Benefits) Form 708, page 2 of 2


Plan Number: FX.PrismCase.CaseIdNmbr.XF

Participant Name : FX.PrismCust.FullName.XF






3. 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 – 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)



SIGN & DATE ON PAGE 1 BEFORE SUBMITTING. THANK YOU.




File Typeapplication/msword
File TitleGeneral Information Form_PBGC Form XXX
AuthorPBGC\IOD
Last Modified ByJo Amato Burns
File Modified2008-07-29
File Created2008-07-29

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