708 Designation of Beneficiary

	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: 02/02/2021

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.