The Prudential Change Beneficiary Form is a critical document for policyholders wishing to alter the beneficiary designation on their life insurance policies under The Prudential Insurance Company of America and its Pruco affiliates. It offers a structured way to modify who will receive the proceeds of the policy upon the policyholder's death, ensuring that such changes are accurately recorded and confirmed. Click the button below to initiate the modification process and ensure your life insurance benefits are aligned with your current wishes.
Life insurance is a crucial component of financial planning, offering peace of mind that loved ones will be financially protected in the event of an untimely death. The Prudential Change Beneficiary Form plays a vital role in this planning process, allowing policyholders to update who will receive the policy proceeds. This form is applicable to policies issued by The Prudential Insurance Company of America, Pruco Life Insurance Company of New Jersey, and Pruco Life Insurance Company, all of which are Prudential Financial companies. It encompasses various sections, including general information and instructions, changing your beneficiary details, and special beneficiary designations, such as naming children as a group or a trust as a beneficiary. Understanding the categories of beneficiaries—primary, contingent, and tertiary—and how they affect the distribution of proceeds is essential. Additionally, the form caters to specific needs such as creditor beneficiaries or funeral home arrangements and outlines the settlement options available. Importantly, the form addresses legal considerations relevant to residents of certain states, such as Kentucky's restrictions on beneficiaries convicted of certain crimes and the acknowledgement of civil unions in states with relevant legislation. Completing this form accurately and returning it in its entirety ensures that the policy reflects the policyholder's current wishes, providing clarity and simplifying the process for all involved.
Request to Change Beneficiary on Life Insurance Policies
The Prudential Insurance Company of America
Pruco Life Insurance Company of New Jersey
Pruco Life Insurance Company
All are Prudential Financial companies.
General Information and Instructions (Read the instructions about the change(s) you wish to make)
•Review the accuracy of any pre-filled information. Initial any corrections or deletions that you make to the preprinted text. If you do not, we may not be able to act upon your request.
•Return the completed form in its entirety. Do not send us your policy.
•We will record the change(s) and send a confirmation.
•On these pages, me, my, you, your, and I refer to the owner(s). We, us, and our refer to the Prudential company that issued the policy.
•This form does not provide for every arrangement. If the arrangement you want is not on this form, please contact our Customer Service Office.
Changing Your Beneficiary (Complete the Request to Change Beneficiary section)
1.To help facilitate payment when a claim is made, we need to have certain information about each beneficiary. The information we request for each beneficiary helps us identify and locate the beneficiary for payment. We recognize the confidential nature of the information requested, and we assure you that this information is for our internal use only and will not be shared.
2.Proceeds will be paid in a lump sum unless indicated otherwise in the Additional/Special Beneficiary Requests section. If information about a different method of payment was requested, we have enclosed A Word About Settlement Options. If you have not received it, contact our Customer Service Office.
3.It is important to understand the difference between primary (class 1), contingent (class 2), and tertiary (class 3) categories of beneficiaries.
•Primary beneficiaries will receive any proceeds payable at the insured’s death.
•If no primary beneficiary survives the insured, the contingent beneficiaries will receive any proceeds.
•If neither primary nor contingent beneficiaries survive the insured, tertiary beneficiaries will receive any proceeds.
4.If there is more than one beneficiary in the same class, they will be paid in equal shares or to the survivor(s) of them, unless specified otherwise.
5.Testamentary Trust (i.e., a trust that is established under a will) – A Testamentary Trust should only be named as a beneficiary if the insured’s last will and testament provides for the establishment of a trust. The death benefit can only be paid to a Testamentary Trust if the trust is named in the will and the will is probated. If the Insured’s last will and testament is not admitted to probate, under the terms of the beneficiary arrangement, we will not be able to pay the claim to the contingent beneficiary (or the insured’s estate if no contingent is named) until 18 months after the Insured’s death (or if permitted by law, a shorter period as requested in the Additional/Special Beneficiary Requests section.)
6.Our responsibility for the payment of the proceeds to a Trust ends with payment made to the Trustee(s); we have no responsibility regarding any subsequent distribution made by the Trustee(s).
Special Beneficiary Designations (Use the Additional/Special Beneficiary Requests section)
For the following designations, include the information shown in the quotations (as well as any other identifying information described in this section).
1. Children as a group. (This would include any legally adopted children.) Write“Children of the insured.”
2.Children by representation. (We do not use the term “per stirpes” in our beneficiary designations.)
If a child is not living and therefore not eligible to receive payment, and if any such child’s share is to be distributed equally to his or her surviving children, then write: “his (or her) children by representation” next to any beneficiary this will apply to.
For children as a group write “children of the Insured, their children by representation.”
3. Creditor Beneficiary or Funeral Home.
a.“(Business Name), of (city, state), its successors or assigns, creditor, as its interest may appear.” For entities other than a corporation omit ‘its successors or assigns’. or
b.“(Individual’s name), his/her estate, creditor of the Insured, as his/her interest may appear.”
For any creditor arrangement, be sure to indicate who is to receive any balance. “Pay balance, if any, to Jane Smith, wife.”
(continued)
COMB 98992
Ed. 4/2014
Page A of Instructions
Customer keeps this page
Special Beneficiary Designations (Use the Additional/Special Beneficiary Requests section) (continued)
4. Dollars and Balance Arrangements. Note: Only one dollar amount can be shown.
•“Pay $80,000, or the proceeds, if less, to Jane Doe, wife, and the balance, if any, to John Doe, son.”
5. Percentages and Fractions.
•Percentage arrangement: “Pay 75% to Jane Doe, wife, and 25% to John Doe, son.”
•Fraction arrangement: “Pay ¾ to Jane Doe, wife, and ¼ to John Doe, son.”
In the examples above, if Jane Doe is not living when the insured dies, her share will not be payable to John Doe. If you want that share to be paid to the other beneficiary (or to someone else), then write:
“Pay 75% to Jane Doe, wife, if living, otherwise to John Doe, son; and 25% to John Doe, son, if living, otherwise Jane Doe, wife.”
6.Short Term Survivorship Provision.
If this provision is chosen, any beneficiary who dies after the insured (but within the period of days you specify) will be considered to have died before the insured. The specified period (from 1 to 30 days) must be indicated, as follows: “Include Short Term Survivorship Provision of (1 to 30) days.”
For Kentucky Residents – Additional Information Regarding the Beneficiary Change
The State of Kentucky prohibits a beneficiary from collecting benefits under an insurance policy if convicted of taking the life of the decedent or of certain felonies involving abuse, neglect or financial exploitation of the decedent resulting in a loss to the decedent of more than $300 in financial or other resources, or both.
The forfeiture will not occur if:
•The insurance policy was executed prior to January 1, 2012.
•The felony was committed prior to January 1, 2012.
•The decedent, knowing of that person’s conviction, reaffirms that person’s right to receive the policy benefits by executing a new policy, or requesting a beneficiary change on an existing policy, which names that person as a beneficiary.
If a forfeiture occurs, and there are no other beneficiaries, the forfeited interest shall be paid to the State for deposit into the elder and vulnerable adult victims trust fund.
Important Notice – Civil Union Act
If your state has enacted a Civil Union Act or similar legislation, which provides that parties treat civil unions and marriages equally in all aspects, we are providing this notice to confirm that we comply with all states Civil Union Acts or similar legislation.
Page B of Instructions
Please print using blue or black ink.
Initial any corrections or deletions that you make to the preprinted text.
About Your Policy
You can use this form to make changes to more than one policy as long as each policy insures the same person(s) and has the same owner, and you are requesting the same changes for each policy.
Policy number(s) (eight or nine characters)
_______________________ _______________________ _______________________ _______________________
Name of insured (first, middle initial, last name)
Name of joint insured, if any (first, middle initial, last name)
Has your mailing address, telephone number(s), or e-mail address changed?
Complete this section only if you are requesting a permanent change in your mailing address, have a new telephone number(s), or e-mail address.
Full address
Telephone number: Home
Mobile (Cell)
e-mail address
Mailing Instructions
Unless otherwise indicated in this section, confirmation of the change(s) will be mailed to the owner at the address in our records.
Name of Recipient of confirmation (first, middle initial, last name)
Request to Change Beneficiary (This revokes all prior beneficiary designations)
All beneficiaries need to be restated even if they are not being changed. For example, if you are changing only the contingent beneficiary, you must restate the primary beneficiary. If more space is needed for additional beneficiaries, use the Additional/Special Beneficiary Requests section.
A. To name individual beneficiary(ies), complete the following:
Primary
Contingent
Name (first, middle initial, last name)
Tertiary
Relationship to insured
Date of birth
Soc. Sec. no.
Page 1 of 3
Return this page to Prudential
Request to Change Beneficiary (continued)
B. To name a trustee under a living (inter-vivos) trust agreement , (the trust must already be in existence) complete the following:
Name of current trustee(s)
Date of trust agreement
/
Trust is (check one) Irrevocable Revocable
Name of trust
Telephone #
Trust taxpayer identification #
Note: Whenever possible, include confirmation of the trust information by providing a copy of those pages of the trust documentation that show the name of the trust, name(s) of the trustee(s) and date of the trust.
C. To name a trust that will be established under the Insured’s Last Will and Testament (i.e. Testamentary Trust), check one of the following:
Primary
Contingent
Note: You may wish to consult legal counsel before choosing this arrangement. Only choose this arrangement if the insured’s will provides for the establishment of a trust. Trusts that are established prior to the insured’s death are not testamentary trusts. To name a trust that has already been established as a beneficiary, complete B above. Please refer to #5 in the Changing Your Beneficiary section on Page A of Instructions for additional information.
D. To name the insured’s estate as your sole beneficiary, check the following:
The insured’s estate. If choosing the insured’s estate, no other beneficiary can be selected.
E. To name a business/organization, complete the following:
Tertiary
Name of business/organization
Employer taxpayer identification #
Type of business/organization
Corporation
Limited Liability Company
Name of sole proprietor (if applicable)
Partnership
Other
Sole Proprietorship
Additional/Special Beneficiary Requests
Use this section to name an additional beneficiary, a class or group not shown in the Request to Change Beneficiary section, or to select a payment option for your beneficiary.
For each additional individual beneficiary or member of a class or group (i.e. Children of the Insured), please provide the class (primary, contingent, tertiary), their full name, relationship to the insured, date of birth, social security number, address, home and/or mobile (cell) telephone number(s) and e-mail address.
Ed. 4/2014Page 2 of 3
Signature(s)/Signature Requirements (Always complete)
Your request cannot be processed without the correct signature(s), date, and applicable documentation.
•For individual policyowner(s), the person (or persons if there are joint owners) that owns the policy must sign.
•For corporations, an authorized officer must sign. Be sure to include the title of the officer and the company name.
•If president – no additional requirements
•If vice president – for policies over $1,000,000, provide a Corporate Secretary’s statement reflecting the vice president’s authority to sign
•If any other officer – provide a corporate resolution
•For limited liability companies (LLC), a copy of the document that identifies who is authorized to act on behalf of the LLC (e.g. operating agreement) must be submitted. The individual(s) authorized to act should sign and include his/her title and the company name.
•For partnerships (LP, LLP, and LLLP), the form should be signed by at least two general partners, followed by the title “general partner” after each signature. If the company only has one general partner, then the sole general partner should sign followed by the title “sole general partner”. Also, include the company name.
•For sole proprietorships, submit the signature of the owner, followed by “doing business as (company name), a sole proprietorship.“
•For trusts, the trustee(s) must sign and include the title “trustee” after their signature. The name of the trust must also be indicated in the space provided for Business/Trust name. All trustees must sign unless the trust itself or state law provides otherwise.
•A holder of a power of attorney for the policyowner must sign the form and include the title “attorney-in-fact for (owner’s name).” In addition, a copy of the power of attorney papers must be submitted along with the request.
•For guardian (conservator) of the estate - sign as “guardian of the estate of (name of ward)”. A copy of the guardianship papers must also be submitted. Depending on the rights granted by the guardianship papers or the state, a court order authorizing the change may also be required.
•For a policy containing a limitation of rights, the person or entity in whose favor the rights have been limited must also sign.
By signing this form, I:
•certify that I am authorized to sign this form,
•certify that the change(s) being requested are not subject to, or in conflict with, any prior agreement, legal proceeding, or court/administrative order, which restrict, limit, or otherwise prohibit such change(s), including, but not limited to divorce or bankruptcy proceedings,
•authorize all request(s) made on this form, both preprinted and handwritten, which are subject to the terms and conditions of the policy,
•request a waiver of any policy provision that requires me to send Prudential the policy for endorsement of the change(s),
•certify that the policy(ies) is/are in my possession and that no other person has any claim or interest in it/them, except for a collateral assignee under any assignment now on record with Prudential,
•certify that if the owner is a corporation or partnership, that it is not under receivership, trusteeship, or conservatorship, and/or has not been dissolved, and if a partnership, that no notice of disassociation has been filed by any partner, and
•understand that any endorsement that Prudential may issue will conform to its rules and practices.
X
Current owner’s signatureDate signed month/day/year
Current joint owner’s signature(s) (if applicable)
Date signed month/day/year
Signer’s title (for business/trust owned only)
Business/Trust name (if applicable)
For Massachusetts residents only
State law requires that a disinterested adult, who is not a party to the policy, witness any request to change the beneficiary arrangement. Your Prudential representative may sign as a witness.
Witness’ signature (Massachusetts only)
Ed. 4/2014Page 3 of 3
When planning for the future, individuals often consider updating their life insurance beneficiaries to ensure their wishes are carried out as intended. Whether it's due to significant life events such as marriage, divorce, the birth of a child, or simply to revise previous choices, updating the beneficiary information is a crucial step in managing a life insurance policy. The Prudential Change Beneficiary Form is designed for policyholders who wish to change the beneficiary(ies) on their life insurance policies. Completing this form accurately is essential for the changes to be processed smoothly. The following steps guide you through completing the Prudential Change Beneficiary Form.
Once Prudential receives and processes your Change of Beneficiary Form, you will be sent a confirmation. This confirmation is important; review it carefully to ensure all changes have been made as requested. Keep this document with your important papers or anywhere you store your policy information. Being organized and keeping track of these changes will help ensure your life insurance benefits are distributed according to your wishes.
To change the beneficiary of your life insurance policy, you must complete the Request to Change Beneficiary section found on the Prudential Change Beneficiary form. Ensure you review any pre-filled information for accuracy, initial any changes you make, and return the entire completed form to Prudential. It is crucial to restate all beneficiaries, even if they are not being changed, to ensure clarity and avoid any misunderstandings.
Yes, you can specify how the proceeds are to be distributed. You can do so by detailing specific dollar amounts, percentages, or fractions in the Additional/Special Beneficiary Requests section. Be mindful that if a beneficiary predeceases you without a provision for distribution of their share, that share might not be distributed as you intended unless specified otherwise in your beneficiary designation.
For each beneficiary, the following information is requested: their name, relationship to the insured, date of birth, Social Security number, full address, telephone number(s), and email address if available. This information assists Prudential in accurately identifying and locating the beneficiary for the payment of proceeds.
Proceeds are paid in a lump sum to beneficiaries unless otherwise indicated in the Additional/Special Beneficiary Requests section of the form. It's essential to provide any desired method of payment details here, or contact Prudential's Customer Service Office if you have specific or unique distribution requests.
Yes, you can name a trust as a beneficiary. If the trust is already established (living or inter-vivos trust), complete section B of the form. For trusts to be established under the insured's last will (testamentary trusts), refer to section C. However, testamentary trusts are only valid if explicitly provided in the insured's will, and the will must be probated for the trust to receive the death benefit.
Yes, you can name a class or group of individuals, like your children, as beneficiaries. Use the special designation "Children of the insured" for children, including legally adopted ones. If you intend for the share of a deceased child to be distributed to their surviving children, you should specify "children by representation" next to the beneficiary this applies to.
To name a creditor or a funeral home as a beneficiary, use the appropriate designation in the Additional/Special Beneficiary Requests section. Specify the entity's name, city, state, and its interest details for a creditor beneficiary or provide similar information for a funeral home and how any balance should be disposed of.
Changes to beneficiaries that are subject to, or in conflict with, any prior agreement, legal proceeding, or court/administrative order that restricts, limits, or otherwise prohibits such changes cannot proceed until those restrictions are resolved. This includes situations like divorce or bankruptcy proceedings.
For Kentucky residents, state law prohibits beneficiaries from collecting benefits if convicted of certain crimes against the insured. Furthermore, Prudential acknowledges and complies with Civil Union Acts or similar legislation in states where such laws are enacted, treating civil unions and marriages equally in all aspects of beneficiary designation.
The completed form should be printed using blue or black ink, with all corrections or deletions initialed by the policy owner. It must be mailed back to Prudential without sending the actual insurance policy. Upon receipt, Prudential will record the changes and send a confirmation. It's essential to include all necessary signatures, dates, and, if applicable, any required documentation based on the policy owner's situation or entity type.
When filling out the Prudential Change Beneficiary form, it is crucial to avoid common mistakes to ensure the desired changes are accurately recorded and legally effective. The following list highlights nine common errors people make during this process:
It is essential to approach the process of changing a beneficiary with diligence and attention to detail to ensure your insurance policies reflect your current wishes accurately.
When you're updating beneficiaries for life insurance policies with a Prudential Change Beneficiary form, it's not uncommon to consider other important documents and forms that may also need reviewing or updating. Here's a selection of documents often associated with such updates:
Keeping your beneficiary designations updated across all these documents can help ensure a smooth transition of your assets according to your wishes. It's a good practice to review these forms regularly or after any major life events.
A Last Will and Testament is similar to the Prudential Change Beneficiary form in that both documents formally designate who will receive an individual's assets after their death. While the former applies broadly to an individual's entire estate, the latter specifically relates to the proceeds of a life insurance policy.
A Transfer on Death (TOD) Registration Form mirrors the Change Beneficiary form as both allow the account holder or policy owner to designate beneficiaries who will receive assets upon the individual's death, bypassing probate. A TOD form applies to financial accounts and securities.
The Beneficiary Designation Form for retirement accounts, 401(k)s, or IRAs is akin to the Prudential document. Both forms enable the account or policy owner to name individuals or entities that will inherit the funds directly, outside of the will or trust process.
A Trust Agreement can also have similar functions, especially when it names beneficiaries for specific assets managed within the trust. However, a Change Beneficiary form is for life insurance specifically, while a trust can encompass a wider variety of assets and has broader applications in estate planning.
The Payable on Death (POD) Agreement Form for bank accounts share similarities with the Change Beneficiary form, in that both permit the designation of beneficiaries to receive assets without going through probate. POD agreements specifically apply to bank accounts upon the account holder's death.
A Life Insurance Application, at its initial stage, requires the policy owner to name primary and contingent beneficiaries, akin to the beneficiary change form. However, the application begins the coverage process, while the Prudential form is for altering the policy's beneficiaries after the policy is in force.
A Power of Attorney (POA) Designation Form, especially a financial POA, can designate someone to manage financial affairs, including the potential to change beneficiaries on life insurance policies, though under more restrictive conditions and generally while the policy owner is still alive.
When you're filling out the Prudential Change Beneficiary form for life insurance policies, it's crucial to get every detail right. Here are some dos and don'ts to guide you through the process:
By following these guidelines, you can ensure that your beneficiary changes are made accurately and efficiently, securing the future payout according to your wishes.
Many people have misconceptions about the process of changing a beneficiary on a life insurance policy with Prudential. Understanding these misconceptions can help policy owners make informed decisions.
In truth, policy owners have the flexibility to change beneficiaries at any time for any reason, provided they follow the proper process and guidelines outlined in the Change Beneficiary form.
After submission, Prudential needs to process the form, record the changes, and issue confirmation. Until you receive this confirmation, the change is not official.
Contrary to this belief, if you have multiple beneficiaries in the same class and want a specific distribution of proceeds, you must stipulate this in the form. Otherwise, proceeds will be divided equally or to the survivor(s).
For a testamentary trust to be a beneficiary, the trust must be specifically named in the beneficiary form, and the will must be probated. Otherwise, Prudential cannot pay the proceeds to the trust.
Prudential does not use “per stirpes” in their designations. Instead, if you want the children of a deceased beneficiary to inherit their parent's share, you must clearly indicate this with “by representation” next to the beneficiary's name.
It’s up to the policy owner to determine and specify the method of payment or distribution among beneficiaries. Prudential only follows the instructions provided on the beneficiary change form.
Awareness and understanding of these misconceptions can smooth the beneficiary change process, ensuring that your life insurance policy benefits are distributed according to your wishes.
When you need to change the beneficiary on your Prudential life insurance policy, it's important to understand the process and requirements to ensure that your intentions are clearly recorded and followed. Here are four key takeaways about filling out and using the Prudential Change Beneficiary form to help guide you through this process:
Remembering these key points will help streamline the process of changing a beneficiary on a Prudential life insurance policy, ensuring your wishes are clearly communicated and can be effectively executed.
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