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______________________________________Date____/____/____ If you need additional space, using the above format, attach a separate piece of paper with the appropriate policy number, the date, and your signature. GUIDELINES FOR DESIGNATION OF BENEFICIARIES General - Please be sure to include the beneficiary’s full name, social security number and relationship to you. Providing this information can help expedite the claim process by making it easier to locate and verify beneficiaries. Minors - Wh.

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