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Get Application Change Beneficiary

Examples of wording that can be used to designate a beneficiary on this Form are set forth below. If the policy proceeds are to be paid other than in a single sum, do not use this form and contact Companion Life Insurance Company for further instructions. Type of Beneficiary 1. Executor or administrator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. Two or more named persons in equal shares . . . . . . . . . . . . . . 3. Two or more named persons in unequal shares . . . . . . . . .

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