You will also need to provide a signed beneficiary statement in addition to any other requirements stated in your Nassau Claims Packet. 3. I was sorry to hear of your recent bereavement.Make sure you include the name of the person who died or mention the specific incident that caused sorrow for the person. 1. Notify Us. Complete our Beneficiary Statement form and have the beneficiary sign it. Our mutual friend, XXX let me know of your bereavement. I was very sorry to hear of XXX's passing.