Beneficiary Designation Form

Use this form:

  • To designate your beneficiaries for Basic Life/Accidental Death, and/or Optional Life/Optional Accidental Death insurance
  • At time of initial enrolment if you want to designate more than 3 primary beneficiaries
  • To change your existing beneficiary(ies). The beneficiary(ies) listed here will replace your previous beneficiary designation

Office Supervisory Plan – Click here to download the Beneficiary Designation form.

  • Please rename the file to include your Company Name prior to uploading (eg: CompanyName-PAD-Form.pdf).


Office Supervisory Plan employees, upload your Beneficiary Designation form below.

How do I know my upload was successful?

Look for the green check mark next to your upload. An example is highlighted in the image below:

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