Change of Beneficiary
Date:  

RE:    Insurance Policy Number:
Insured:
Owner:    

Dear Sir or Madam:

I am writing to instruct you to make the following change(s) to the above policy.  I would like to change a primary beneficiary.

The new primary beneficiary should be: ___________________.

Please send me a confirmation letter and, if necessary, a form to make this change.

Thank you for your assistance.

Best regards,


_____________
Insurance Policy Owner
 
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