Beneficiary Change Request (BCR)

Beneficiary Change Request (BCR)
To process a Beneficiary Change Request (BCR) please complete the form fields below. After the BCR is submitted, our team will review the information provided and will pre-fill the necessary documents required by the custodian. The documents will then be emailed to you via DocuSign for your eSignature.
Full Name*

First NameLast Name
Home Address*

Street Address

Street Address Line 2

CityState

Zip Code
Mobile Phone Number*
Email Address?*
example@example.com

Beneficiary Information
Beneficiary designations allow you to specify who will receive your account(s) in the event of your death. Properly designating your beneficiaries is one of the most important (and often overlooked) estate planning techniques.

There are two types of beneficiaries...Primary and Contingent.

A Primary Beneficiary is the person (or persons) who are "first in line" to receive your account(s).

A Contintgent Beneficiary is the person (or persons) who are "next in line" to receive your account(s). A Contingent Beneficiary will only receive your account(s) if all Primary Beneficiaries are unavailable.
How many Primary Beneficiaries do you have?*
Please complete the Primary Beneficiary Details information below.
How many Contingent Beneficiaries do you have?*
Please complete the Contingent Beneficiary Details information below.
Primary Beneficiary Details

All primary beneficiaries must total to 100%
Primary Beneficiary #1 - Name / Entity Name / Trust Name
Primary Beneficiary #1 - Home Address

Street Address

CityState

Zip Code
Primary Beneficiary #1 - Mobile Phone Number
Please enter a valid phone number.
Primary Beneficiary #1 - Email
example@example.com
Primary Beneficiary #1 - Date of Birth / Date of Trust

MonthDayYear
Primary Beneficiary #1 - Social Security Number / Tax ID Number
###-##-#### or ##-#######
Primary Beneficiary #1 - Percentage
All primary beneficiaries must total to 100%
Primary Beneficiary #2 - Name / Entity Name / Trust Name
Primary Beneficiary #2 - Home Address

Street Address

CityState

Zip Code
Primary Beneficiary #2 - Mobile Phone Number
Please enter a valid phone number.
Primary Beneficiary #2 - Email
example@example.com
Primary Beneficiary #2 - Date of Birth / Date of Trust

MonthDayYear
Primary Beneficiary #2 - Social Security Number / Tax ID Number
###-##-#### or ##-#######
Primary Beneficiary #2 - Percentage
All primary beneficiaries must total to 100%
Primary Beneficiary #3 - Name / Entity Name / Trust Name
Primary Beneficiary #3 - Home Address

Street Address

CityState

Zip Code
Primary Beneficiary #3 - Mobile Phone Number
Please enter a valid phone number.
Primary Beneficiary #3 - Email
example@example.com
Primary Beneficiary #3 - Date of Birth / Date of Trust

MonthDayYear
Primary Beneficiary #3 - Social Security Number / Tax ID Number
###-##-#### or ##-#######
Primary Beneficiary #3 - Percentage
All primary beneficiaries must total to 100%
Primary Beneficiary #4 - Name / Entity Name / Trust Name
Primary Beneficiary #4 - Home Address

Street Address

CityState

Zip Code
Primary Beneficiary #4 - Mobile Phone Number
Please enter a valid phone number.
Primary Beneficiary #4 - Email
example@example.com
Primary Beneficiary #4 - Date of Birth / Date of Trust

MonthDayYear
Primary Beneficiary #4 - Social Security Number / Tax ID Number
###-##-#### or ##-#######
Primary Beneficiary #4 - Percentage
All primary beneficiaries must total to 100%
Contingent Beneficiary Details

All contingent beneficiaries must total to 100%
Contingent Beneficiary #1 - Name / Entity Name / Trust Name
Contingent Beneficiary #1 - Home Address

Street Address

CityState

Zip Code
Contingent Beneficiary #1 - Mobile Phone Number
Please enter a valid phone number.
Contingent Beneficiary #1 - Email
example@example.com
Contingent Beneficiary #1 - Date of Birth / Date of Trust

MonthDayYear
Contingent Beneficiary #1 - Social Security Number / Tax ID Number
###-##-#### or ##-#######
Contingent Beneficiary #1 - Percentage
All contingent beneficiaries must total to 100%
Contingent Beneficiary #2 - Name / Entity Name / Trust Name
Contingent Beneficiary #2 - Home Address

Street Address

CityState

Zip Code
Contingent Beneficiary #2 - Mobile Phone Number
Please enter a valid phone number.
Contingent Beneficiary #2 - Email
example@example.com
Contingent Beneficiary #2 - Date of Birth / Date of Trust

MonthDayYear
Contingent Beneficiary #2 - Social Security Number / Tax ID Number
###-##-#### or ##-#######
Contingent Beneficiary #2 - Percentage
All contingent beneficiaries must total to 100%
Contingent Beneficiary #3 - Name / Entity Name / Trust Name
Contingent Beneficiary #3 - Home Address

Street Address

CityState

Zip Code
Contingent Beneficiary #3 - Mobile Phone Number
Please enter a valid phone number.
Contingent Beneficiary #3 - Email
example@example.com
Contingent Beneficiary #3 - Date of Birth / Date of Trust

MonthDayYear
Contingent Beneficiary #3 - Social Security Number / Tax ID Number
###-##-#### or ##-#######
Contingent Beneficiary #3 - Percentage
All contingent beneficiaries must total to 100%
Contingent Beneficiary #4 - Name / Entity Name / Trust Name
Contingent Beneficiary #4 - Home Address

Street Address

CityState

Zip Code
Contingent Beneficiary #4 - Mobile Phone Number
Please enter a valid phone number.
Contingent Beneficiary #4 - Email
example@example.com
Contingent Beneficiary #4 - Date of Birth / Date of Trust

MonthDayYear
Contingent Beneficiary #4 - Social Security Number / Tax ID Number
###-##-#### or ##-#######
Contingent Beneficiary #4 - Percentage
All contingent beneficiaries must total to 100%

Form Submission
Thank you for completing a Beneficiary Change Request (BCR). If you want to print your information, please click the Print Form button below. When complete, please submit your information by clicking the Submit button.
Should be Empty:

Beneficiary Change Request (BCR)

Primary Beneficiary Details

Contingent Beneficiary Details