Update for NBC Gold Plan Beneficiary Nomination Form

Update for NBC Gold Plan Beneficiary Form

This form is intended for members who wish to update their existing beneficiary details.
Member's Full Name
Scheme Name
Ghana Card Number
SSNIT Number
Phone Number
Please enter a valid phone number.Format: (233) 000-000000.
Beneficiary Nomination Form

Beneficiary Nomination

Rows	Dependant Full Name	Relationship	Telephone	Percentage of Benefit (%)(Sum up to 100%)	Date of Birth	Ghana Card / NHIS / Passport Number	GPS Address	Location	Email
Beneficiary 1
Beneficiary 2
Beneficiary 3
Beneficiary 4
Beneficiary 5
Beneficiary 6
Beneficiary 7
Beneficiary 8
Beneficiary 9
Beneficiary 10

NB:Please note that the total percentage of benefit allocation must equal 100%. If the beneficiary percentage does not add up to 100%, the form cannot be submitted.
Calculation
Next of Kin Full Name
Next of Kin's Contact
Member Declaration
I hereby confirm that the information provided is correct. I am not a member of any other similar scheme, I am not in possession of another contributor enrolment number, and I am duly informed and to my full understanding that, I will be liable for prosecution for any false declaration herein or hereafter made to the scheme. Additionally, I hereby consent to the deduction of any outstanding liabilities owed to the employer from my provident fund benefits upon exit, in accordance with the scheme rules and applicable law
Member's Full Name
Member's Signature
Member's Declaration Date

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Beneficiary percentage must total 100
Sorry, the beneficiary percentages you entered don't add up to a total of 100%
Should be Empty:

Update for NBC Gold Plan Beneficiary Form