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  1. Use this form to change the beneficiary(ies) of amounts due under a structured settlement annuity contract (SSA Contract) issued by Prudential. If you die, your beneficiary(ies) will receive the guaranteed payments payable after your death that have not already been paid to you.

  2. 10 Φεβ 2023 · Use this form to change who you’d like to receive any proceeds payable in the event of the passing of the owner or annuitant (see prospectus for more details). This form can be used to make this change on an annuity contract held with Prudential.

  3. You can use this form to make changes to more than one policy as long as each policy insures the same person(s) and has the same owner, and you are requesting the same changes for each policy. Policy number(s) (eight or nine characters)

  4. Use this form to designate or make changes to the beneficiary(ies) of your Group Insurance death proceeds. The information on this form will replace any prior beneficiary designation.

  5. Structured Settlements Beneficiary Change Form. REQUEST TO SELECT/CHANGE BENEFICIARY. For use by Structured Settlement claimants/payees only. After you have completed this form, please return to Prudential using the Return instructions provided below in Section 4.

  6. Use this form to designate or make changes to the beneficiary(ies) of your Group Insurance death proceeds. The information on this form will replace any prior beneficiary designation.

  7. Use this form to designate or make changes to the beneficiary(ies) of your Group Insurance death proceeds. The information on this form will replace any prior beneficiary designation.

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