Beneficiary Change Form
Member Account Number : 9999999999 aaaaaaaaaa
Select Share ID

Please review the updated beneficiary information below and sign in the space provided. If there are changes, please note the correction and return the form to an Alliant Member Service Representative for processing.


A M D Beneficiary Name Address SSN DOB %
Bill Hampe 12345 W. Carmichael Blvd.Rancho Cucamonga, CA 12345-6654 xxx-xx-1234 12/12/2014 50%
Sandhya Gowravajhala Trump Tower 2345 Northwestern Ave, Unit 213 Chicago, IL 60666-0945 xxx-xx-1234 12/12/2014 50%
Total: