Fillable Coverdell Esa Beneficiary Update Form printable pdf download

COVERDELL ESA BENEFICIARY UPDATE

CURRENT DESIGNATED BENEFICIARY’S

COVERDELL ESA TRUSTEE’S OR CUSTODIAN’S

NAME AND ADDRESS

Trustee’s or Custodian’s

Social Security Number

Date of Birth

Home Phone

Coverdell ESA Account Identification

Phone Number

COVERDELL ESA DEATH BENEFICIARY(IES)

NAME/RENAME DEATH BENEFICIARY(IES) - I designate the individual(s) or entity(ies) named below as the primary and/or contingent death beneficiary(ies) of this

Coverdell ESA and hereby revoke all prior death beneficiary(ies) designations, if any.

If neither primary nor contingent is indicated, the individual or entity will be deemed to be a primary death beneficiary. If more than one primary death beneficiary is

designated and no distribution percentages are indicated, the death beneficiaries will be deemed to own equal share percentages in the Coverdell ESA. Multiple

contingent death beneficiaries with no share percentage indicated will also be deemed to share equally. If any primary or contingent beneficiary dies before the

designated beneficiary, his or her interest and the interest or his or her heirs will terminate completely, and the percentage share of any remaining death beneficiary(ies)

will be increased on a pro rata basis. If no primary death beneficiary(ies) survives the designated beneficiary, the contingent death beneficiary(ies) will acquire the

designated share of the Coverdell ESA. If no death beneficiaries are named, the designated beneficiary's estate will be the death beneficiary.

Social Security

Relationship to

Primary or

No.

Death Beneficiary's Name and Address

Date of Birth

Share %

Number

Designated Beneficiary

Contingent

Primary

Contingent

Primary

Contingent

Primary

Contingent

Primary

Contingent

SIGNATURES

I certify that I am authorized by the Coverdell ESA plan agreement to change the designated beneficiary and/or change or add death beneficiaries at any time

by completing and delivering the proper form to the trustee or custodian. The trustee or custodian has provided no tax or legal advice to me regarding my

beneficiary designation. In addition, if this form is being used to change the current designated beneficiary, I certify that the designated beneficiary named

above is a member of the current designated beneficiary's family as described in Section 529(e)(2). The trustee or custodian has provided no tax or legal

advice to me regarding my beneficiary designations.

(Coverdell ESA Responsible Individual/Contributor)

(Date)

(Authorized Signature of Custodian)

(Date)

Rules and Conditions Applicable to Designation of Beneficiaries

This option is designated to replace or add Coverdell ESA death beneficiaries. Any balance to the credit of the Designated

COVERDELL ESA DEATH

Beneficiary shall be distributed within 30 days of the date of such Designated Beneficiary's death unless the designated

BENEFICIARY(IES)

death beneficiary is a family member of the Designated Beneficiary who is under the age of 30 on the date of death. In such

a case, the family member shall become the Designated Beneficiary as of the date of death.