Postretirement Death Benefit Application Package
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17AMERICAN FEDERATION OF MUSICIANS AND EMPLOYERS’ PENSION FUND
PO Box 2673 • New York, New York 10117-0262
POST-RETIREMENT DEATH BENEFIT APPLICATION INSTRUCTIONS
WEBSITE
Use this application if the decedent was receiving pension benefits from the Fund
1.
The Application:
•
This is a fillable form which allows you to enter the information requested into the appropriate
spaces. Please answer questions 1 – 15 completely and accurately.
•
Print your completed application, make sure to sign and date the application in the presence of a
Notary Public, and mail it with all required documents to the Fund Office:
American Federation of Musicians and Employers’ Pension Fund
PO Box 2673, New York, NY 10117-0262
Attention: Death Benefit Claims
A certified copy of the Pensioner’s Death Certificate is required, unless
it has already been submitted.
2.
Other Required Documents:
In addition to the completed application and certified death certificate, please submit all of the
required documents, which are applicable, from the following list. See the following page for a
list of acceptable proof of age documents.
•
If you are the deceased pensioner’s spouse, copies of your marriage certificate and proof of age
are required.
•
If you are not the deceased pensioner’s spouse, a copy of your proof of age is required.
•
If the Beneficiary is a Minor Child, copies of the child’s proof of age, Social Security card and
Court Letter of Guardianship or Conservatorship of the Estate for the Minor Child are required.
•
If the Beneficiary/Alternate Payee is incompetent, a copy of the Durable Power of Attorney or
Court Letter of Guardianship or Conservatorship is required.
•
If the Beneficiary is the deceased pensioner’s Estate, a copy of the Court Letter of Administration
or Letters Testamentary are required.
•
If the Beneficiary is the deceased pensioner’s Trust, a copy of the Trust Agreement, Letter of
Acceptance from the Trustee and the Trust identification number are required.
•
If the Beneficiary/Alternate Payee died before the pensioner, a copy of the Beneficiary/Alternate
Payee’s certified death certificate is required.
9.2.3.052516
05-25-16
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