Death benefit nomination form template
Recent customers:
If you provide a life insurance/death in service benefit you can issue a Death Benefit Nomination form for your employee to confirm who they want to be considered to receive any lump sum benefit. This could be a family member, a friend, a charity, a business or any other organisation.

Death benefit nomination form
In the event of my death, I would like my lump sum benefit to be paid to the following named beneficiaries, in the proportions shown:
Full name of beneficiary: | Relationship: | Percentage of benefit: |
To the Trustees and Scheme Administrators
I understand that this request will be used as a guide
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What is this for?
An Employee Death Benefit Nomination Form is a legal document used by an employee to specify who should receive any death benefits payable from their employer's life insurance policy or pension plan in the event of their death.
Many employers offer life insurance and/or pension plans as part of their employee benefits package. These plans typically provide death benefits in the event of the employee's death. When an employee enrolls in these plans, they are usually required to designate one or more beneficiaries who will receive the death benefits in the event of their death.
The Employee Death Benefit Nomination Form allows the employee to specify or update their beneficiary designation as needed. This can be important if the employee's circumstances change, such as if they get married, have children, or get divorced.
