Date:

RE:    Insurance Policy Number:
Insured:
Owner:

Dear Sir or Madam:

I am writing to instruct you to make the following change(s) to the above policy.  I would like to change a primary beneficiary.

The new primary beneficiary should be: ___________________.

Please send me a confirmation letter and, if necessary, a form to make this change.

Thank you for your assistance.

Best regards,

_____________
Insurance Policy Owner

Change of Beneficiary
Review List

This review list is provided to inform you about this document in question and assist you with its preparation.  This letter should be sent out promptly if your life circumstances change such as through death of a former beneficiary, your divorce, or other such circumstance.

1. Make multiple copies.  Send one to the insurance company and your agent, if you have one.  Keep one in the transaction file.

2. Make a note to follow-up with in two weeks if you do not hear back.  And keep after it until you implement the change you desire.