Notice Of Data Event

Request to Change Beneficiary Form (MYGA)

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Allocations need not be equal. Allocations for primary beneficiaries must equal 100%. Allocations for contingent beneficiaries must equal 100%. If additional space is needed, please attach Supplemental Beneficiary form.

Request to Change Beneficiary Form (MYGA)

Complete

Using a blue or black ink pen

Submit in 1 of 3 Ways

Email: [email protected]

Fax: 1 (808) 942-1235

or Mail:
Pacific Guardian Life
1440 Kapiolani Blvd.,
Suite 1700
Honolulu, HI 96814