INSTRUCTIONS: ALABAMA CHANGE OF BENEFICIARY FORM PRIOR TO RETIREMENT (Form RSA 100-C)

Alabama public employees who wish to change the beneficiaries of their retirement benefits and state-administered plans do so using a form RSA 100-C. This document can be obtained from the website of the Retirement Systems of Alabama.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 1: All parts of the form must be printed or typed in black ink. The first section, "Member Information," must be completed by all people filing this form. On the first blank line, enter your first name, middle or maiden name and last name.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 2: On the second blank line, enter your Social Security number.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 3: On the third blank line, enter your date of birth.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 4: On the fourth blank line, enter your home telephone number.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 5: Indicate whether you are an active or inactive member with a check mark.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 6: In the next section, designate your primary beneficiary. On the first blank line here, enter their name.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 7: On the second blank line, enter their relationship to you.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 8: On the third blank line, enter their date of birth.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 9: On the fourth blank line, enter their Social Security number.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 10: On the fifth blank line, enter their address.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 11: In the next section, provide the same information for the contingent beneficiary who will receive benefits if your primary beneficiary is deceased.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 12: If you wish to designate additional primary or contingent beneficiaries, enter the same information for them on the back of the form.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 13: Sign and date the form before a notary public.