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

In Alabama, public employees enrolled in the state's retirement systems use a form RSA 100-C to change their designated primary or contingent beneficiaries or to correct information about them. 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: On the first blank line, enter the first name, middle or maiden name, and last name of the member.

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

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

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

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

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 6: The next section concerns the primary beneficiary. Enter their name on the first blank line.

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

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

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

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 10: On the fifth blank line, enter the primary beneficiary's street address or P.O. box number, city, state and zip code.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 11: Provide the same information concerning your contingent beneficiary in the next section. Additional primary or contingent beneficiaries can be documented on the second page.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 12: Sign and date the form where indicated, then appear before a notary public, who will affix their seal and enter their signature and the date of the expiration of their commission.