Malvern House Group Insurance Trust Beneficiary Nomination Form

To:       The Trustees of Malvern House Group Insurance Scheme.

It is my wish that any benefits arising under the above scheme in the event of my death, should be paid in the proportions and to the person or persons indicated below, being either related to me or financially dependent upon me.
I understand that Trustees will not be bound by this expression of wish but request due consideration.

I confirm that this expression of my wishes supersedes any previously made by me.

Any and all lump sum benefits arising under the Scheme on the death of a member will be paid to beneficiaries as nominated below. Trustees of the Scheme will act in accordance with the powers contained in the Trust .  A member may express a wish as to who should benefit although this will not be binding. If your circumstances change you can change nominees at any time.

Please complete the details below, in submitting this form you consent for the details on our system to be amended if necessary and any new information to be held in line with our policy.

If you want to add additional nominees, please get in contact with the office.