Page 14 - American Century Retirement Plan Enrollment Guide

Attach an extra page (following the format below) if you want to designate more than two primary or secondary beneficiaries.
6Your Beneficiaries Primary Beneficiary #1
Designated Percentage %
Relationship
Address
City
Primary Beneficiary #2
Designated Percentage %
Relationship
Address
City
Name/Trust
// --
Date of Birth (mm/dd/yyyy)
Social Security Number
State Zip
Name/Trust
// -- Date of Birth (mm/dd/yyyy) Social Security Number
State Zip
Secondary Beneficiary #1 (to receive your account if all primary beneficiaries are deceased) Designated Percentage %
Name/Trust
// --
Relationship
Address
City
Date of Birth (mm/dd/yyyy)
Social Security Number
State Zip
Secondary Beneficiary #2 (to receive your account if all primary beneficiaries are deceased) Designated Percentage %
Name/Trust
Relationship
Address
City
// -- Date of Birth (mm/dd/yyyy) Social Security Number
State Zip
Return this form to: Benefits Department American Century Investments
P.O. 410141
Kansas City, MO 64179-0355
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