Capital Credits Beneficiary Designation Form You may name a beneficiary to receive your capital credits upon your death. If you complete the Capital Credits Beneficiary form, we will keep the information on file. Upon your death, the beneficiary you have named on the form may claim the capital credits in your account. Having this form on file with SMECO will simplify the process of claiming capital credits for your loved ones during a sad and stressful time. By naming your beneficiary, capital credit funds will not be tied up with your estate; they will be paid directly to your beneficiary. Please complete the form below, and make a copy of the information and include it with your important papers. For more information, please call SMECO at (888) 440-3311 to speak with a customer care representative, or visit our Capital Credits page. Residential members: Please submit only 1 form, even if you have more than 1 account. Commercial accounts, charitable organizations, trusts, or businesses cannot name a beneficiary, and they cannot be designated as a beneficiary. SMECO must receive the Beneficiary Designation Form at least 30 days before the member’s death SMECO may require additional documentation in order to process the member’s final Capital Credit refund SMECO Member’s InformationMember's Name(Required) First Last Are you a current SMECO member?(Required) Yes No Account Number(Required) Last 4 Digits of Member's Social Security Number(Required) Phone(Required)SMECO Service Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Mailing Address(Required) Same as Service Address Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Email(Required) Primary Beneficiary Beneficiaries must be a natural person over the age of 18 as of today’s date Beneficiaries may not be a business, trust, foundation, or other organization The spouse of the member may be named as a primary beneficiary We recommend that you designate a primary beneficiary and a secondary beneficiary If both beneficiaries are deceased at the time of your death, your capital credit funds will go to your estate Beneficiary Name(Required) First Last Phone(Required)Date of Birth (mm/dd/yyyy)(Required) MM slash DD slash YYYY Last 4 Digits of Social Security Number(Required) Mailing Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Email Would You Like to Name a Secondary Beneficiary?(Required)(The secondary beneficiary will only receive funds if the primary beneficiary named is deceased.) Yes No Secondary BeneficiaryName First Last PhoneDate of Birth (mm/dd/yyyy) Month Day Year Last 4 Digits of Social Security Number Mailing Address Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Email SignatureElectronic Signature (type your name)(Required)
