Beneficiary Designation Form Instructions

If a member would like to list more than the allotted number of beneficiaries for either the Primary or Secondary Beneficiary sections please click here to print the Beneficiary Designation Form for Death Benefits. Members can print as many copies of the form as they need for the desired number of beneficiaries. Using the same link members can also find detailed instructions on the second page for filling out the Beneficiary Designation Form for Death Benefits.

Members can designate a minor as a beneficiary; however, APRS does not pay benefits to minors, therefore a legal guardian of the minor must be appointed by a court. 

Note: Secondary Beneficiary(ies) listed are only entitled to collect the death benefits if the Primary Beneficiary(ies) are deceased.

Please upload the Beneficiary Designation Form for Death Benefits to the Member Portal if the member chooses not to complete the electronic version. A confirmation will be sent to the member once we receive the completed form. If a member receives a confirmation and has not initiated a change of their beneficiary, please contact the System immediately. Please follow up with the System if you do not receive a confirmation e-mail within 2 business days.

For questions or concerns, please contact the System.

SECTION A: MEMBER INFORMATION