Fillable form sglv 8286 prudential insurance servicemembers. All entries except the signature and those requested to be in the servicemembers own handwriting, must be typed or printed in ink. This form replaces any prior beneficiary or payment instructions. Family coverage election servicemember s information last name first name middle name suffix jr. Please read the instructions before completing this form. Sgli is a lowcost term insurance for members of the uniformed services. All contracting cadets need to read this thoroughly pdf fillable dd form 93 record of emergency data pdf fillable dd form 2351dodmerb medical examination form pdf fillable dd form 2492 dodmerb medical history form pdf fillable sglv 8286 soldiers group life insurance form pdf fillable. Servicemembers group life insurance election and certificate use this form to. The way to complete the online sglv 8283 form on the internet. Effective 52012 sglv 8286 page 2 of 4 i have read the instructions and understand that.
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Sglv 8286 veterans benefits administration veterans affairs. Members should be encouraged to name a specific beneficiary. Servicemembers group life insurance sgli the official. The amount of the service members sgli coverage should be verified to make sure the amount requested for the spouse does not exceed that of the service member. They include the benefits and obligations of all contracted. If the beneficiary is a married woman, use named beneficiary will. If a member does not want to designate a specific beneficiary but prefers the proceeds to be paid in the order of precedence, the member should enter by law. Servicemembers group life insurance sgli veterans affairs. Enter your official identification and contact details. Sgli is a group life insurance policy purchased by va from a commercial life. Forms college of arts and sciences santa clara university. Military pay inprocessing packet checklist of required documents for military pay.
Sgli8714, application for veterans group life insurance. Va form sglv 8285, request for insurance sgli completed va form sglv 8286, service members group life insurance completed va form sglv 8285a, request for family coverage sgli completed va form sglv 8286a, family coverage election sgli completed eligibility for overseas deployment ar 61430, overseas service verified. Report of death of a family member, this form is used by military. Directions to personnel clerks of the uniformed services for. Sglv 8286, servicemembers group life insurance election and certificate author. Servicemembers group life insurance election and certi. This form is used by military personnel and department of defense civilian and contractor personnel, collectively referred to. Spouse coverage is granted under the servicemembers group life insurance provisions of title 38, united states code, and is subject to this law and the regulations pertaining to this law. This form is used by military personnel and department of defense civilian and contractor personnel, collectively referred to as civilians, when applicable. Use this stepbystep guideline to fill out the sglv 8283 form quickly and with excellent accuracy. Sglv 8286 soldier s group life insurance form pdf fillable 2015 w4 form employee withholding allowance certificate pdf fillable da form 4824 simultaneous membership program agreement for. Updating the sglv 8286 service members should update their sglv 8286 whenever a change in a beneficiary status changes. If you do not name beneficiaries above, your insurance will be paid by law.
Sglv 8286, servicemembers group life insurance election. However, your spouse will be notified if you reduce coverage or name a beneficiary other than your spouse. All appropriate items on this form must be completed. Servicemembers group life insurance election and certificate beneficiary continuation. Sglv 8286 soldiers group life insurance form pdffillable. Certain situations, such as those listed in paragraph 3, may require the use of the sglv 8286. Dd 93 record of emergency data pdf fillable sglv 8286 soldiers group life insurance form. All entries except the signature and those requested to be in the servicemembers own handwriting must be typed or printed in ink. This form cancels any prior beneficiary or payment instructions.
If this form is being used to decline sgli coverage, inform the service member that this action will mean that heshe will no longer have. Spousal family sgli coverage, you should take action to discontinue payment of spousal family sgli premiums. Periods of coverage coverage for spouses began on november 1, 2001, for service members insured under sgli who were married as of that date. If canceling sgli have the service member complete sglv 8286a to end payment of family sgli premiums.
The following documents are for informational purposes only. Sglv 8286, servicemembers group life insurance election and certificate. If you are unable to find your form here, you may want to visit. Sailors who require an emergent change in coverage, or beneficiaries who cannot immediately access soes may elect to fill out a paper copy of the sglv 8286, which should be witnessed, signed, and submitted to the ompf. Servicemembers group life insurance sgli is granted under title 38, united states code, and is subject to the provisions of that title and its amendments, and title 38 code of federal regulations. Start a free trial now to save yourself time and money. Payment is made to the principal beneficiary ies listed on the sglv form 8286 servicemembers group life. You may name anyone as beneficiary without hisher consent. Servicemembers group life insurance sgli is the life insurance currently available to all members of the uniformed services. If you are in any uniformed service, except the public health service, and have fulltime sgli coverage you no longer need to use the sglv 8286a to make family sgli elections. Servicemembers group life insurance election and certificate office of servicemembers group life insurance 1.
The way to complete the online sglv 8286 form on the internet. About your coverage this form replaces all prior designations. Servicemembers group life insurance sgli is granted under title 38, united states code, and is subject to the provisions of that title. If you reduce or cancel sgli on the first day of duty, your election will be effective immediately. Va form 21p535, may 2018 important if you are certifying that you are married for the purpose of va benefits, your marriage must be recognized by the place where you andor your spouse resided at the time of marriage, or where you andor your spouse resided when you filed your claim or a. The advanced tools of the editor will direct you through the editable pdf template.
Vgli is lifetime renewable postseparation coverage available to. Application instructions for veterans group life insurance vgli to apply for vgli, complete the attached application and return it with your first premium payment to the office of servicemembers group. The most secure digital platform to get legally binding, electronically signed documents in just a few seconds. Sglv 8286 fillable fill online, printable, fillable. Servicemembers group life insurance election and certificate. However, eligible service members should complete and file form sglv 8286, service members group life insurance election and certificate, to designate a beneficiary or beneficiaries to receive the. Browse 24 prudential life insurance forms and templates collected for any of your needs. Veterans mortgage life insurance statement fillable file type.
Sglv 8286, family coverage election and certificate. Sglv form 8286 servicemembers group life insurance election. These contracts will be prepared by the rotc office, however the information will be the same. Servicemembers group life insurance, or sgli, is a program of low cost group life insurance for service members on active duty, ready reservists, members of the national guard, members of the commissioned corps of the national oceanic and atmospheric administration and the public health service, cadets and midshipmen of the four service. Have the member sign sglv 8286 to certify that heshe understands that heshe is free to name anyone as beneficiary. If this page is completed it should be copied and distributed together with page 2 of this form. For military personnel, it is used to designate beneficiaries for.
Sign, fax and printable from pc, ipad, tablet or mobile. Request for dd 214 or other military records nara sf 180. All entries except the signature and those requested to be in the service members own handwriting, must be typed or printed in ink. After thousands of years, we have finally perfected the art of the. All contracting cadets need to read this thoroughly pdf fillable dd form 93 record of emergency data pdf fillable dd form 2351 dodmerb medical examination form pdf fillable dd form 2492 dodmerb medical history form pdf fillable sglv 8286 soldiers group life insurance form pdf fillable. About you print name first, middle, last rank, title or grade. Servicemembers group life insurance sgli sgli provides lowcost term life insurance coverage to eligible service members such as active duty, ready reserve, or national guard members. Member information in addition to the beneficiaries i have named on page 2 of this form sglv 8286 i also designate the following beneficiary ies to receive payment of my insurance proceeds. Department of veterans affairs form sglv 8286 author. Sign, fax and printable from pc, ipad, tablet or mobile with pdffiller instantly. Check the box and complete supplemental sgli beneficiary form, sglv 8286s. Servicemembers group life insurance, or sgli, is a program of low cost group. All contracting cadets need to read this thoroughly pdf fillable.
If you qualify for sgli, you are automatically enrolled and issued the maximum sgli coverage. Sign, fax and printable from pc, ipad, tablet or mobile with pdffiller instantly no software. Sglv 8286, servicemembers group life insurance election and. Sglv 8286a pdf 28 sep servicemembers group life insurance sgli forms sglv a family coverage election sgli. Application instructions for veterans group life insurance vgli to apply for vgli, complete the attached application and return it with your first premium payment to.
To apply, fill out the sgli disability extension application sglv 8715 and send it to the osgli address listed on the application. If the beneficiary is a married woman, use her given first and middle names. Dd 93 record of emergency data pdf fillable sglv 8286 soldier s group life insurance form pdf fillable contracting forms. Fill out, securely sign, print or email your sglv 8286 fillable 20072019 form instantly with signnow. Direct deposit enrollment or change this form is for. Include the name, address, and social security number if available of the beneficiaryies, and the. Sglv 8286 8286 servicemembers group life insurance election and certificate sgli election and certificate reduce sgli coverage increase.
Video instructions and help with filling out and completing sglv a fillable. If the member wants to decline coverage or take a lesser amount of spouse. The form is in pdf format, readable with the adobe reader version. The amount of the service members sgli coverage should be verified to make sure the. Sglv 8286 form fill out and sign printable pdf template.
Rotc forms california state university, northridge. Include the name, address, and social security number if available of the beneficiaryies. Related to sglv 8286 fillable pdf dd form 93 if other than natural father is listed indicate relationship. Sglv 8286 soldiers group life insurance form pdf fillable 2015 w4 form employee withholding allowance certificate pdf fillable da form 4824 simultaneous membership program agreement for army reservists. Please do not send any of the forms or copies to the office of servicemembers group life insurance or to the department of veterans affairs. A new sglv 8286 must be completed to change your beneficiary. If you are in any uniformed service, except the public health service, and have fulltime sgli coverage you no longer need to use the sglv 8286 to make sgli elections.
Use this stepbystep instruction to fill out the sglv 8600 form quickly and with ideal accuracy. A representative of the uniformed services must sign his or her name. The way to complete the online sglv 8600 on the internet. Sglv 8286 fillable 2012 form check the box and complete supplemental sgli beneficiary form, sglv 8286s. Servicemembers group life insurance sgli offers lowcost term coverage to eligible service members. This is a continuation of my beneficiary designation on page 2 of this form, servicemembers group life insurance election and certificate.
Pdf sglv 8286 soldiers group life insurance form pdf w4 employee withholding allowance certificate pdf. Directions to personnel clerks of the uniformed services 1. Complete this section only if you are restoring or increasing coverage. To reduce or cancel your sgli, you must complete and file a form sglv 8286 service members group life insurance election and certificate.
Fillable army sgli fill online, printable, fillable, blank pdffiller. Sglv 8283 form fill out and sign printable pdf template. View, download and print fillable sglv 8286 prudential insurance servicemembers group life insurance election and certificate in pdf format online. Directions to personnel clerks of the uniformed services for sgli family coverage election and certificate 1. Sglv 8600 fill out and sign printable pdf template signnow. Sglv 8286 page 2 of 4 i have read the instructions and understand that. Directions to personnel clerks of the uniformed services. All contracting cadets need to read this thoroughly pdf fillable dd form 93 record of emergency data pdf fillable dd form 2351dodmerb medical examination form pdf fillable dd form 2492 dodmerb medical history form pdf fillable sglv 8286 soldier s group life insurance form pdf fillable. Sglv 8286a fillable sglv 8286a july 2006 fill online. Sglv a fillable fill online, printable, fillable, blank pdffiller. Fill sglv 8286 fillable, download blank or editable online.
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