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KTA Welfare Trust > WELFARE TRUST FUND ENROLLMENT FORM
  • KENMORE TEACHER’S ASSOCIATION

    205 Yorkshire Road
    Tonawanda, NY 14150
    (716) 837-3710   FAX (716) 833-1096

    WELFARE TRUST FUND ENROLLMENT FORM

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  • You may name any person, persons, institution, trust, estate, religious or charitable institution or other entity as your primary or contingent beneficiary (ies). List a person's full name (use proper name, not nickname), address, social security number and relationship to you. If the beneficiary is not related either by blood or marriage, insert the words, "Not Related". If a religious or charitable institution is listed, include the institution's tax identification number.

    Primary Beneficiaries - If more than one primary beneficiary is named, the share of any beneficiary who dies before me shall be divided equally among the surviving primary beneficiaries.

    Contingent Beneficiaries - Should I survive my primary beneficiary or beneficiaries, any benefit payable at my death shall be paid in equal shares, unless otherwise indicated, to the surviving contingent beneficiary or beneficiaries.

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