GE - Billy Blue Communication Design

To collect a small amount of information,
sometimes it is necessary to communicate
a great deal of instructions. This is often true
of forms that ask users to make choices having
legal or financial consequences.
For emphasis, reverse short
instructions from a 2-pica bar.
Vertical type is difficult to read
and generally should be avoided.
Nevertheless, here it provides
more space for responses.
3-pica spaces accommodate
two lines of typewritten text.
Vertical rules at the margin
generally are unnecessary and
should be avoided. Nevertheless,
here they create boxes for the
user's responses.
Examples are shown at a reduced size.
Forms with Extensive Instructions 270.15
To make such forms easy to use,
• provide sufficient space for responses
• separate instructions from response spaces
• format instructions in a narrow column to make
them easy to read
GE Identity Program 270, Forms & Checks GE Identity Website: www.ge.com/identity
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GE Employee Benefits Plans
Beneficiary Designations
General Electric Company
Return to Name
Write your initials in the appropriate
boxes for each beneficiary listed
All GE Benefits
If you initial this block, do not
initial other blocks.
GE Pension Plan
GE Savings & Security Program
Accumulated Securities
GE Savings & Security Program
Insurance
GE Life Insurance Benefits
GE Personal Accident
Insurance Plan
A Plus Life Insurance
Department
Home telephone no.
I hereby revoke any and all previous designations of primary beneficiary(ies)
and contingent beneficiary(ies) applicable to the plan(s)
I have indicated below. In accordance with the provisions of those
GE Employee Benefit Plans I have initiated, I hereby designate below
beneficiary(ies) under said plan(s) in the event of my death.
If more than one beneficiary is named as contingent beneficiary,
amounts payable under the plan(s) shall be paid in equal shares
to the designated beneficiaries who survive me, unless otherwise
provided. If no beneficiary survives me, payment will be made in
accordance with the terms of the applicable plan.
Print or type name of beneficiary
(first, middle, last)
Consent of spouse: (to be completed only if spouse is not designated a 100% primary
beneficiary under GE Savings & Security Program for accumulated securities
or insurance.) I hereby consent to the making of the foregoing election by my spouse.
I understand that, by execution of this consent , I am surrendering my right under the Plan to
receive the full amount or insurance proceeds in my spouse’s account in the event of my
spouse’s death and that I will receive in that event only such amount, if any, as I may be
entitled to by reason of being named a designated beneficiary.
Effective date and signature: Any payment made in good faith to the legal representative
of my estate shall be in full discharge of the liability under the Plan(s) indicated above. All
decisions upon questions of fact which are made in good faith in determining any unnamed
persons which are based on proof by affidavit or other written evidence shall be conclusive.
I reserve the right to change the primary beneficiary or beneficiaries and/or contingent beneficiary
or beneficiaries without their consent. This beneficiary designation revokes and supersedes
any prior beneficiary designation under the Plan(s) indicated or any predecessor plans.
Form no.
For payroll use only
This form must be typewritten
or printed with a ballpoint pen.
Social security no.
Pay no.
Work telephone no.
Salary Hourly Married Single
(P) for primary
or (C) for
contingent
beneficiary
Spouse signature
Notice with respect to GE Pension Plan: If under the terms of
the GE Pension Plan a Pre-retirement Spouse Benefit becomes
payable upon your death to your then surviving spouse, that Benefit
will be paid in lieu of the payments that would otherwise become
payable to your beneficiaries designated on this form unless a valid
waiver of the Pre-retirement Spouse Benefit has been submitted and
consented to by your spouse.
Address of beneficiary Relationship Date of
birth
Witness (plan representative or notary public)
Employee signature (please sign in ink)
Date
Date
Date