Designation of Beneficiary

Customer Information

  • OK First Name is required
  • OK Middle Initial is required
  • OK Last Name is required
  • OK Social Security Number is required
  • OK Date of Birth is required
  • OK Email is required
  • OK Cell/Home Phone is required
  • OK Work Phone is required
  • OK Street is required
  • OK City is required
  • OK State is required
  • OK Zip is required

Account Information

  • OK Account Number is required

Beneficiary Information

  • OK First Name is required
  • OK Middle Initial is required
  • OK Last Name is required
  • OK Social Security Number is required
  • OK Date of Birth is required
  • OK Phone Number is required
  • OK Street is required
  • OK City is required
  • OK State is required
  • OK Zip is required
  • OK Relationship is required
  • Optional OK Additional Comments is required

Security Code

  • OK is required

    By clicking submit below, I instruct Washington Savings Bank to add the above beneficiary to my account number listed. This request supersedes all prior requests and only one beneficiary can be designated per account in accordance with Massachusetts law. I am not depending on Washington Savings Bank for legal or estate planning advice. Other requirements may apply. I agree to be bound by the terms and conditions covered in the appropriate Disclosure Statement and Cardholder Agreement.

  • OK Type your name here as your signature is required
  • OK Mother's Maiden name or Account Code is required

    • This document is being secured using SSL encryption provided by your browser. Your information will be encrypted when using this form while in transit between your browser and Washington Savings Bank.