Personal Information

Personal
Information

Employer
Information

Fund
Information

Review

Terms &
Conditions

Confirm

Please review the 403(b) Custodial Agreement before completing your application.

Owner Information

An asterisk ( * ) indicates a required field

Prefix

First Name*

M. Initial

Last Name*

Suffix

Social Security Number* - -

Date of Birth*

Citizenship* U.S. Citizen
U.S. Resident Alien

Accounts are available only to U.S. citizens and U.S. resident aliens.

Address Line 1*

Address Line 2

City*

State*

Zip* -

Telephone (primary)* - -

Telephone (alternate) - -

Email Address*

Designate Your Beneficiary (optional)

- By expanding this section, the following fields with an asterisk (*) are required.

- To skip Beneficiary, collapse this section and select "Continue."

- NOTE: The designation entered here replaces and revokes any prior designation you may already have on file for this plan type.

Prefix

First Name*

M. Initial

Last Name*

Suffix

Date of Birth*

Address Line 1*

Address Line 2

City*

State*

Zip* -

*Spouse Beneficiary: If you live in a community property state and you do not designate your spouse as your sole primary beneficiary, consult your attorney or tax advisory to determine if your spouse must consent in writing to your designation of beneficiary. If your state requires spousal consent, please complete aDesignation of Beneficiary form and mail it to us.*

In the event of my death, pay the balance of my 403(b) as indicated above.

If you live in a community property state and you do not designate your spouse as your sole primary beneficiary, consult your attorney or tax advisor to determine if your spouse must consent in writing to your designation of beneficiary. If your state requires spousal consent, please complete a Designation of Beneficiary form and mail it to us.

If you are not married, death benefits will be paid to the beneficiaries shown in this section.
If you are married, or later become married, and your plan is covered under ERISA, both you and your spouse must consent to alternative beneficiaries by completing a Designation of Beneficiary form and having your spouse's signature notarized in the spousal consent section. Please skip this section and mail us your completed Beneficiary form.
If you are married, or later become married, and your plan is subject to the Qualified Preretirement Survivor Annuity (QPSA) requirements of the Employee Retirement Income Security Act of 1974 (ERISA), both you and your spouse must consent to alternative beneficiaries by completing the Designation of Beneficiary form.
To designate a trust as your beneficiary, you must complete a Designation of Beneficiary form.
American Century Investments will pay benefits only to those beneficiaries living at the time of your death.
You can change your beneficiaries at any time by completing a Designation of Beneficiary form. Your organization may require additional information with your designation of a beneficiary. Please check with your Human Resources office before completing this section.
To designate multiple beneficiaries, complete a Designation of Beneficiary form.

Review and update your designation periodically, especially if there is a change in your family status (marriage, divorce, adoption of children, death of a family member) or if the information for a beneficiary changes. In the event of a divorce, a designation of a former spouse may not be valid unless you re-designate your former spouse by submitting a new beneficiary form after the divorce is final.

American Century Investments respects your privacy. We may use the information you provide to communicate with you and to provide information about our products and services.

Read more about our Privacy & Security Policy.

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Call us at Call 1-800-345-3533