Add (or Edit) Claimant

Select the relationship of the claimant to the beneficiary from the drop-down menu. Values include:

• Not Defined
• Estate, Individual Name Provided
• Family Member, Individual Name Provided
• Other, Individual Name Provided
• Estate, Entity Name Provided (e.g., “The Estate of First Last”)
• Family, Entity Name Provided (e.g., “The Family of First Last”)
• Other, Entity Name Provided (e.g., The Trust of First Last)

Claimant’s Tax Identification Number, Employer Identification Number (EIN) or Social Security Number (SSN) of the claimant. 

Enter 9 digits. Enter the unique TIN for each claimant entered.

(Optional)

Provide the Given/First Name of the claimant.

First name may contain only alpha characters and embedded spaces. Middle initial may contain only a letter or space.

Enter the middle initial of the claimant. Optional.

Middle initial may contain only a letter or space.

Provide the Surname/Last Name of the claimant. 

Last Name can be comprised of letters, and embedded spaces, hyphens or apostrophes. 

First and Last Names are required and Middle Initial is optional when a Relationship is reported as one of the following, otherwise leave these fields blank:

• Estate, Individual Name Provided
• Family Member, Individual Name
• Other, Individual Name

If First and Last names are not applicable, provide the claimant’s entity or organization name. 

Required only when a relationship is reported as one of the following, otherwise leave blank: 

• Estate, Entity Name Provided (e.g., “The Estate of First Last”)
• Family, Entity Name Provided (e.g., “The Family of First Last”)
• Other, Entity Name Provided (e.g., The Trust of First Last)

Enter the claimant’s primary mailing street address. 

Leave blank if “Foreign Country” is selected for State.

Enter the phone number and extension (optional) of the claimant. 

Enter only numeric digits for the phone and extension. Leave the entire phone number blank for a Foreign Claimant. 

Select the type of representative from the drop-down menu. Values include: 

• Not Defined
• None
• Attorney
• Guardian/Conservator
• Power of Attorney
• Other

Select None if the claimant does not have a representative and do not complete the rest of the claimant representative information.

Claimant representative’s Tax Identification Number, Employer Identification Number (EIN) or Social Security Number (SSN) of the claimant. Enter 9 digits. 

(Optional)

Provide the Given/First Name of the claimant’s representative. 

First Name may contain only alpha characters and embedded spaces.

Provide the Surname/Last Name of the claimant’s representative. 

Last Name can be comprised of letters, and embedded spaces, hyphens, or apostrophes. Not required if firm name is provided. Both firm name and First and Last Names may be entered.

Required if the claimant has a representative and an organization name is not entered. However, information can be entered in both fields.

Provide the claimant representative’s organization or firm name. 

Alpha numeric characters are allowed. Only required if First, Last Name not provided.

Enter the phone number and extension (optional) of the claimant’s representative. 

Enter only numeric digits for the phone and extension. Leave the entire phone number blank for a foreign claimant representative.