exv10w19






Exhibit 10.19




	 	 	 
	 

	 	 
	 

	 	Print or Type Employee’s Name










BENEFICIARY DESIGNATION







CHS INC.

DEFERRED COMPENSATION PLAN





	1.	 	I,                                          (please print name), hereby designate my death
Beneficiary or Beneficiaries under the Plan, as follows:






	 	A.	 	Primary Beneficiary or Beneficiaries. All of my death benefit shall be paid in
equal shares (unless otherwise specified)* to such of the following persons as survive
me:





	 	 	 	 	 	 	 	 	 
	Name** and Address of Person(s) Designated	 	Social Security Account Number	 	 	Relationship to Me	 
	 
	 	 	 	 	 	 	 	 






	 	B.	 	Alternative Beneficiary or Beneficiaries. If none of the persons named in Part A
above survives me, all of my death benefit shall be paid in equal shares (unless
otherwise specified)* to such of the following persons as survive me:





	 	 	 	 	 	 	 	 	 
	Name** and Address of Person(s) Designated	 	Social Security Account Number	 	 	Relationship to Me	 
	 
	 	 	 	 	 	 	 	 







 




			
	*	 	NOTE: If no person qualifies for a particular fractional share, that share
shall be distributed pro rata among the fractional shares for which one or more persons
do qualify.
	 
	**	 	NOTE: A married woman must be designated by her given name and not by her
husband=s name. EXAMPLE: Mary Doe not Mrs. John Doe.






	2.	 	If I have used any of the following terms on this form and I have not otherwise specifically
defined that term, the term shall have the following meaning: “issue” means all persons who
are lineal descendants of the person whose issue are referred to, including legally adopted
descendants and their descendants; “child” means an issue of the first generation;
“per stirpes” means in equal shares among living children of the person whose issue are
referred to and the issue (taken collectively) of each deceased child of such person, with
such issue taking by right of representation of such deceased child; and “survive” means
living after my death; provided, however, that if there is not sufficient evidence that a
Beneficiary was living after my death, it
shall be deemed that the Beneficiary was not living after my death. Unless I have otherwise






 









 









	 	 	specified in this designation, if a Beneficiary survives me but dies before receipt of all
payments due him or her under the Plan, such remaining payments shall be payable to his or her
estate and not to any other Beneficiary.
	 
	3.	 	If I designate as a Beneficiary the person who is my spouse on the date of this designation
either by name or by relationship, or both, the dissolution, annulment or other legal
termination of my marriage to such person shall revoke such designation and this form shall be
interpreted as if such person did not survive me. If I designate any other Beneficiary both
by name and by relationship to me, the description of the relationship is for identification
purposes only and the designation of the Beneficiary by name will be given effect without
regard to whether the relationship exists now or at my death. Any designation of a
Beneficiary only by statement of relationship to me shall be effective only to designate the
person or persons having such relationship to me at my death.
	 
	4.	 	Any previous Beneficiary designation made by me is hereby revoked. I reserve the power to
change this designation at any time by a form similar to this both signed by me and received
by you prior to my death.
	 
	5.	 	This Beneficiary designation shall be effective only if it is both signed by me and received
by you prior to my death.





	 	 	 	 	 
	Date:                                         , 20     
	 	Signature:	 	 
	 
	 	 	 
	 
	 	 	 	 
	 
	 	Address:	 	 
	 
	 	 	 
	 
	 	 	 	 
	Social Security Number:      -     -     
	 	 	 	 
	 	 	 





 





Please deliver this form to:




CHS Benefits Department MS480

CHS Inc.

5500 Cenex Drive

Inver Grove Heights, MN 55077






The above designation was received on 

                    , 20     .




CHS INC.




	 	 	 
	By
	 	 
	 

	 	 
	 

	 	For the Committee