Form TSP-3 

Designation of Beneficiary

October 2013 

Thrift Savings Plan

Use this form to designate a beneficiary or beneficiaries to receive your Thrift Savings Plan (TSP) account after your death. 

If you would like your TSP account to be distributed according to the statutory order of precedence, do not complete this 

form. (See the instructions inside for an explanation of the order of precedence.) This Designation of Beneficiary form 

will stay in effect until you submit another valid Form TSP-3 or you cancel it. The beneficiary designation(s) you provide 

on this form will automatically cancel all previous designations you submitted. Complete this form in accordance with 

the instructions. Do not alter or change any information you provide on the form. Make a copy of this form for your 

records and send the original to the TSP. Do not give this form to your agency or service.

Mail the original to: Thrift Savings Plan

P.O. Box 385021

Birmingham, AL 35238

Or fax to: 1-866-817-5023

If you have questions, call the toll-free ThriftLine at 1-TSP-YOU-FRST (1-877-968-3778) or the TDD at 1-TSP-THRIFT5 

(1-877-847-4385). Outside the U.S. and Canada, please call 404-233-4400 (not toll free).

You will receive a confirmation of your designation once your form is processed. 

For Federal civilian employees, members of the uniformed services, and beneficiary participants
Form TSP-3 (10/2013)

PREVIOUS EDITIONS OBSOLETE

FORM TSP-3, INFORMATION AND INSTRUCTIONS FOR PAGE 1

This form stays in effect until you submit another valid Form TSP-3 

naming other beneficiaries or cancelling all prior designations. It 

does not affect the disposition of any other benefits you may have 

such as a FERS Basic Annuity, a CSRS annuity, or military retired pay. 

Complete this form only if you want payment to be made in a way 

other than the following statutory order of precedence:

1. To your spouse;

2. If none, to your child or children equally, and to descendants 

of deceased children by representation;

3. If none, to your parents equally or to the surviving parent;

4. If none, to the appointed executor or administrator of your 

estate; or

5. If none, to your next of kin who would be entitled to your estate 

under the laws of the state in which you resided at the time 

of your death.

In this order of precedence, a child includes a natural child (even if 

the child was born out of wedlock) and a child adopted by the participant; it does not include a stepchild or a foster child who was not 

adopted. Note: If your natural child was adopted by someone other 

than your spouse, that child is not entitled to a share of your TSP account under the statutory order of precedence. “By representation” 

means that if a child of yours dies before you do, that child’s share 

will be divided equally among his or her children. “Parent” does not 

include a stepparent unless the stepparent adopted you.

Making a valid designation. To name specific beneficiaries to receive 

your TSP account after you die, you must complete this form, and 

it must be received by the TSP on or before the date of your death. 

Only a Form TSP-3 is valid for designating beneficiaries to your TSP 

account(s); a will or court order (i.e., divorce decree) is not valid for 

the disposition of a TSP account. You may, however, designate your 

estate or a trust as a beneficiary on Form TSP-3.

You are responsible for ensuring that each page of your Form 

TSP-3 is properly completed, signed, and witnessed. Do not submit 

an altered form; it may be deemed invalid. If you need to correct or 

change the information you have entered on the form, start over on 

a new form.

Changing or cancelling your Designation of Beneficiary. To cancel a 

Form TSP-3 already on file, follow the instructions for Section II. 

Keep your designation (and your beneficiaries’ addresses) current. It 

is a good idea to review how you have designated your beneficiaries 

from time to time — particularly when your life situation changes 

(e.g., through marriage, divorce, the birth or adoption of a child, or 

the death of a beneficiary).

By law, the TSP must pay your properly designated beneficiary under 

all circumstances. For example, if you designate your spouse as a 

beneficiary of your TSP account, that spouse will be entitled to death 

benefits, even if you are separated or divorced from that spouse or 

have remarried. This is true even if the spouse you designated gave 

up all rights to your TSP account(s). Consequently, if your life situation changes, you may want to file a new Form TSP-3 that changes 

or cancels your current beneficiary designation.

Unless you designate a contingent beneficiary, the share of any primary beneficiary who dies before you do will be distributed proportionally among the surviving designated TSP beneficiaries. If none of 

your designated beneficiaries is alive at the time of your death, the 

order of precedence will be followed.

SECTION I — Participant Information. For this and all sections of 

this form, carefully type or print the requested information inside the 

boxes using black or dark blue ink. 

Check the box that indicates whether you intend your beneficiary(ies) 

to receive funds from your civilian, uniformed services, or beneficiary participant account (i.e., an account inherited by the spouse of 

a deceased TSP participant). If you have a civilian and a uniformed 

services account and want to designate the same beneficiaries and 

shares for both accounts, check both boxes. If you have a civilian 

and/or uniformed services account in addition to a beneficiary participant account, you will need to complete a second Form TSP-3 

to designate beneficiaries for your beneficiary participant account. 

If you have more than one beneficiary participant account, you will 

need to complete a separate TSP-3 form for each beneficiary participant account since every beneficiary participant account has its own 

account number. Note: To avoid the possibility of having your form 

rejected, be sure to provide the correct account number (civilian/

uniformed services or beneficiary participant) and check the correct 

box(es) that corresponds to the account for which you want to designate beneficiaries. 

If you use an Air/Army Post Office (APO) or Fleet Post Office (FPO) 

address, enter your address in the two available address lines (include the unit designation). Enter APO or FPO, as appropriate, in the 

City field. In the State field, enter AE as the state abbreviation for Zip 

Codes beginning with 090-098, AA for Zip Codes beginning with 340, 

and AP for Zip Codes beginning with 962-966. Then enter the appropriate Zip Code. 

If you have a foreign address, check the box to indicate that this is a 

foreign address and enter the address as follows:

First address line: Enter your street address or post office box number, and, if applicable, apartment number.

Second address line: Enter the city or town name, other principal 

subdivision (e.g., province, state, county) and postal code, if known. 

(The postal code may precede the city or town.)

City/State/Zip Code Fields: Enter the entire country name in the City 

field; leave the State and Zip Code fields blank. 

SECTION II — Cancellation. To cancel a Form TSP-3 already on file 

without naming new beneficiaries, check the box in Item 10, sign 

and date the form, and have it witnessed. If you check this box, your 

account will be paid according to the order of precedence described 

earlier. Do not complete this section if you intend to name new beneficiaries in Section IV. Your new designation(s) will automatically 

cancel any previous designation(s) on file with the TSP.

SECTION III — Signatures. Sign and date the form on all pages on the 

same date. Do not ask the individuals you name as beneficiaries of your 

TSP account to witness your Form TSP-3. A person named as a primary 

or contingent beneficiary of your TSP account who is also a witness cannot receive a share of the account. A witness must be age 21 or older.

Incorrect

3 / 6 / 1 9 8 2 / / 3 6

1 9

82

C O R R E C T

Exa

Correct

Foreign address? 

Check here.

City Zip Code

F R A N C E

Street Address Line 2

Street Address or Box Number

Y

0 6 5 7 0 P A R I S

2 0 4 5 R U E R O A L E

–

EXAMPLE OF FOREIGN ADD

State


DESIGNATION OF BENEFICIARY

THRIFT SAVINGS PLAN TSP-3

 FORM TSP-3, Page 1 (10/2013)

PREVIOUS EDITIONS OBSOLETE

Do Not Write Below This Line

*PIIS00228701200000000PII S *

This form is designed to be read by an optical scanner. To ensure that your request is not delayed, carefully type or print the information requested using black or dark blue ink. Leave a space between words, but not between the digits in your account number. Type 

or print legibly inside the boxes. If you print by hand, use simple block letters. Limit your responses to the number of available boxes. 

Do not alter this form or the information you enter. Altered forms may be rejected.

Ii. cancellation — To cancel all previous designations without designating new beneficiaries, check the

 In the event of your death, payment from the TSP will be made according to the order of precedence set by the United States

 Code (5 U.S.C. § 8424(d)). (If cancelling, submit only Page 1.)

10. Check here only to cancel all prior beneficiary designations without naming new beneficiaries (see instructions for 

 additional information and complete Section III).

III. signatures — You and your witnesses must complete this section. This entire form is valid only if this page is w

 by two persons. A witness must be age 21 or older and cannot be a primary or contingent beneficiary of any portion of this TSP 

 account. By signing below, the witnesses affirm that the participant: (a) signed in their presence, or (b) informed them that the 

 signature is the participant’s own signature.

/ /

Date Signed (mm/dd/yyyy)

Witness 2: Signature

Witness 1: Print Full Name

Witness 2: Print Full Name

Participant’s Signature

/ /

Witness 1: Signature Date Signed (mm/dd/yyyy)

/ /

Date Signed (mm/dd/yyyy)

I. participan

This applies to my: Civilian Account Uniformed Services Account Beneficiary Participant Account

1. 

2. 3. 4.

5. 6.

7. 8. 9.

Daytime Phone (Area Code and Number)

–

State

Last Name First Name Middle Name

City Zip Code

Street Address Line 2

Street Address or Box Number (For a foreign address, see Information and Instructions for Page 1.)

/ /

TSP Account Number Date of Birth (mm/dd/yyyy)

Foreign address? 

Check here.

remembe to: •  Enter your full Name and TSP Account Number at the top of ea

 • Provide your signature and your witnesses’ signatures above, along with the dates signed. 

 • Sign and date each page that you submit to the TSP.

• Have the same two witnesses sign and date all pages that you submit to the TSP.

 • Complete each section in accordance with the instructions.

 • Make a copy of this form for your records.

 • Mail the completed form to the TSP. Do not submit this form to your agency or service.
Form TSP-3 (10/2013)

PREVIOUS EDITIONS OBSOLETE

FORM TSP-3, INFORMATION AND INSTRUCTIONS FOR PAGE 2

SECTION IV — Primary Beneficiary Designations. You may name 

any person, a trust, your estate, or a legal entity/corporation as a 

beneficiary. Note: If the beneficiary is a minor child, benefits will be 

made payable directly to the child.

Enter the share for each beneficiary as a whole percentage. Percentages for the primary beneficiaries must total 100%. Do not use 

fractions or decimals.

To name a primary beneficiary:

• Check the box that indicates the beneficiary’s relationship to 

you.

• For each individual you designate, enter the full name, share, 

address, and date of birth or Social Security number (SSN) or 

other tax ID (such as an Employer Identification Number 

(EIN)). If providing a foreign address, see Information and 

Instructions for Page 1.

• If the beneficiary is a trust, check the box marked “Trust.” 

Enter the name of the trust and the trustee’s name and address in the boxes indicated. Enter the EIN, if available. Leave 

the date of birth boxes blank. Note: Filling out this form will 

not create a trust; you must have a trust that is already established.

• If the beneficiary is your estate, check the box marked 

“Estate.” Enter the name of the estate and the executor’s 

name and address in the boxes indicated. Enter the EIN, if 

available. Leave the date of birth boxes blank.

• If the beneficiary is a legal entity or corporation, check the 

box marked “Legal Entity/Corporation.” Enter the name of the 

entity in the boxes indicated. Enter the legal representative’s 

name in the boxes marked “Trustee/Executor,” and provide 

the legal representative’s address. Enter the EIN, if known. 

Leave the date of birth boxes blank.

If you are naming more than 3 primary beneficiaries, photocopy 

Page 2 of this form. Enter your name and TSP account number on 

the top of each page, and follow the instructions for completing Section IV. You must sign and date all additional pages; the same two 

witnesses who signed Page 1 must also sign and date all pages, 

including any extra pages, that you submit to the TSP. 

If you want to designate contingent beneficiaries, complete 

Section V on Page 3.

EXAMPLES  Below are examples of how to designate primar

beneficiaries. 

EXAMPLES OF DESIGNATING PRIMARY BENEFICI

PRIVACY ACT NOTICE. We are authorized to request the information you provide on this form under 5 U.S.C. chapter 84, Federal Employees’ Retirement System. 

We will use this information to identify your TSP account and to process your request. 

In addition, this information may be shared with other Federal agencies for statistical, 

auditing, or archiving purposes. We may share the information with law enforcement 

agencies investigating a violation of civil or criminal law, or agencies implementing 

a statute, rule, or order. It may be shared with congressional offices, private sector 

audit firms, spouses, former spouses, and beneficiaries, and their attorneys. We 

may disclose relevant portions of the information to appropriate parties engaged in 

litigation and for other routine uses as specified in the Federal Register. You are not 

required by law to provide this information, but if you do not provide it, we will not be 

able to process your request.

Relationship to you: Spouse Other Individual Trust Estate Legal Entity/Corporation Share: %

Relationship to you: Spouse Other Individual Trust Estate Legal Entity/Corporation Share: %

3 3

A Z

State

T U C S O N

City

8 5 7 3 5 3 0 0 3

Zip Code

Street Address Line 2

1 0 6 6 C H U R C H I L L L A N E

Street Address or Box Number (For a foreign address, see Information and Instructions for Page 1.)

Foreign address? 

Check here.

1 2 2 2 1 9 8 4 / / Date of Birth (mm/dd/yyyy)

9 2 6 3 5 8 0 7 2

SSN/EIN/Tax ID

Name of Trustee/Executor (if applicable)

G R E E N S T E I N E L E A N O R R U T H

Name of Individual (Last, First, Middle)/Trust/Estate/Legal Entity or Corporation

L A

State

N E W O R L E A N S

City

7 0 1 2 4 1 9 2 0

Zip Code

Street Address Line 2

2 1 N O R T H L A K E W O O D D R I V E

Street Address or Box Number (For a foreign address, see Information and Instructions for Page 1.)

Foreign address? 

Check here.

1 0 1 1 1 9 6 0 / / Date of Birth (mm/dd/yyyy)

9 1 5 9 9 2 1 3 5

SSN/EIN/Tax ID

Name of Trustee/Executor (if applicable)

P A R K E T M O L L Y J A N E

Name of Individual (Last, First, Middle)/Trust/Estate/Legal Entity or Corporation

X

3 3

DESIGNATING MULTIPLE PRIMARY BENEFICIARIES

Relationship to you: Spouse Other Individual Trust Estate Legal Entity/Corporation Share: %

F L

State

M I R A M A R

City

3 3 0 2 8 1 2 3 4

Zip Code

Street Address Line 2

1 5 0 6 A R B O R R O A D

Street Address or Box Number (For a foreign address, see Information and Instructions for Page 1.)

Foreign address? 

Check here.

6 1 3 1 9 9 1 / / Date of Birth (mm/dd/yyyy)

9 0 2 3 7 6 6 3 3

SSN/EIN/Tax ID

Name of Trustee/Executor (if applicable)

A B B O T T H O W A R D K E N N E T H J R

Name of Individual (Last, First, Middle)/Trust/Estate/Legal Entity or Corporation

3 4

X

X

–

–

–

M D

State

B E T H E S D A

City

2 0 8 1 5 0 6 3 7

Zip Code

S U I T E 2 4 0 A

Street Address Line 2

6 4 7 3 0 C O N N E C T I C U T A V E N U E

Street Address or Box Number (For a foreign address, see Information and Instructions for Page 1.)

Foreign address? 

Check here.

Relationship to you: Spouse Other Individual Trust Estate Legal Entity/Corporation Share: % 1 0 0

/ / Date of Birth (mm/dd/yyyy)

7 9 9 9 9 9 9 9 9

SSN/EIN/Tax ID

E L E A N O R J A R V I S

Name of Trustee/Executor (if applicable)

T H E X Y Z F O U N D A T I O N

Name of Individual (Last, First, Middle)/Trust/Estate/Legal Entity or Corporation

N Y

State

N E W Y O R K

City

1 4 6 0 7 8 2 9 5

Zip Code

Street Address Line 2

1 1 1 1 D E L A W A R E L A N E

Street Address or Box Number (For a foreign address, see Information and Instructions for Page 1.)

Foreign address? 

Check here.

/ / Date of Birth (mm/dd/yyyy)

SSN/EIN/Tax ID

E R I C P M A N O

Name of Trustee/Executor (if applicable)

J O H N P M A N O T R U S T

Name of Individual (Last, First, Middle)/Trust/Estate/Legal Entity or Corporation

Relationship to you: Spouse Other Individual Trust Estate Legal Entity/Corporation Share: %

C A

State

A L A M E D A

City

9 4 5 1 0 7 4 8 1

Zip Code

Street Address Line 2

1 5 0 R O S S M O Y N E D R I V E

Street Address or Box Number (For a foreign address, see Information and Instructions for Page 1.)

Foreign address? 

Check here.

/ / Date of Birth (mm/dd/yyyy)

SSN/EIN/Tax ID

M A R L A M C C L A I N

Name of Trustee/Executor (if applicable)

E S T A T E O F R U T H R J O N A H

Name of Individual (Last, First, Middle)/Trust/Estate/Legal Entity or Corporation

Relationship to you: Spouse Other Individual Trust Estate Legal Entity/Corporation Share: %

1 0 0

1 0 0

DESIGNATING A TRUST

DESIGNATING AN ESTATE

X

X

X

DESIGNATING A LEGAL ENTITY/CORPORATION

–

–

–
Do Not Write In This Section FORM TSP-3, Page 2 (10/2013)

PREVIOUS EDITIONS OBSOLETE

TSP Account Number:

(Last, First, Middle)

Name:

City State

-

Zip Code

Street Address Line 2

Street Address or Box Number (For a foreign address, see Information and Instructions for Page 1.)

Foreign address? 

Check here.

/ /

Date of Birth (mm/dd/yyyy)

SSN/EIN/Tax ID

Name of Trustee/Executor (if applicable)

Name of Individual (Last, First, Middle)/Trust/Estate/Legal Entity or Corporation

Relationship to you: Spouse Other Individual Trust Estate Legal Entity/Corporation Share: 

City State

-

Zip Code

Street Address Line 2

Street Address or Box Number (For a foreign address, see Information and Instructions for Page 1.)

Foreign address? 

Check here.

/ /

Date of Birth (mm/dd/yyyy)

SSN/EIN/Tax ID

Name of Trustee/Executor (if applicable)

Name of Individual (Last, First, Middle)/Trust/Estate/Legal Entity or Corporation

Relationship to you: Spouse Other Individual Trust Estate Legal Entity/Corporation Share: 

Check here if naming more than three primary beneficiaries 

(see instructions for submitting additional pages).

Participant’s Signature Date Signed Witness 1: Signature Date Signed

Witness 2: Signature Date Signed

 IV. primary be

To designate more than three primary beneficiaries, make a copy of this page.

Relationship to you: Spouse Other Individual Trust Estate Legal Entity/Corporation Share: 

City State

-

Zip Code

Street Address Line 2

Street Address or Box Number (For a foreign address, see Information and Instructions for Page 1.)

Foreign address? 

Check here.

/ /

Date of Birth (mm/dd/yyyy)

SSN/EIN/Tax ID

Name of Trustee/Executor (if applicable)

Name of Individual (Last, First, Middle)/Trust/Estate/Legal Entity or Corporation
Form TSP-3 (10/2013)

PREVIOUS EDITIONS OBSOLETE

FORM TSP-3, INFORMATION AND INSTRUCTIONS FOR PAGE 3

SECTION V — Contingent Beneficiary Designations. Do not complete this page if you are not naming contingent beneficiaries. You 

may designate one or more contingent beneficiaries for each primary beneficiary you name on Page 2. The contingent beneficiary(ies) 

you name will share the portion of the TSP account that you designated for a specific primary beneficiary who dies before you do. 

For example, Joe Brown is one of your two primary beneficiaries, 

and his share is 30% of your account. If you designate Mary Brown 

and Sue Brown (Joe‘s daughters) as his contingent beneficiaries, 

and each is to get 50%, each would get 50% of Joe‘s portion. Since 

Joe’s share is 30% of your account, each will get 15% of your account. (You cannot designate contingent beneficiaries for contingent 

beneficiaries. In this case, you cannot designate contingent beneficiaries for Mary or Sue Brown.) For another example of this situation, see Example 2 below.

Check the box that indicates the contingent beneficiary’s relationship to you. If you are only naming one contingent beneficiary for a 

primary beneficiary, the share for that contingent beneficiary must 

be 100%. If you name more than one contingent beneficiary for a 

primary beneficiary, the combined share values for those contingent 

beneficiaries must equal 100%. 

Provide the identifying information for contingent beneficiaries according to the instructions for designating primary beneficiaries 

in Section IV. For each contingent beneficiary you designate, enter 

the full name, share, address, and Social Security number (SSN) or 

other tax ID (such as Employer Identification Number (EIN)). If you 

do not have all the requested information, you must provide at least 

the contingent beneficiary’s name and share. You must also provide 

the primary beneficiary’s name and tax ID information (e.g., SSN or 

EIN, if available) or date of birth. 

If you want to name the same contingent beneficiary for multiple 

primary beneficiaries, you should list your contingent beneficiary 

multiple times in order to link it to each primary beneficiary. 

If you are naming more than 3 contingent beneficiaries, photocopy 

Page 3 of this form. Enter your name and TSP account number on 

the top of each page and follow the instructions for completing Section V. You must sign and date all additional pages; the same two 

witnesses who signed Page 1 must also sign and date all pages, 

including any extra pages, that you submit to the TSP. 

Note: If a named beneficiary dies, you may prefer to submit another 

Form TSP-3 to change your designation(s).

EXAMPLES  Below are examples of how to designate contingen

beneficiaries.

EXAMPLES OF DESIGNATING CONTINGENT BENEFICIAR

A Z

State

T U C S O N

City

8 5 7 3 5 3 0 0 3

Zip Code

1 0 6 6 C H U R C H I L L L A N E

Street Address or Box Number (For a foreign address, see Information and Instructions for Page 1.)

Foreign address? 

Check here.

Relationship to you: Spouse Other Individual Trust Estate Legal Entity/Corporation Share: % 1 0 0

3 1 8 2 0 0 3 / / Date of Birth (mm/dd/yyyy)

9 7 4 0 2 3 9 4 1

SSN/EIN/Tax ID

Name of Trustee/Executor (if applicable)

G R E E N S T E I N A M Y J O A N

Name of Contingent: Individual (Last, First, Middle)/Trust/Estate/Legal Entity or Corporation

G R E E N S T E I N E L E A N O R R U T H

Primary Beneficiary’s Name (Last, First, Middle)/Trust/Estate/Legal Entity or Corporation

9 2 6 3 5 8 0 7 2

SSN/EIN/Tax ID or Date of Birth

Contingent to which primary beneficiary? 

EXAMPLE 1

In the above example, if the primary beneficiary, Eleanor Ruth Greenstein, dies 

before you do, Amy Joan Greenstein would receive 100% of her share. Thus, if 

Eleanor’s share is 33% of your account, Amy would receive all of Eleanor’s share.

X

–

C A

State

R O C K L A W N

City

9 4 5 1 0 9 8 7 6

Zip Code

1 4 9 2 M A R I G O L D A V E N U E

Street Address or Box Number (For a foreign address, see Information and Instructions for Page 1.)

Foreign address? 

Check here.

Relationship to you: Spouse Other Individual Trust Estate Legal Entity/Corporation Share: %

5 2 6 1 9 5 5 / / Date of Birth (mm/dd/yyyy)

9 9 9 8 8 7 7 7 7

SSN/EIN/Tax ID

Name of Trustee/Executor (if applicable)

H A L T R I C H A R D A L A N

Name of Contingent: Individual (Last, First, Middle)/Trust/Estate/Legal Entity or Corporation

P A R K E T M O L L Y J A N E

Primary Beneficiary’s Name (Last, First, Middle)/Trust/Estate/Legal Entity or Corporation

9 1 5 9 9 2 1 3 5

SSN/EIN/Tax ID or Date of Birth

Contingent to which primary beneficiary?

5 0

C A

State

R O C K L A W N

City

9 4 5 1 0 9 8 7 7

Zip Code

2 0 0 7 I R I S C O U R T

Street Address or Box Number (For a foreign address, see Information and Instructions for Page 1.)

Foreign address? 

Check here.

Relationship to you: Spouse Other Individual Trust Estate Legal Entity/Corporation Share: % 5 0

1 2 6 1 9 6 2 / / Date of Birth (mm/dd/yyyy)

9 4 2 2 6 7 8 9 2

SSN/EIN/Tax ID

Name of Trustee/Executor (if applicable)

H A L T M E L I S S A E L A I N E

Name of Contingent: Individual (Last, First, Middle)/Trust/Estate/Legal Entity or Corporation

P A R K E T M O L L Y J A N E

Primary Beneficiary’s Name (Last, First, Middle)/Trust/Estate/Legal Entity or Corporation

9 1 5 9 9 2 1 3 5

SSN/EIN/Tax ID or Date of Birth

Contingent to which primary beneficiary?

In the above example, if the primary beneficiary, Molly Jane Parket, dies before 

you do, Richard Alan Halt and Melissa Elaine Halt would each receive 50% of 

her share. In other words, if Molly Jane Parket’s share is 33% of your account 

balance, they would each get 50% of what Molly would have received — not 50% 

of your account.

X

X

EXAMPLE 2

–

–

I L

State

C H I C A G O

City

6 0 6 0 1 1 7 4 8

Zip Code

6 5 4 3 A R K A N S A S D R I V E

Street Address or Box Number (For a foreign address, see Information and Instructions for Page 1.)

Foreign address? 

Check here.

Relationship to you: Spouse Other Individual Trust Estate Legal Entity/Corporation Share: %

1 1 3 0 1 9 8 3 / / Date of Birth (mm/dd/yyyy)

9 7 1 0 8 6 2 3 4

SSN/EIN/Tax ID

Name of Trustee/Executor (if applicable)

R O B S O N J A N I C E M A R I A

Name of Contingent: Individual (Last, First, Middle)/Trust/Estate/Legal Entity or Corporation

J E R O M E W H E E L I S T R U S T

Primary Beneficiary’s Name (Last, First, Middle)/Trust/Estate/Legal Entity or Corporation

Contingent to which primary beneficiary?

1 0 0

In the above example, if the primary beneficiary, the Jerome Wheelis Trust, is 

terminated before your death, Janice Maria Robson would receive the entire share 

that you designated for the Jerome Wheelis Trust.

X

EXAMPLE 4

SSN/EIN/Tax ID or Date of Birth

–

I D

State

B O I S E

City

8 3 7 0 9 2 1 4 3

Zip Code

9 2 O A K S T R E E T

Street Address or Box Number (For a foreign address, see Information and Instructions for Page 1.)

Foreign address? 

Check here.

Relationship to you: Spouse Other Individual Trust Estate Legal Entity/Corporation Share: % 1 0 0

/ / Date of Birth (mm/dd/yyyy)

SSN/EIN/Tax ID

T I M O T H Y R E E L S

Name of Trustee/Executor (if applicable)

E S T A T E O F B E T S Y A L U C A S

Name of Contingent: Individual (Last, First, Middle)/Trust/Estate/Legal Entity or Corporation

Z A C H A R I A S I D N E Y S T E V E N

Primary Beneficiary’s Name (Last, First, Middle)/Trust/Estate/Legal Entity or Corporation

Contingent to which primary beneficiary?

In the above example, if the primary beneficiary, Sidney Steven Zacharia, dies 

before you do, the estate of Betsy A. Lucas would receive 100% of the amount you 

designated for Sidney Steven Zacharia.

X

EXAMPLE 3

9 0 3 2 4 7 6 5 2

SSN/EIN/Tax ID or Date of Birth

–
TSP Account Number:

(Last, First, Middle)

Name:

 FORM TSP-3, Page 3 (10/2013

PREVIOUS EDITIONS OBSOLETE

Do Not Write In This Section

TSP Account Number:

(Last, First, Middle)

Name:

 V. contingent be

To designate more than three contingent beneficiaries, make a copy of this page.

Relationship to you: Spouse Other Individual Trust Estate Legal Entity/Corporation 

Participant’s Signature Date Signed Witness 1: Signature Date Signed

Witness 2: Signature Date Signed

Check here if naming more than three contingent beneficiaries (see instructions for submitting additional pages).

City State

 -

Zip Code

Street Address or Box Number (For a foreign address, see Information and Instructions for Page 1.)

Foreign address? 

Check here.

/ /

Date of Birth (mm/dd/yyyy)

SSN/EIN/Tax ID

Name of Trustee/Executor (if applicable)

Name of Contingent: Individual (Last, First, Middle)/Trust/Estate/Legal Entity or Corporation

Name (Last, First, Middle)/Trust/Estate/Legal Entity or Corporation SSN/EIN/Tax ID or Date of Birth

Contingent to which primary beneficiary?

SHARE of

Primary’s 

Portion:

City State

-

Zip Code

Street Address or Box Number (For a foreign address, see Information and Instructions for Page 1.)

Foreign address? 

Check here.

 Relationship to you: Spouse Other Individual Trust Estate Legal Entity/Corporation 

/ /

Date of Birth (mm/dd/yyyy)

SSN/EIN/Tax ID

Name of Trustee/Executor (if applicable)

Name of Contingent: Individual (Last, First, Middle)/Trust/Estate/Legal Entity or Corporation

Name (Last, First, Middle)/Trust/Estate/Legal Entity or Corporation SSN/EIN/Tax ID or Date of Birth

Contingent to which primary beneficiary?

SHARE of

Primary’s 

Portion:

City State

-

Zip Code

Street Address or Box Number (For a foreign address, see Information and Instructions for Page 1.)

Foreign address? 

Check here.

 Relationship to you: Spouse Other Individual Trust Estate Legal Entity/Corporation 

/ /

Date of Birth (mm/dd/yyyy)

SSN/EIN/Tax ID

Name of Trustee/Executor (if applicable)

Name of Contingent: Individual (Last, First, Middle)/Trust/Estate/Legal Entity or Corporation

Name (Last, First, Middle)/Trust/Estate/Legal Entity or Corporation SSN/EIN/Tax ID or Date of Birth

Contingent to which primary beneficiary?

SHARE of

Primary’s 

Portion:
 FORM TSP-3 (10/2013

PREVIOUS EDITIONS OBSOLETE

Check to make sure that:

 You have provided your name and account number on each page that you 

submit to the TSP.

 You have signed all pages you completed (including any extra pages you may 

have added) on the same date.

 You have had the same two witnesses sign and date all pages—including any 

extra pages—after you have signed and dated the form.

 You have not altered this form or any information you provided on it.

 Your primary beneficiaries’ shares add up to 100%.

 If you named contingent beneficiaries, you named a primary beneficiary for 

each contingent beneficiary.

 If you named contingent beneficiaries, the shares for all contingent 

beneficiaries for each primary beneficiary add up to 100%.

 You have kept a copy of your completed form (and any pages you may 

have added) for your records.

 You have addressed this form to:

 Thrift Savings Plan

 P.O. Box 385021

 Birmingham, AL 3523