exv4w3



 





Exhibit 4.3




                                                   




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:	 	The above designation was received on
	 	 	                                      , 20                   .
	 
	 	 	 	 	 	 
	                                       Committee
	 	 	 	 	 	 
	CHS Inc.	 	CHS INC.
	5500 Cenex Drive
	 	 	 	 	 	 
	Inver Grove Heights, MN 55007
	 	 	 	 	 	 
	 
	 	 	 	 	 	 
	

	 	By
	 	                                      	 	 
	

	 	 	 	For the Committee	 	 







(After this designation is received, you will be given a copy of it.)