City of Jacksonville

Beneficiary Forms

Are Your Beneficiaries Current?

When was the last time you checked your beneficiary designation?
Most employees and retirees have several benefit plans that require a beneficiary; Life Insurance Plans, Empower Accounts and your Pension Retirement all require beneficiaries. Beneficiaries take precendence over wills and trusts in mose cases, making it extremely important that they are always kept current. 

To update your beneficiaries with Empower or the Pension office please contact them directly. 

Empower Retirement  - (904) 255 -5569
General Pension - (904) 255 - 7280
Police and Fire Pension Fund - (904) 255 - 7373

To update your beneficiary for the city Life Insurance plans, please click to download and print the beneficiary form below based on your work status.

Please Note: MUST be NOTARIZED. Beneficiary forms received by mail that are NOT notarized will be returned to sender.

Full Time Employee
Full Time Employee under BU 11
Part Time Employee
Public Safety Officers
Retiree Beneficiary Fom
Former Elected Officials