SPECIAL SERVICES AGREEMENT. Designation of Beneficiary. DECLARATION

Name of Special Service Agreement holder

Duty Station/Country Office

SSA Contract no.

DECLARATION

I hereby request the World Food Programme (WFP) to pay any monies due to me as described in the Special Services Agreement User Guide in case of my death, to the person(s) indicated below.

1. If any of the beneficiaries should predecease me, a new designation should be submitted. If no new designation is submitted, the share of the deceased beneficiary will be divided among the surviving beneficiaries in the ratio of their own share.
2. If any person named below is a minor, a guardian (legal representative) must be designated and the name and address provided.
3. Where a beneficiary cannot be located by repeated registered mail within one year from the date of death of the Special Services Agreement holder, his/her share shall be treated as if the beneficiary had predeceased the Special Services Agreement holder.

Name of beneficiary

Full postal address

Relationship

Date of birth

Percentage share

1.

2.

If child(ren) below 18: Guardian:

SSA holder signature

(WFP Officials’ Name and Title)

(WFP Official’s Signature)

(Date)

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