Beneficiary Form

WHITTIER CITY SCHOOL DISTRICT

UNDER GOVERNMENT CODE SECTION 53245

TO: Whittier City School District

In the event of my death, I hereby designate:

as the person entitled to receive all warrants or checks that will be payable to me from the

Whittier City School District. Said person is my,

Husband

Wife

Parent,


Child	Other	Not Related	,and may be identified as follows:

Age:

Occupation:

Last Four of S.S.#

Address:

(Note):

Identification information may be necessary since warrants and checks can only be delivered to your designee after sufficient proof of

identity is supplied.


Date	Employee Signature
	Digital Signature I Agree that ...


School Site	Position

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Government Code Section 53245: Designation of Person to Receive Warrants or checks upon
Death of Employee.

Any person now or hereafter employed by a county, city, municipal corporation, district, or
other public agency may file with his appointing power a designation of a person who,
notwithstanding any other provision of law, shall, on the death of the employee, be entitled to
receive allwarrants or checks that would have been payable to the deceased had he survived.
The employee may change the designation from time to time. A person so designated shall
claim such warrants or checks from the appointing power. On sufficient proof of identity, the
appointing power shall deliver the warrants or checks tothe claimant. A person who receives a
warrant or check pursuant to this section is entitled to negotiate it as if he were the payee

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Form No. 5546 Rev. 6/02