DESIGNATION OF BENEFICIARY FORM

FOOD AND AGRICULTURE ORGANIZATION OF THIS FORM IS COMPLETED BY FOLLOWING THE BELOW
THE UNITED NATIONS STEPS:

This declaration does not affect benefits from the UNJSPF which  All fields indicated with asterisks (*) are filled in.
are covered by a UNJSPF form: “Designation of Recipient of a
Residual Settlement and eventual benefits from the Compensation  At least one line of the fields is filled out between 1-4
Fund of the Organization”. Separate forms are to be completed for under Section B.
Group Life Accident and Disability Insurance and FAO Credit
Union.  Percentage share must add up to 100%.
 Section C must be completed by two witnesses.
Section A – Personnel
*Name: *Date of Birth: Index Number1:
Javier Alexander Bonilla Ortiz 22/03/1992 3082423

DECLARATION
I hereby request the Food and Agriculture Organization of the United Nations (FAO) to pay any monies due to me from FAO under the Staff Regulations
and Rules in case of my death to the person(s) indicated below. If applicable, I specifically reserve the right to remove or change any or all beneficiaries
at any time and without the knowledge or consent of those beneficiaries.
NOTE:
1. Your beneficiaries should be natural persons.
2. If any of the beneficiaries should predecease you, a new designation should be submitted. In such circumstances, if a new form is not submitted,
the share of the deceased beneficiary will be divided among the surviving beneficiaries in the ratio of their own shares.
3. Unless otherwise stated below, you agree that:
- if more than one beneficiary is named, the beneficiaries shall receive equal shares;
- if none of the beneficiaries survives you, the proceeds shall be transferred to your estate.
4. If any person named below is a minor, a guardian (legal representative) must be designated and the name and address provided in the
Remarks or Special Instructions in section B below. A new designation should be submitted when the minor beneficiary becomes of age or
change occurs in respect of his/her guardian (legal representative).
5. Where a beneficiary cannot be located by repeated registered mail within one year of the date of your death, their share shall be treated as if
the beneficiary had predeceased you.
6. National laws may impose conditions on the division of estates or nomination of guardians/legal representatives. Your attention is drawn to the
need that any designation be in line with applicable national laws in order to avoid that the person(s) designated by you in this form be called in
national courts to defend their position. Please note that it is your responsibility to keep this form up to date.
Section B – Beneficiaries
*Name of beneficiary *Full postal address, Phone number and *Relationship *Date of Percentage
Email address birth share

Sebastian Bonilla Calle 22 d numero 82 a 65 int 6 Bogota (Colombia),

1 Selexca@hotmail.com, 0057 320 366 22 12 Brother 26/06/2002 100%

Remarks or Special Instructions (Please refer to Staff Rules 302.9.629 and 302.9.121 for payment of Repatriation and Death Grants)

Section C – Witnesses
Please note that it is mandatory for this form to be signed by two witnesses who cannot be beneficiaries.
We, the undersigned, having no interest in this subject matter, directly or indirectly, hereby certify that we are personally acquainted with the person
subscribing thereto and that this instrument was subscribed in our presence and in the presence of each other.
*Name *Signature
of witness (printed) *Full postal address *Date

Calle 22 d numero 82 a 65 int 6 Bogota (Colombia),

* Nancy Ortiz Selexca14@hotmail.com, 0057 320 459 47 91 29/04/2021
1

Calle 22 d numero 82 a 65 int 6 Bogota (Colombia),

29/04/2021
*
2 Lubin Bonilla Selexca@hotmail.com, 0057 320 366 22 12

*
Candidate’s signature: *Date: 29/04/2021

1 Please note that if this is your first assignment with FAO, you do not have an index number. Your index number will be generated once the recruitment process is finalized and your

number will be recorded by HR services.

1. PE 13/1 2. Personnel
ADM:AFH60E (UPDATED JUNE 2018)