Beneficiary Designation : of Life Insurance Policy or Pension Plan (IRA, or other Retirement plans):

You can furnish the following (or other appropriate language) to your insurance company or your retirement plan administrator. Ask them to provide you with the form needed.

“I hereby designate the Janaka Foundation, 14618 Tyler Foote Rd., #242, Nevada City, California as recipient of $ __________ (or _________ %) of the proceeds of my [insurance policy or retirement plan].

Janaka Foundation Tax ID number: 94-3400189