Beneficiary Designation Change Witness Form Summary

Beneficiary Designation Consent Thrift Savings Plan

JACKLYN K BOYCE has requested a change to his or her beneficiary designation(s) on 01-27-2026. For the beneficiary designation(s) to be valid you must witness these changes by 03-26-2026. Please note you should only sign this witness form if you meet the following two requirements: (1) you are at least 21 years of age, and (2) are not named as a primary or contingent beneficiary below. If you sign this witness form and are named as a primary or contingent beneficiary below, your designation as a beneficiary will not be valid and you will not be entitled to receive a death benefit payment under this pending beneficiary designation. Primary Beneficiary

Name Relationship Benefit %

Jaycee Boyce Child 100%

Total 100%

Witness

By signing this form, I certify that I meet the witness requirements noted above. I understand that if I do not meet the second requirement, I forego my designation as a beneficiary on this account via this process. . I voluntarily witness the primary beneficiary designation(s) listed above.

{{Sig_es_:signer1:signature}}

Witness Signature

Jason Phelps

*************@*****.***

[PRIVACY ACT NOTICE. We are authorized to request the information you provide on this form under 5 U.S.C. chapter 84, Federal Employees' Retirement System. We will use this information to identify your TSP account and to process your request. In addition, this information may be shared with other federal agencies for statistical, auditing, or archiving purposes. We may share the information with law enforcement agencies investigating a violation of civil or criminal law, or agencies implementing a statute, rule, or order. It may be shared with congressional offices, private sector audit firms, spouses, former spouses, and beneficiaries, and their attorneys. We may disclose relevant portions of the information to appropriate parties engaged in litigation and for other routine uses as specified in the System of Records Notice (SORN) associated with this information collection, FRTIB-1, Thrift Savings Plan Records, published at 85 FR 53370. You are not required by law to provide this information, but if you do not provide it, we will not be able to process your request.] Jason Phelps (Jan 27, 2026 16:20:50 CST)

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