Uniform Single or Multiple Party Account Form
Parties (Name one or more parties):
____________________ _____________________
Ownership (Select one and initial):
_____ single party account
_____ multiple party account
Parties own account in proportion to net contributions unless there is clear and convincing evidence of a
different intent.
Rights at death (select one and initial):
_____ single party account
At death of party, ownership passes as part of party's estate.
_____ single party account with POD
(pay on death) designation
(Name of one or more beneficiaries):
_______________________ _________________________
At death of party, ownership passes to POD (pay on death) beneficiaries and is not part of party's estate.
_____ multiple party account with right of survivorship
At death of party, ownership passes to surviving parties.
Multiple party account with right of survivorship and POD (pay on death) designation
(Name one or more beneficiaries):
_________________________ __________________________
At death of last surviving party, ownership passes to POD (pay on death) beneficiaries and is not part of last surviving party's estate.
_____ multiple party account without right of survivorship
At death of party, deceased party's owner ship passes as part of deceased party's estate.
Agency (power of attorney) designation (optional)
Agents may make account transactions for parties but have no ownership or rights at death unless named as POD (pay on death) beneficiaries.
(To add agency designation to account, name one or more agents):
________________________ _________________________
(Select one and initial):
_____ agency designation survives disability or incapacity of parties
_____ agency designation terminates on disability or incapacity of parties
A.R.S. § 14-6204