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 One Or More Beneficiaries): ......................
At death of party, ownership passes to POD 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 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 ownership 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 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
Neb. Rev. Stat. §§ 30-2719