_Forms

_Forms 1. Mississippi Department of Public Safety requires the following Death Benefits Trust forms to qualify for payment of benefits under the Law Enforcement Officers and Fire Fighters Death Benefits Trust Fund: a. Beneficiary Designation Form (Form DB-010) - To be completed by "Covered Individuals" as defined by the statute, upon employment or during the Covered Individual’s lifetime, for purposes of naming a beneficiary or beneficiaries for receiving death benefits payments; and, b. Death Benefits Trust Claim Application (Form DB-020) - To be completed by the "Employer", as defined by the statute, and submitted to the Mississippi Department of Public Safety on behalf of a Covered Individual and his/her beneficiaries. c. Funeral and Burial Payment Application (Form DB-030) - To be completed by both the Next of Kin and the Employer and submitted to the Mississippi Department of Public Safety on behalf of a Covered Individual.