This government document is issued by Peace Officers' Annuity & Benefit Fund for use in Georgia
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https://www.google.com/url?client=internal-element-cse&cx=450907bf5042c4844&q=https://poab.georgia.gov/document/member-form/beneficiary-death-benefits-designation-form/download&sa=U&ved=2ahUKEwio6JaNy4qHAxVr6wIHHdH5A4o4KBAWegQIBxAB&usg=AOvVaw2-0AIr3eGA_hdJY-uSUV4L&fexp=72519171,72519168