|
A reciprocal beneficiary relationship is a legal relationship created when
two consenting adults who are prohibited from marriage declare their intent
to enter a reciprocal beneficiary relationship. Neither of the parties may be
married or a party to another reciprocal beneficiary relationship. Those persons
desiring to enter into a reciprocal beneficiary relationship must register their
relationship as reciprocal beneficiaries with the Department of Health. All
requirements of the Hawaii Revised Statutes, Chapter 572C must be met.
The Department of Health is responsible only for registering the declaration
of reciprocal beneficiary relationship. The Department of Health neither makes
any determination of the validity of the reciprocal beneficiary relationship
nor is an information source on the rights and benefits extended to reciprocal
beneficiaries.
Either party to a reciprocal beneficiary relationship may terminate the relationship
by filing a signed, notarized declaration of termination of reciprocal beneficiary
relationship with the Department of Health.
The Department of Health is responsible only for recording the declaration
of termination of reciprocal beneficiary relationship. The Department of Health
neither makes any determination of the validity of the termination of reciprocal
beneficiary relationship nor is an information source on the consequences of
the termination to the former reciprocal beneficiaries.
Getting Information on Registering a Reciprocal Beneficiary Relationship
or Filing a Declaration of Termination of Reciprocal Beneficiary Relationship
by Telephone
Information on registering a reciprocal beneficiary relationship or
filing a declaration of termination of reciprocal beneficiary
relationship with the Department of Health may be obtained via the
telephone system, any day or any time, by calling (808) 586-4533.
Contacting this Office by E-mail
To send an e-mail message, click on vr-info@doh.hawaii.gov
now.
Who is Eligible to Enter Into a Reciprocal Beneficiary
Relationship?
In order to enter into a valid reciprocal beneficiary relationship, it
shall be necessary that:
- Each of the parties be at least eighteen years old;
- Neither of the parties be married nor a party to another reciprocal
beneficiary relationship;
- The parties be legally prohibited from marrying one another under HRS
chapter 572;
- Consent of either party to the reciprocal beneficiary relationship has
not been obtained by force, duress, or fraud; and
- Each of the parties sign a declaration of reciprocal beneficiary relationship
as provided in HRS section 572C-5.
How to Register a Reciprocal Beneficiary Relationship
- Prepare and file a Registration of Reciprocal Beneficiary
Relationship form with the Department of Health (Registration forms may
be downloaded from this site -see below).
- The Registration form must be signed by both parties and notarized - contact
your local bank about notary public services.
- A fee of $8.00 (money order or cashier’s check only - made
payable to the State Director of Finance - and no cash or personal
checks will be accepted) must be paid at the time of the filing of the Registration form.
- At least one stamped, self-addressed, legal-sized envelope must be provided along
with the Registration form - two stamped, self-addressed, legal-sized envelopes
must be provided if the two Certificates (see below) are to be sent to two different
addresses.
- The notarized Registration form, payment, and envelope must be sent by postal mail to:
RBR Office
P.O. Box 591
Honolulu, HI 96809-0591
- After being registered, two Certificates of Registration of
Reciprocal Beneficiary Relationship (one for each party) will be sent
by postal mail using the provided stamped, self-addressed, legal-sized
envelope(s).
- Registration will not be accepted and Certificates of Registration
will not be issued on a walk-in basis.
- Copies of the Certificate of Registration are available upon
written request, sent to the same address listed above, at a fee of
$8.00 per copy (payment must be made in the same manner as for the
initial registration), and a stamped, self-addressed, legal-sized
envelope must be provided along with the request and payment.
How to File a Declaration of
Termination of Reciprocal Beneficiary Relationship
- Prepare and file a Declaration of Termination of Reciprocal
Beneficiary Relationship form with the Department of Health
(Declaration of Termination forms may be downloaded from this site -see below).
- The Declaration of Termination form must be signed by either of the parties
and notarized - contact your local bank about notary public services.
- A fee of $8.00 (money order or cashier’s check only - made
payable to the State Director of Finance - and no cash or personal
checks will be accepted) must be paid at the time of the filing of the
Declaration of Termination form.
- At least one stamped, self-addressed, legal-sized envelope must be
provided along with the Declaration of Termination form - two stamped,
self-addressed, legal-sized envelopes must be provided if the two
Certificates (see below) are to be sent to two different addresses.
- The notarized Declaration of Termination form, payment, and
envelope(s) must be sent by postal mail to:
RBR Office
P.O. Box 591
Honolulu, HI 96809-0591
- After filing, two Certificates of Termination of Reciprocal
Beneficiary Relationship (one for each party) will be sent by postal
mail using the provided stamped, self-addressed, legal-sized envelope(s).
- Declarations of Termination will not be accepted and Certificates
of Termination will not be issued on a walk-in basis.
- Copies of the Certificate of Termination of Reciprocal Beneficiary Relationship
are available upon written request, sent to the same address listed above,
at a fee of $8.00 per copy (payment must be made in the same manner as for
the initial registration), and a stamped, self-addressed, legal-sized envelope
must be provided along with the request and payment.
How to Obtain Registration or Declaration of Termination
Forms
Registration and Declaration of Termination forms may be picked up at the
following locations:
| Honolulu |
|
Department of Health Building
Lobby Area (1st floor)
1250 Punchbowl St.
(corner of Beretania and Punchbowl Streets)
(808) 586-4533 |
| |
|
|
| Hilo |
|
Governor's Liason Office
75 Aupuni Street
(808) 974-6262 |
| |
|
|
| Kailua-Kona |
|
Governor's Liason Office
75-5722 Kuakini Highway, Suite 215
(808) 327-4953 |
| |
|
|
| Wailuku |
|
Governor's Liason Office
2264 Aupuni Street, #1
(808) 243-5796 |
| |
|
|
| Lihue |
|
Governor's Liason Office
3060 Eiwa Street, #106
(808) 274-3100 |
Registration and Declaration of Termination
forms for downloading are in Adobe Acrobat portable document format (PDF).
| If you do not have the Adobe Acrobat Reader installed
on your computer, you need to install it before you can view and print
the downloadable PDF files. The Acrobat Reader is free and can be downloaded
to your computer by clicking on the button: |
|
 |
|
