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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.
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:
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Honolulu |
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Department of Health
Building
Lobby Area (1st floor)
1250 Punchbowl St.
(corner of Beretania and
Punchbowl Streets)
(808) 586-4533 |
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Hilo |
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Governor's Liason Office
75 Aupuni Street
(808) 974-6262 |
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Kailua-Kona |
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Governor's Liason Office
75-5722 Kuakini Highway, Suite 215
(808)
327-4953 |
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Wailuku |
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Governor's Liason Office
2264 Aupuni Street, #1
(808) 243-5796 |
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Lihue |
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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).
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at
Commitment Ceremonies
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