Top Banner Resources

 

Most Requested Forms

 

Select links to download forms (PDFs).

 

Loan Application, Agreement and Promissory Note (Group Retirement Products Only)

Loan Application, Agreement and Promissory Note (Fixed Annuities, Fixed Indexed Annuities, Variable Annuities)

Form Description: Use this form to establish a loan on your retirement account.

 

Non-Financial Change (Group Retirement Products Only)

Non-Financial Change (Fixed Annuities, Fixed Indexed Annuities, Variable Annuities)

Non-Financial Change (New York products Only)

Form Description: Modify or change information regarding: Owner, Joint Owner, Annuitant, Beneficiary and/or address change.

 

Required Minimum Distribution (Group Retirement Products Only)

Required Minimum Distribution (Fixed Annuities, Fixed Indexed Annuities, Variable Annuities)

Required Minimum Distribution (New York Products Only)

Form Description: Use this form to request a Required Minimum Distribution.

 

Scheduled Systematic Withdrawal (Group Retirement Products Only)

Scheduled Systematic Withdrawal (Fixed Annuities, Fixed Indexed Annuities, Variable Annuities)

Scheduled Systematic Withdrawal (New York Products Only)

Form Description: Use this form to establish or change a Scheduled Systematic Withdrawal (SSW).

Forms

 

For help on filling out the forms, please view the instructions.

 

Looking for State Replacement Forms? Click here.

 

For First Security Benefit Life Insurance and Annuity Company of New York annuity products, visit fsbl.com.


Fixed Annuities


Fixed Indexed Annuities


Flexible Spending Forms


Group Retirement Products


NEA & AEA Valuebuilder Retirement Program


Variable Annuities

 

The AdvisorDesigns, AdvanceDesigns®, SecureDesigns and Premier Choice variable annuities for New York are issued by First Security Benefit Life Insurance and Annuity Company of New York (FSBL), New York, NY. Variable annuities issued by Security Benefit Life Insurance Company are generally available in all states except New York. Contact our Service Center for product availability in your state, 800.888.2461.

 

Security Distributors

 

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