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Most Requested Forms

 

Select links to download forms (PDFs).

 

Loan Application, Agreement and Promissory Note: Use this form to establish a loan on your retirement account for group retirement products.

 

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

 

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

 

Non-Financial Change: Modify or change information regarding: Owner, Joint Owner, Annuitant, Beneficiary and/or address change.

 

Non-Financial Change (Group Retirement Products Only)

 

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

 

Forms:

NEA Valuebuilder® Variable Annuity TSA 403(b)

 

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

 

Form Description
Annuitization For annuitizing your contract, designating Annuity Life and Non-Life options and Secondary Payee information. Select your investment basis, method and frequency of the payout, and tax withholding information.
Asset Reallocation Allows you to automatically transfer funds monthly, quarterly, semi-annually, or annually to maintain a specific percent allocation among your investment options. Must be accompanied by the Fund Investment Options Sheet.
Change Investment Allocations Use this form to modify your existing and/or future investment allocations. Must be accompanied by the Fund Investment Options Sheet.
Dollar Cost Averaging Allows you to periodically exchange contract value from one investment option to one or more other options. You may select the option by which you would like funds transferred as well as select the transfer to occur monthly, quarterly, semi-annually or annually. Must be accompanied by the Fund Investment Options Sheet.
Electronic Bank Information Use this form to activate or update electronic bank deposits/withdrawals.
Fund Investment Options Sheet This form lists the investment line-up for NEA Valuebuilder. It must accompany the Asset Reallocation, Change Investment Allocations, Dollar Cost Averaging, and the Incoming Funds Transfer-Rollover form.
Incoming Funds Transfer Rollover For transferring assets from your Current Carrier to a Security Benefit Annuity Contract. Must be accompanied by the Fund Investment Options Sheet.
Internal Exchange Statement and Agreement For closing an existing NEA or Security Benefit Account and transferring the proceeds to a new NEA Valuebuilder Account. This form must also be completed if your client is establishing a new NEA Valuebuilder Account and they would like to keep their existing NEA or Security Benefit Account as a separate Account.
Loan Application Agreement & Promissory Note For applying for a loan, selecting your repayment frequency, applying to make payments electronically via Electronic Funds Transfer (EFT), or selecting your Loan Disbursement Method. Please read the most commonly asked questions on the last two pages of the form. Note: The loan amount available to you is dependent on your contract value.
NEA Service Form To be completed each time an NEA Valuebuilder representative meets with a customer. It gives the rep and SB the opportunity to obtain comments from customers. It also gives the customer an opportunity to increase their contribution amount.

Non-Financial Change

(Name, Address, Beneficiary, etc.)

For changing the name and/or address of the existing Annuitant/Participant, Owner of the Contract or changing the primary and/or contingent beneficiary(ies).
One-Time Withdrawal To make a one-time withdrawal from your account, please contact your Advisor or our Service Center (800.888.2461) to request a form.
Proof of Death For selecting how to handle proceeds, applying to receive payments electronically via Electronic Funds Transfer (EFT), and selecting Federal income tax options. Note: Every beneficiary is required to complete his or her own form in the case of a death benefit.
Required Minimum Distribution To add or change Required Minimum Distribution options, contact your Advisor or our Service Center (800.888.2461) to request a form.
Salary Reduction Agreement For the purchase of a 403(b) Annuity Contract (through Salary Reduction) to provide retirement benefits for the employee.
Scheduled Systematic Withdrawal To add or change Scheduled Systematic Withdrawal options, contact your Advisor or our Service Center (800.888.2461) to request a form.
Surrender Charge Waiver For establishing privileges to withdraw funds from your contract without incurring a surrender penalty. Must meet requirements outlined on the form. This form must accompany any withdrawal form requested under the Hospital/Nursing Home, Disability or Terminal Illness Waiver Option.

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