Service Forms

This form can be used to accomplish a FULL or a PARTIAL Exchange of policies pursuant to Internal Revenue Code (IRC) Section 1035.

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.

Use this form to request a one-time withdrawal from your annuity account. Further, this form should be used when proceeds from a Non-Qualified contract are being used to fund a Brokerage account.

Use this form to assign a Non-Qualified Contract/Policy (the "Contract") as collateral.

For transferring assets internally from one Security Benefit Contract type to another Security Benefit product. For example, transfer assets from your 403(b) TSA to your 401(k) Account. Please read Transfer Procedures carefully.

This form gives the authority set forth in section 3 to another person ("attorney in fact") to act on your behalf for the Contract/Account Number identified below.

For changing the name and/or address of the existing Annuitant/Participant, Beneficiary(ies), Owner, or Joint Owner of the Contract.

This form is to be completed when an applicant wishes to identify a beneficiary with a per stirpes designation.

Use this form to transfer funds internally from an existing RateTrack^® contract to another contract/account. This form and accompanying application can be submitted within 30 days of contract anniversary.

Use this form to select the new guarantee period for reallocations.