Service Forms

Fixed Index Annuity

Account Value Reallocation Request for ClearLine Annuity

Use this form to allocate Account Value among the Fixed Account and Index Accounts.

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If you would like to make changes to your allocations, this form must be received within 10 days after your Contract Anniversary date for the changes to take effect. Please type or print.

By Mail

Security Benefit
P.O. Box 750497
Topeka, KS 66675-0497
United States

Overnight Delivery

Security Benefit
Mail Zone 497
One Security Benefit Place
Topeka, KS 66636-0001
United States

By Fax
Download
For questions or assistance, please call 800.888.2461.
Fixed Index Annuity

Income Election Form for ClearLine Annuity

This form is used to request Annual Income payments under the Rising Income Rider of your Contract.
Refer to the Guide to Understanding the Income Election Form for additional details.

Note the following:

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Please type or print.

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Fixed Index Annuity | Variable Annuity

Investment Advisor Authorization Clearline & EliteDesigns

Use this form to establish authority of your investment advisor.

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Please print or type.

By Mail

Security Benefit
P.O. Box 750497
Topeka, KS 66675-0497
United States

Overnight Delivery

Security Benefit
Mail Zone 497
One Security Benefit Place
Topeka, KS 66636-0001
United States

By Fax
Download
For questions or assistance, please call 800.888.2461.
Fixed Index Annuity

Investment Advisor Authorization for ClearLine Annuity

Use this form to establish authority for your investment advisor.

Download
By Mail

Security Benefit
P.O. Box 750497
Topeka, KS 66675-0497
United States

Overnight Delivery

Security Benefit
Mail Zone 497
One Security Benefit Place
Topeka, KS 66636-0001
United States

By Fax
Download
For questions or assistance, please call 800.888.2461.
Fixed Index Annuity | Mutual Fund | Fixed Annuity | Variable Annuity | Other | VUL / SEB

Per Stirpes Designation

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

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By Mail

Security Benefit
P.O. Box 750497
Topeka, KS 66675-0497
United States

Overnight Delivery

Security Benefit
Mail Zone 497
One Security Benefit Place
Topeka, KS 66636-0001
United States

By Fax
Download
For questions or assistance, please call 800.888.2461.
Fixed Annuity | Variable Annuity | Fixed Index Annuity

Stretch Systematic Withdrawal

Use this form to establish the Scheduled Systematic Withdrawal (SSW) from your account, as required by the Internal
Revenue Service for beneficiary accounts.

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