Service Forms
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.
DownloadBy MailSecurity Benefit
P.O. Box 750497
Topeka, KS 66675-0497
United StatesOvernight DeliverySecurity Benefit
Mail Zone 497
One Security Benefit Place
Topeka, KS 66636-0001
United StatesBy FaxFor questions or assistance, please call 800.888.2461.
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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Download
Please type or print.
Investment Advisor Authorization Clearline & EliteDesigns
Use this form to establish authority of your investment advisor.
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Please print or type.
DownloadBy MailSecurity Benefit
P.O. Box 750497
Topeka, KS 66675-0497
United StatesOvernight DeliverySecurity Benefit
Mail Zone 497
One Security Benefit Place
Topeka, KS 66636-0001
United StatesBy FaxFor questions or assistance, please call 800.888.2461.
Investment Advisor Authorization for ClearLine Annuity
Use this form to establish authority for your investment advisor.
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-
DownloadBy Mail
Security Benefit
P.O. Box 750497
Topeka, KS 66675-0497
United StatesOvernight DeliverySecurity Benefit
Mail Zone 497
One Security Benefit Place
Topeka, KS 66636-0001
United StatesBy FaxFor questions or assistance, please call 800.888.2461.
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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DownloadBy Mail
Security Benefit
P.O. Box 750497
Topeka, KS 66675-0497
United StatesOvernight DeliverySecurity Benefit
Mail Zone 497
One Security Benefit Place
Topeka, KS 66636-0001
United StatesBy FaxFor questions or assistance, please call 800.888.2461.
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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