Service Forms
Internal Exchange Statement and Agreement for Annuity Contract
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.
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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.
Large Case Review Questions
Use this form for cases over a million dollars.
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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.
Lifetime Income Election for Annuity Contract
The contract owner must complete the applicable sections of this form to begin receiving payments under the Income Rider of his/her contract.
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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.
Non-Financial Change for Annuity Contract
For changing the name and/or address of the existing Annuitant/Participant, Beneficiary(ies), Owner, or Joint Owner of the Contract.
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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.
Non-Resident Information for Annuity Contract
Use this form whenever an applicant applies for an annuity in a state that is not his/her resident state.
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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.
Proof of Death for Annuity Contract
This form is to be completed in order to claim proceeds payable upon death. A separate Proof of Death form should be completed and signed by each beneficiary.
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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.
Proposed Contract Review for Annuity Contract
This form allows a preliminary review for suitability and in no way eliminates the required suitability paperwork.
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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.
Required Minimum Distribution (RMD) for Annuity Contract
The Internal Revenue Service ("IRS") requires individuals to begin receiving a Required Minimum Distribution ("RMD") from qualified accounts(s) at 73. Upon attaining this age, it is your responsibility to request these distributions.
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Scheduled Systematic Withdrawal Request for Annuity Contract
Use this form to establish a Scheduled Systematic Withdrawal (SSW) from fixed annuities, fixed index annuities, and variable annuities (excludes Mutual of Omaha or NEA).
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