Service Forms
Asset Reallocation for SecureDesigns® Variable Annuity
Use this form to automatically transfer account values to maintain a specific percentage allocation among your current and future investment options.
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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.
1035 EXCHANGE / ROLLOVER / TRANSFER eFORM
This form can be used to accomplish a FULL or a PARTIAL Exchange of policies pursuant to Internal Revenue Code (IRC) Section 1035.
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Complete the entire form. Please type or print.
- Complete this form and any applicable state-required replacement forms.
- Please contact the current carrier for any requirements it may have for transferring money to another company.
- Upon receiving this material Security Benefit will send an acceptance letter to the carrier.
- If you are completing this form for a 403(b) or 403(b)(7) account/contract please contact your employer for any processing instructions the employer or third party administrator may require.
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.
Annuitization for Annuity Contract
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.
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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.
Annuity Contract Withdrawal Request
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.
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Change Investment Allocation for SecureDesigns® Variable Annuity
Use this form to modify your existing and/or future investment allocations. This includes a one time re-balance and/or a transfer of Contract Value between investment options.
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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.
Collateral Assignment for Annuity Contract
Use this form to assign a Non-Qualified Contract/Policy (the "Contract") as collateral.
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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.
Dollar Cost Averaging for SecureDesigns® Variable Annuity
Use this form to request periodic exchanges from one investment option to one or more investment options.
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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.
Electronic Authorization for Annuity Contract
Use this form to activate electronic services. Transactions may be requested via telephone, Internet, or other electronic means by the Owner and/or Financial Advisor based on instructions of the Owner.
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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.
Electronic Bank Information for Annuity Contract
For establishing the privilege to have payments made from your Security Benefit Contract directly to your Bank Account. This form works similar to the Electronic Funds Transfer form, it enables you to transfer funds electronically.
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For transferring assets from your Current Carrier to a Security Benefit Annuity Contract.
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.
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.
- Download
-
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.