Service Forms

Please type or print in black ink. Complete the entire form and please note the following:

• Electronic Bank Deposit – Funds can be sent from your Security Benefit account to your bank account and arrive within 3 business days after the withdrawal.
• Electronic Bank Withdrawals – Funds can only be drafted from your bank account to be deposited as a contribution into a Roth IRA or Traditional IRA. You may also request funds to be withdrawn to make loan payments. Loan payments must be for an amount equal to your scheduled loan payment. Deposits to your Security Benefit account will be allocated according to the future allocations on file. Additional deposits must meet specified product minimums.

Please type or print in black ink. A separate Proof of Death form should be completed and signed by each beneficiary.

Although the Company reserves the right to require or obtain further information, the following is required:

1. Proof of Death Form
    
2. Death Certificate
    
3. Consular Report of Death of a U.S. Citizen Abroad (if the deceased died in a foreign country)
    
4. Notice of Name Change