Fixed Annuity | Variable Annuity | Fixed Index Annuity

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.

  1. Complete this form and any applicable state-required replacement forms.
  2. Please contact the current carrier for any requirements it may have for transferring money to another company.
  3. Upon receiving this material Security Benefit will send an acceptance letter to the carrier.
  4. 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.
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 | Fixed Index Annuity | Variable Annuity

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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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 | Fixed Index Annuity | Variable Annuity

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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Fixed Annuity | Variable Annuity | Fixed Index Annuity

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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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

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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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

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 72. Upon attaining this age, it is your responsibility to request these distributions.

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Fixed Annuity | Variable Annuity | Fixed Index Annuity | Mutual Fund

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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Fixed Annuity | Variable Annuity | Fixed Index Annuity

Surrender Charge Waiver for Annuity Contract

For establishing privileges to withdraw funds from your contract without incurring a surrender charge penalty, such as for Nursing Home stay or a Terminal Illness diagnosis. Must meet requirements outlined on the form and in your contract.

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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 | Mutual Fund

Withdrawal Request for Annuity Contract

Use this form to make a one-time withdrawal from fixed annuities, fixed indexed annuities, variable annuities (excludes Mutual of Omaha or NEA).

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