Service Forms

Variable Annuity | Mutual Fund

Salary Reduction Agreement for Annuity Contract

Use this form to set up or change contributions to your account from your paycheck.


Please type or print.

Please check with your employer to verify that this agreement meets your employer’s requirements. You must complete sections 1, 5 and any of the following that apply:

  • Section 2 for 401(k)
  • Section 3 for 403(b)
  • Section 4 for 457
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
For questions or assistance, please call 800.888.2461.