Service Forms
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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Limited Power of Attorney for Annuity Contract
This form gives the authority set forth in section 3 to another person ("attorney in fact") to act on your behalf for the Contract/Account Number identified below.
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Limited Power of Attorney for Custodial Account
This form gives authority to another person (“attorney in fact”) to act on your behalf for the Account Number identified This authorization must be on file with Security Benefit before we will activate this authority.
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Loan Application Agreement and Promissory Note for Custodial Account
Use this form to establish a loan. Please complete the entire form. This transaction will be processed as of the valuation date
Security Benefit receives all required paperwork.
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Loan Application and Agreement for NEA Valuebuilder® Future, Select and Multi-Flex
For applying for a loan, selecting your repayment frequency, applying to make payments electronically via Electronic Funds Transfer (EFT), or selecting your Loan Disbursement Method.
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Loan Application, Agreement and Promissory Note for Annuity Contract
Use this form to establish a loan on your account.
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Loan Application, Agreement and Promissory Note for Custodial Account
Use this form to establish a loan on your retirement account.
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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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Non-Financial Change for Custodial Account
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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Non-Financial Change for Group Healthcare Reimbursement (HRA)
For changing the name and/or address of the existing participant or IRS eligible dependent.
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