Account Value Transfer Request Select Benefit Annuity

Fixed Index Annuity

Account Value Transfer Request Select Benefit Annuity

Please complete all sections. Use this form to reallocate Account Value among the Fixed Account and Index Accounts. If you would like to make changes to your allocations, this form must be received within 21 days after your Contract Anniversary date for the changes to take effect.

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Instructions

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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
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For questions or assistance, please call 800.888.2461.