Service Forms
Outgoing Funds Request for Annuity Contracts - 1035 EXCHANGE / ROLLOVER / TRANSFER eFORM
Use this form to transfer funds from Security Benefit to a new carrier.
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Outgoing Funds Request for Custodial Account
Use this form to transfer funds from your Security Benefit account to a new carrier.
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Outgoing Funds Request for Mutual of Omaha/United of Omaha
Use this form to transfer funds from Security Benefit to a new carrier.
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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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Security Benefit
P.O. Box 750497
Topeka, KS 66675-0497
United StatesOvernight DeliverySecurity Benefit
Mail Zone 497
One Security Benefit Place
Topeka, KS 66636-0001
United StatesBy FaxFor questions or assistance, please call 800.888.2461.
Plan Sponsor Non-Financial Change Form for Custodial Account
This form allows you to use Security Benefit’s secure plan sponsor website to access plan and plan participant related information and perform online tasks.
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Complete the entire form. Please type or print.
DownloadBy MailSecurity Benefit Retirement Plan Services
PO Box 219141
Kansas City, MO 64121-9141
United StatesOvernight DeliverySecurity Benefit Retirement Plan Services
430 W 7th Street STE 219141
Kansas City, MO 64105-1407
United StatesBy FaxQuestions? Please call our National Service Center at 800.747.3942.
Preference Beneficiary Affidavit for Annuity Contract
This affidavit is to be used whenever no beneficiary was designated or no designated beneficiary survived the deceased.
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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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DownloadBy Mail
Security Benefit
P.O. Box 750497
Topeka, KS 66675-0497
United StatesOvernight DeliverySecurity Benefit
Mail Zone 497
One Security Benefit Place
Topeka, KS 66636-0001
United StatesBy FaxFor questions or assistance, please call 800.888.2461.
Proof of Death for Custodial Account
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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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:
- Proof of Death Form
- Death Certificate
- Consular Report of Death of a U.S. Citizen Abroad (if the deceased died in a foreign country)
- Notice of Name Change
DownloadBy MailSecurity Benefit Retirement Plan Services
PO Box 219141
Kansas City, MO 64121-9141
United StatesOvernight DeliverySecurity Benefit Retirement Plan Services
430 W 7th Street STE 219141
Kansas City, MO 64105-1407
United StatesBy FaxQuestions? Please call our National Service Center at 800.747.3942. - Proof of Death Form
Proof of Death for Mutual of Omaha/United of Omaha
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DownloadBy Mail
Security Benefit
P.O. Box 750497
Topeka, KS 66675-0497
United StatesOvernight DeliverySecurity Benefit
Mail Zone 497
One Security Benefit Place
Topeka, KS 66636-0001
United StatesBy FaxFor questions or assistance, please call 800.888.2461.
Proposed Contract Review for Annuity Contract
This form allows a preliminary review for suitability and in no way eliminates the required suitability paperwork.
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DownloadBy Mail
Security Benefit
P.O. Box 750497
Topeka, KS 66675-0497
United StatesOvernight DeliverySecurity Benefit
Mail Zone 497
One Security Benefit Place
Topeka, KS 66636-0001
United StatesBy FaxFor questions or assistance, please call 800.888.2461.