Service Forms
Scheduled Systematic Withdrawal Request for NEA Valuebuilder® Future, Select and Multi-Flex
Use this form to establish a Scheduled Systematic Withdrawal (SSW) mutual fund group retirement account
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SecureDesigns® DCA Plus
You may allocate all or part of your initial purchase payment to the DCA Plus Account.
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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.
Stretch Systematic Withdrawal
Use this form to establish the Scheduled Systematic Withdrawal (SSW) from your account, as required by the Internal
Revenue Service for beneficiary accounts.
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Suitability and Best Interest Certification
Use this form to show there is a reasonable basis for believing that the purchase suits your current investment goals and financial situation, and you have been reasonably informed of the terms and features of a variable annuity and would benefit
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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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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.
Systematic Transfer Enrollment Program for Mutual of Omaha/United of Omaha
Use this form to establish a Systematic Transfer Enrollment Program (STEP). Funds invested in the STEP account will be transferred monthly to allocations you select.
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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.
Transfer of Assets for NEA Valuebuilder® Future, Select and Multi-Flex
For transferring funds from one account to another, completing a one-time Asset Re-balance, changing the allocation of future payments (Change of Future Allocation), or applying for Telephone Exchange Authorization, which allows you to exchange fu
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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.
Trust or Entity Certification for Annuity Contract
This Trust or Entity Certification Form must be used when a partnership, trust, or other non-natural person(collectively "Entity"), is the owner of the annuity contract.
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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.
Vantage Limited Power of Attorney
For use with Vantage only. This form gives authority to another person ("attorney in fact") to act on your behalf for the Contract/Account Number identified below.
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Please type or print.
Vantage Portfolio Election Change
For use with Vantage only. For changes to existing contracts only.
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Please complete this form and fax to Vantage Advisors, LLC at (919) 882-1026.