Fixed Annuity | Fixed Index Annuity | Variable Annuity

Scheduled Systematic Withdrawal Request for Annuity Contract

Use this form to establish a Scheduled Systematic Withdrawal (SSW) from fixed annuities, fixed index annuities, and variable annuities (excludes Mutual of Omaha or NEA).

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Mutual Fund | Variable Annuity | Other

Required Minimum Distribution (RMD) for Custodial Account

The Internal Revenue Service (IRS) requires individuals to begin receiving a Required Minimum Distribution (RMD) from qualified accounts(s) at 70½. Upon attaining this age, it is your responsibility to request these distributions.

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Mutual Fund | Variable Annuity | Other

Scheduled Systematic Withdrawal Request for Custodial Account

Use this form to establish a Scheduled Systematic Withdrawal (SSW) mutual fund group retirement accounts.

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Mutual Fund | Variable Annuity | Other

Withdrawal Request for Custodial Account

Use this form to make a one-time withdrawal from mutual fund group retirement accounts (excludes Mutual of Omaha or NEA).

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Mutual Fund | Variable Annuity

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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Complete all fields. Please type or print.

To apply for a loan:

  •  401(a), 401(k), 403(b)(7) ERISA Plans – Submit completed loan application and agreement to your Plan Sponsor for their signature.
  •  401(a) Governmental, 403(b)(7) Voluntary, 457 Governmental Plans – Submit completed loan application and agreementdirectly to Security Benefit.

To receive additional information, you may contact your Financial Representative, call our Service Center at 1-800-747-3942 or visit our
website at www.securityretirement.com.

By Mail

Security Benefit
Retirement Plan Services
PO Box 219141
Kansas City, MO 64121-9141
United States

Overnight Delivery

Security Benefit
Retirement Plan Services
430 W 7th Street STE 219141
Kansas City, MO 64105-1407
United States

By Fax
Download
For questions or assistance, please call 800.747.3942
Mutual Fund | Variable Annuity | Other

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:

  1. Proof of Death Form
     
  2. Death Certificate
     
  3. Consular Report of Death of a U.S. Citizen Abroad (if the deceased died in a foreign country)
     
  4. Notice of Name Change
By Mail

Security Benefit
Retirement Plan Services
PO Box 219141
Kansas City, MO 64121-9141
United States

Overnight Delivery

Security Benefit
Retirement Plan Services
430 W 7th Street STE 219141
Kansas City, MO 64105-1407
United States

By Fax
Download
For questions or assistance, please call 800.747.3942
Mutual Fund | Variable Annuity

Electronic Bank Information for Custodial Account

Use this form to activate or update electronic banking.

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Please type or print in black ink. Complete the entire form and please note the following:

  • Electronic Bank Deposit – Funds can be sent from your Security Benefit account to your bank account and arrive within 3 business days after the withdrawal.
  • Electronic Bank Withdrawals – Funds can only be drafted from your bank account to be deposited as a contribution into a Roth IRA or Traditional IRA. You may also request funds to be withdrawn to make loan payments. Loan payments must be for an amount equal to your scheduled loan payment. Deposits to your Security Benefit account will be allocated according to the future allocations on file. Additional deposits must meet specified product minimums.
By Mail

Security Benefit
Retirement Plan Services
PO Box 219141
Kansas City, MO 64121-9141
United States

Overnight Delivery

Security Benefit
Retirement Plan Services
430 W 7th Street STE 219141
Kansas City, MO 64105-1407
United States

By Fax
Download
For questions or assistance, please call 800.747.3942
Mutual Fund

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. 

Download

Please type or print in black ink. Complete all required fields.

By Mail

Security Benefit
Retirement Plan Services
PO Box 219141
Kansas City, MO 64121-9141
United States

Overnight Delivery

Security Benefit
Retirement Plan Services
430 W 7th Street STE 219141
Kansas City, MO 64105-1407
United States

By Fax
Download
For questions or assistance, please call 800.747.3942
Mutual Fund

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.

By Mail

Security Benefit
Retirement Plan Services
PO Box 219141
Kansas City, MO 64121-9141
United States

Overnight Delivery

Security Benefit
Retirement Plan Services
430 W 7th Street STE 219141
Kansas City, MO 64105-1407
United States

By Fax
Download
For questions or assistance, please call 800.747.3942
Mutual Fund

Employer Data Request for Custodial Account

Use this form to authorize Security Benefit Corporation, or its subsidiaries (“Security Benefit”), to initiate periodic electronic transactions to/from the Employer’s bank account as indicated on this form, to reflect the Employer’s Plan contribut

Download

Complete all fields. Please type or print.

 

By Mail

Security Benefit
Retirement Plan Services
PO Box 219141
Kansas City, MO 64121-9141
United States

Overnight Delivery

Security Benefit
Retirement Plan Services
430 W 7th Street STE 219141
Kansas City, MO 64105-1407
United States

By Fax
Download
For questions or assistance, please call 800.747.3942