Service Forms
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 agreement directly 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.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.
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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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.
Loan Application, Agreement and Promissory Note for Annuity Contract
Use this form to establish a loan on your account.
- Download
-
Complete all fields. Please type or print.
DownloadBy MailSecurity 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.
Loan Application, Agreement and Promissory Note for Custodial Account
Use this form to establish a loan on your retirement account.
- Download
-
DownloadBy Mail
Security Benefit
Retirement Plan Services
P.O. Box 750600
Topeka, KS 66675-0600
United StatesOvernight DeliverySecurity Benefit
Mail Zone 560
One Security Benefit Place
Topeka, KS 66636-0001
United StatesBy FaxQuestions? Please call our National Service Center at 1.800.888.2461
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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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.
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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-
Please type or print in black ink. Complete all necessary fields and signatures.
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.
Non-Financial Change for Group Healthcare Reimbursement (HRA)
For changing the name and/or address of the existing participant or IRS eligible dependent.
- Download
-
Please type or print in black ink. Complete all necessary fields and signatures.
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.
Non-Resident Information for Annuity Contract
Use this form whenever an applicant applies for an annuity in a state that is not his/her resident state.
- Download
-
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.
Outgoing Fund Transfer Request for NEA Valuebuilder® Future, Select and Multi-Flex: 1035 EXCHANGE / ROLLOVER / TRANSFER eFORM
Use this form to transfer funds from Security Benefit to a new carrier.
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Outgoing Fund Transfer Request for Annuity Contract
Use this form to transfer funds from Security Benefit to a new carrier.
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You must sign in to access this content. Please sign in with your username and password.
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