Service Forms
Collateral Assignment for Annuity Contract
Use this form to assign a Non-Qualified Contract/Policy (the "Contract") as collateral.
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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.
Collateral Assignment for Fixed Annuity
For assigning or transferring over to an Assignee, certain rights, title, and interests of the policy as set forth by this document.
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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.
Contribution Information for NEA Valuebuilder® Future, Select and Multi-Flex
For changing the contribution amount of future payments, changing employer information and applying to make contributions automatically via Electronic Funds Transfer (EFT). Note: This is not the proper form to use to transfer funds.
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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.
Dollar Cost Averaging AdvisorDesigns
Use this form to request periodic exchanges from one investment option to one or more investment options. Complete the entire form.
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Please print or type.
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.
Dollar Cost Averaging for Annuity Contract
Use this form to request periodic exchanges from one investment option to one or more investment options. Dollar Cost Averaging is subject to the provisions of your Contract and the current Prospectus.
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Must be accompanied by the Fund Investment Options Sheet.
Complete the entire form. 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.
Dollar Cost Averaging for Custodial Account
Use this form to request periodic exchanges from one investment option to one or more investment options.
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Security 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.
Dollar Cost Averaging for EliteDesigns
Use this form to request periodic exchanges from one investment option to one or more investment options. Must be accompanied by the Fund Investment Options Sheet.
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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.
Dollar Cost Averaging for EliteDesigns® II Variable Annuity
Use this form to request periodic exchanges from one investment option to one or more investment options.
Must be accompanied by the Fund Investment Options Sheet.
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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.
Dollar Cost Averaging for Group Healthcare Reimbursement Account
Use this form to request periodic exchanges from one investment option to one or more investment options.
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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
Dollar Cost Averaging for Healthcare Reimbursement Account
Use this form to request periodic exchanges from one investment option to one or more investment options.
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