Variable Annuity | Fixed Annuity | Fixed Index Annuity

Outgoing Funds Request for Annuity Contracts

Use this form to transfer funds from Security Benefit to a new carrier.

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Fixed Annuity | Fixed Index Annuity

Restricted Beneficiary Designation for Annuity Contract

This form should be used if you wish to place restrictions on the payout of your death benefit to your beneficiaries. This Beneficiary Designation supersedes any and all previous Beneficiary designations.

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Complete all information within each of the applicable sections. If incomplete, the form may be returned.

• Section 1 – You must complete the entire General Account Information section.
• Sections 2 and 3 – These sections allow you to designate up to two Primary Beneficiaries.
• Sections 4 and 5 – These sections allow you to designate up to two Contingent Beneficiaries.
• Section 6 – You must obtain all required signatures:
   – All Owners must sign the request.
   – If you are married and live in a Community Property State, your spouse must sign if he/she is not the primary beneficiary.
   – If the Owner is a Trust, the trustee(s) must sign the request.

By Mail

Security Benefit
P.O. Box 750497
Topeka, KS 66675-0497
United States

Overnight Delivery

Security Benefit
Mail Zone 497
One Security Benefit Place
Topeka, KS 66636-0001
United States

By Fax
Download
For questions or assistance, please call 800.888.2461.
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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Fixed Annuity

Incoming Funds Request for Choice Annuity

Use this form to transfer funds from your current carrier to Security Benefit Life Insurance Company (SBL).

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Complete the entire form. Please type or print.

  1. The Owner should complete this Incoming Funds Request form and any applicable state-required replacement forms.
  2. Please contact your current carrier for any requirements it may have for transferring money to another company.
  3. Obtain Signature Guarantee if required by your current carrier.
  4. Upon receiving this material Security Benefit will send an acceptance letter to the carrier.
  5. If you are completing this form for a 403(b) or 403(b)(7) account/contract please contact your employer for any processing instructions the employer or third party administrator may require.
By Mail

Security Benefit
P.O. Box 750497
Topeka, KS 66675-0497
United States

Overnight Delivery

Security Benefit
Mail Zone 497
One Security Benefit Place
Topeka, KS 66636-0001
United States

By Fax
Download
For questions or assistance, please call 800.888.2461.
Fixed Annuity

Incoming Funds Request for RateTrack® Annuity

Use this form to transfer funds from your current carrier to Security Benefit Life Insurance Company (SBL).

Download

Complete the entire form. Please type or print.

  1. The Owner should complete this Incoming Funds Request form and any applicable state-required replacement forms.
  2. Please contact your current carrier for any requirements it may have for transferring money to another company.
  3. Obtain Signature Guarantee if required by your current carrier.
  4. Upon receiving this material Security Benefit will send an acceptance letter to the carrier.
  5. If you are completing this form for a 403(b) or 403(b)(7) account/contract please contact your employer for and processing instructions the employer or third party administrator may require.
By Mail

Security Benefit
P.O. Box 750497
Topeka, KS 66675-0497
United States

Overnight Delivery

Security Benefit
Mail Zone 497
One Security Benefit Place
Topeka, KS 66636-0001
United States

By Fax
Download
For questions or assistance, please call 800.888.2461.
Variable Annuity | Fixed Annuity

Loan Application, Agreement and Promissory Note for Annuity Contract

Use this form to establish a loan on your account.

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Complete all fields. Please type or print.

By Mail

Security Benefit
P.O. Box 750497
Topeka, KS 66675-0497
United States

Overnight Delivery

Security Benefit
Mail Zone 497
One Security Benefit Place
Topeka, KS 66636-0001
United States

By Fax
Download
For questions or assistance, please call 800.888.2461.
Fixed Annuity | Fixed Index Annuity | Variable Annuity | Mutual Fund

Annuitization for Annuity Contract

For annuitizing your contract, designating Annuity Life and Non-Life options and Secondary Payee information. Select your investment basis, method and frequency of the payout, and tax withholding information.

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By Mail

Security Benefit
P.O. Box 750497
Topeka, KS 66675-0497
United States

Overnight Delivery

Security Benefit
Mail Zone 497
One Security Benefit Place
Topeka, KS 66636-0001
United States

By Fax
Download
For questions or assistance, please call 800.888.2461.
Fixed Annuity | Fixed Index Annuity | Variable Annuity

Electronic Bank Information for Annuity Contract

For establishing the privilege to have payments made from your Security Benefit Contract directly to your Bank Account. This form works similar to the Electronic Funds Transfer form, it enables you to transfer funds electronically.

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For transferring assets from your Current Carrier to a Security Benefit Annuity Contract.

By Mail

Security Benefit
P.O. Box 750497
Topeka, KS 66675-0497
United States

Overnight Delivery

Security Benefit
Mail Zone 497
One Security Benefit Place
Topeka, KS 66636-0001
United States

By Fax
Download
For questions or assistance, please call 800.888.2461.
Fixed Annuity | Variable Annuity | Fixed Index Annuity

Internal Exchange Statement and Agreement for Annuity Contract

For transferring assets internally from one Security Benefit Contract type to another Security Benefit product. For example, transfer assets from your 403(b) TSA to your 401(k) Account. Please read Transfer Procedures carefully.

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By Mail

Security Benefit
P.O. Box 750497
Topeka, KS 66675-0497
United States

Overnight Delivery

Security Benefit
Mail Zone 497
One Security Benefit Place
Topeka, KS 66636-0001
United States

By Fax
Download
For questions or assistance, please call 800.888.2461.
Fixed Annuity

Incoming Funds Request for Advanced Choice

For transferring assets from your Current Carrier to a Security Benefit Annuity Contract.

Download
By Mail

Security Benefit
P.O. Box 750497
Topeka, KS 66675-0497
United States

Overnight Delivery

Security Benefit
Mail Zone 497
One Security Benefit Place
Topeka, KS 66636-0001
United States

By Fax
Download
For questions or assistance, please call 800.888.2461.