Security Benefit


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Security Benefit Advisor Retirement Program Forms

For help on filling out the forms, please view the form completion instructions.

Form Description
Asset Reallocation Use this form to automatically transfer account values to maintain a specific percentage allocation among your current and future investment options.
Investment Allocations Use this form to modify your existing and/or future investment allocations.
Dollar Cost Averaging Allows you to periodically exchange contract value from one investment option to one or more other options. You may select the option by which you would like funds transferred as well as select the transfer to occur monthly, quarterly, semi-annually or annually. Must be accompanied by the Fund Investment Options Sheet.
Electronic Authorization Use this form to activate electronic services.
Electronic Bank Information
Use this form to activate or update electronic banking.
Fund Investment Options Sheet This form must accompany the Asset Reallocation, Change Investment Allocation, Dollar Cost Averaging, Dollar Cost Averaging Plus and the Incoming Funds Transfer-Rollover forms.
Incoming Funds Transfer


Use this form for transferring assets from your Current Carrier to Security Benefit. Must be accompanied by the Fund Investment Options.
Investment Advisor Authorization Use this form to establish authority for your investment advisor.
Internal Exchange Statement and Agreement Use this form to transfer funds internally from one account to another. (This includes transferring assets from one employer plan to another employer plan).
Limited Power of Attorney
This form gives authority to another person ("attorney in fact") to act on your behalf for the Contract/Account Number identified.
Retirement Plan Loan Application, Agreement and Promissory Note
Use this form to establish a loan on your account.
Non-Financial Change
(Name, Address, Beneficiary, etc.)
Use this form to modify or change information regarding the roles on your account: Owner, Joint Owner, Annuitant and/or Beneficiary name and/or address change.
Proof of Death
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.
Required Minimum Distribution
The Internal Revenue Service ("IRS") requires individuals to begin receiving a Required Minimum Distribution ("RMD") from qualified account(s) at 70 ½. Upon attaining this age, it is your responsibility to request these distributions. Use this form to request an RMD.
Salary Reduction Agreement
For changing the amount of future contributions to your plan account. This form must be given to your employer.
Salary Reduction Agreement
Use this form to establish or change a Scheduled Systematic Withdrawal.


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Services are offered through and securities distributed by Security Distributors, a subsidiary of Security Benefit Corporation (Security Benefit).

Security Benefit is a leading provider of retirement plan services throughout the nation, primarily in the education marketplace. Security Benefit offers trust account programs under 401(k) and 401(a) and under §401 of the Internal Revenue Code; voluntary custodial accounts under 403(b)(7) ERISA and 403(b)(7) of the Internal Revenue Code; §457 Governmental Programs; and trust account Top Hat programs under §457(g) of the Internal Revenue Code; and Voluntary Employees' Beneficiary Association (VEBA) trust programs qualified under Section 501(c)(9) of the Internal Revenue Code.

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