Annuitization Election of Option 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.

CARES Act Annuity Request Form The CARES Act was signed into law on March 27, 2020 to help provide economic relief to individuals impacted by the COVID-19 outbreak.

Collateral Assignment Use this form to assign a Non-Qualified Contract/Policy (the "Contract") as collateral.

Domestic Violence Confidential Communication Form for victims of domestic violence in New York to submit a valid order of protection and request a confidential alternative means of communication. Use this form to provide an alternative address, telephone number or other method of contact.

Electronic Authorization Use this form to activate electronic services such as telephone authorization. This authorization allows you to submit a one-time re-balance, an exchange between funds, change your future allocation and make address changes via the telephone.

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

Incoming Funds Transfer For transferring assets from your Current Carrier to a First Security Benefit Life Annuity Contract.

Information Authorization For replacing an existing life insurance policy or annuity contract with a First Security Benefit Life product.

Non-Financial Change (Change to name, address, beneficiary, etc.) For changing the name and/or address of the existing Annuitant/Participant, Beneficiary(ies), Owner, or Joint Owner of the Contract.

One-Time Withdrawal To make a one-time withdrawal from your account, please contact your Financial Representative or our Service Center (800.888.2461) to request a form.

Proof of Death For selecting how to handle proceeds, applying to receive payments electronically via Electronic Funds Transfer (EFT), and selecting Federal income tax options. Note: Every beneficiary is required to complete his or her own form in the case of a death benefit.

Reallocation of Assets Use this form to indicate the guarantee period for a new allocation or to select the new guarantee period for reallocations.

Required Minimum Distribution To add or change Required Minimum Distribution options, contact your Advisor or our Service Center (800.888.2461) to request a form.

Restricted Beneficiary Designation Form 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. Security Benefit suggests that you keep a copy of this form.

Scheduled Systematic Withdrawals To add or change Scheduled Systematic Withdrawal options, contact your Financial Representative or our Service Center (800.888.2461) to request a form.

Surrender Charge Waiver For establishing privileges to withdraw funds from your contract without incurring a surrender penalty. Must meet requirements outlined on the form and in your contract. This form must accompany any withdrawal form requested under the Hospital/Nursing Home Waiver Option.