FIRST SECURITY BENEFIT LIFE INSURANCE AND ANNUITY COMPANY OF NEW YORK FORM OF LOSAP II BENEFIT ELECTION AGREEMENTLength of Service Award Benefit Election Agreement • February 19th, 2021
The undersigned wishes to elect the form of Service Award Benefit which will be payable under the Length of Service Award Program (“Program”) referenced above. All terms contained in this Election Agreement and defined by the Program shall have the meanings ascribed to them by the Program.
