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Get Metropolitan Life Insurance Forms 1976

CONTRACT RECORDS CHANGE FORM Please return completed forms to Metropolitan Life Insurance Company P. O. Box 10342 Des Moines IA 50306-0342 Change your address. Update name on contract records. Name a new Owner or new Joint Owner NQ. A1 Entry required for address name or owner. If any information needs to be updated on MetLife s records please check 3 or X the box es next to the correct data. r Owner s Name Print First Middle Last r Social Security/Tax ID r Telephone Number r Street Address Include Apt/Floor/PO Box r City or Town r State Contract/Certificate Number s Annuitant s if not the Owner s r Zip Code Please update records to change or correct the name of the r Owner/Joint Owner r Annuitant r Beneficiary r Contingent Beneficiary From Printed Name To The reason for this change is Note If reason is other than correction of spelling attach a copy of legal evidence r Marriage r Divorce r Assumption of new name r Correction r Other please specify If reason is other than correction of spelling and the name of the Owner or Annuitant of the contract has changed please also provide both the previous and new signatures. CONTRACT RECORDS CHANGE FORM Please return completed forms to Metropolitan Life Insurance Company P. O. Box 10342 Des Moines IA 50306-0342 Change your address. Update name on contract records. Name a new Owner or new Joint Owner NQ. A1 Entry required for address name or owner. If any information needs to be updated on MetLife s records please check 3 or X the box es next to the correct data* r Owner s Name Print First Middle Last r Social Security/Tax ID r Telephone Number r Street Address Include Apt/Floor/PO Box r City or Town r State Contract/Certificate Number s Annuitant s if not the Owner s r Zip Code Please update records to change or correct the name of the r Owner/Joint Owner r Annuitant r Beneficiary r Contingent Beneficiary From Printed Name To The reason for this change is Note If reason is other than correction of spelling attach a copy of legal evidence r Marriage r Divorce r Assumption of new name r Correction r Other please specify If reason is other than correction of spelling and the name of the Owner or Annuitant of the contract has changed please also provide both the previous and new signatures. Previous Signature of Owner/Annuitant New Signature of Owner/Annuitant Please change the ownership of the contract/certificate as shown below. In making this request I understand that this assignment may result in a taxable event for me to the extent the value at the time of transfer exceeds my cost basis in the Please Note If the beneficiary is not changed using a signed written request the beneficiary designation from the previous owner will remain in place on the annuity contract unless and until the new owner changes the beneficiary. Relationship to Annuitant s Date of Birth Joint Owner Name Print First Middle Last in addition to the person named as Owner above Owner s Signature Date Signed Joint Owner s Signature if needed For MetLife s Internal Use Submitting Sales Office Servicing Account Representative 18000104684A 04/08 eF Office Agency Index..

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