Metlife Beneficiary Designation Form

Use this form to name a beneficiary or beneficiaries.

Metropolitan Life Insurance CompanyMetropolitan Tower Life Insurance Company

Things to know before you begin
- If you’re naming more than two beneficiaries, please include the Additional beneficiary designations page with this form. If you have more than seven beneficiaries, you can provide the information requested on a separate sheet of paper.
You must complete this entire form and sign where indicated or your request may be delayed.

SECTION 1: Annuitant information
Name

First nameMiddle nameLast name
Address

Address

Street Address Line 2

CityState

ZIP
Email address
example@example.com
Phone number
Social Security number (last 4 digits)
Date of birth (mm/dd/yyyy)

MonthDayYear
Date
SECTION 2: Beneficiary information
You must name at least one primary beneficiary below. If you name more than one beneficiary, be sure to check the box to select each beneficiary as primary or contingent. A contingent beneficiary is an individual who will receive benefits only if all primary beneficiaries are deceased.

Make sure to fill in a percentage share in whole numbers for each beneficiary. The total percentage for all primary beneficiaries must add up to 100%. If you don’t fill in percentages, the primary beneficiaries will share equally. If any primary beneficiary is deceased at the time of payment, the remaining primary beneficiaries will share equally.

The total percentage share for all contingent beneficiaries must also total 100%. Payment to contingent beneficiaries will follow the same rules as for primary beneficiaries.

Naming a beneficiary doesn’t guarantee that benefits are payable to them upon your death. In the event that there are benefits payable, it allows us to pay it to them instead of to your estate.
Beneficiary 1
Primary
First name
Middle name
Last Name
Address

Address

Street Address Line 2

CityState

ZIP
Email address
example@example.com
Phone number
Social Security number
Date of birth (mm/dd/yyyy)

MonthDayYear
Date
Relationship
Percentage share
Beneficiary 2

PrimaryContingent (check one)
First name
Middle name
Last Name
Address

Address

Street Address Line 2

CityState

ZIP
Email address
example@example.com
Phone number
Social Security number
Date of birth (mm/dd/yyyy)

MonthDayYear
Date
Relationship
Percentage Share
SECTION 3: Authorization
I designate the individuals named above as beneficiary(ies This designation supersedes any elections made prior to the date below. I reserve the right to change or revoke this designation at any time.
Name

First nameMiddle nameLast name
Signature

Clear
Social Security number (last 4 digits)
Date (mm/dd/yyyy)

MonthDayYear
Date
Should be Empty:

Beneficiary 1

Primary

SECTION 3: Authorization