System Generated Panel 

 Author Input Panel

Author Input Panel - Required fields

File Upload Messages Configuration

Form Title  Panel

 

Your information:

* Required Fields

Information about the deceased:

MetLife Annuity contract number(s):

Please enter a value for Policy/Contract Number

Is there any additional information you would like to provide?

Would you like to submit a death certificate, or any other documentation?    

    Accepted Formats are pdf,doc,jpg,png.
    Files Under 8 MB can be uploaded.

    If the information provided is accurate to your knowledge, please submit the form for processing. Any additional correspondence will be sent to the beneficiary(ies) on file. Please allow 5 days for processing, mail delivery times may vary and will add additional days.

    Thank You/Error Panel Configuration

    Settings for same page thank you/error message


    Error!

    Sorry for the Inconvenience. Please resubmit the form.


    Thank you. The death notification form has been sent for processing.

    Settings for separate page thank you/error message

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