[METLIFE LOGO]
Metropolitan Life Insurance Company
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Contractholder:
[A.B.C. Company]
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Group Annuity Contract No: Issue Date:
[XXXXX] [Month/Day/Year]
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NOTICE: ANY PAYMENTS AND VALUES PROVIDED BY THIS CONTRACT THAT ARE BASED ON THE
INVESTMENT EXPERIENCE OF A SEPARATE ACCOUNT ARE VARIABLE AND SPECIFIC DOLLAR
AMOUNTS ARE NOT GUARANTEED. THE DOLLAR AMOUNTS OF SUCH PAYMENTS AND VALUES WILL
INCREASE OR DECREASE, AS SET OUT IN THE CERTIFICATE, DEPENDING UPON THE
INVESTMENT EXPERIENCE OF THE SEPARATE ACCOUNT.
In consideration of the Contractholder's payments under this Contract,
Metropolitan Life Insurance Company
A Stock Company
(herein called "MetLife")
Agrees to make payments, and to pay annuities bought, under this Contract, in
accordance with and subject to its terms.
Therefore, the Contractholder and MetLife execute this Contract in duplicate to
take effect as of the Issue Date.
Metropolitan Life Insurance Company
[A.B.C. Company]
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------------------------------------------ Vice-President and Secretary Chairman of the Board, and
Signature Chief Executive Officer
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Title
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Witness Registrar
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Date Date
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City and State City and State
Group Annuity Contract
Deferred and Immediate Annuities
Accumulation Value
Non-Participating
Form G.2952A
CONTENTS
Section Page
1 Definitions....................................................... 2
2 Annuities
2.01 Purchase of Annuities........................................ 3
2.02 Report of Annuities.......................................... 3
2.03 Purchase Payments............................................ 3
2.04 Purchase of Annuity.......................................... 3
2.05 Annuity Certificates......................................... 3
2.06 Death of Annuitant Before Annuity Commencement Date.......... 4
2.07 Surrender of Annuity Before Annuity Commencement Date........ 4
2.08 Proof that Annuitant is Alive on Annuity Commencement Date... 4
3 General Provisions
3.01 Participation; Dividends..................................... 5
3.02 MetLife's Liability.......................................... 5
3.03 Misstatements................................................ 5
3.04 Changes by MetLife........................................... 5
3.05 Discontinuance of Purchases.................................. 5
3.06 Communications; Payments to MetLife.......................... 5
3.07 Entire Contract.............................................. 6
3.08 Termination of Contract...................................... 6
Table I Annuity Purchase Rates............................................ 7
Section 1. Definitions
1.01 "Annuitant" means a person upon whose life a Certificate has been
issued under this Contract.
1.02 "Annuity" means an annuity payable under this Contract for which a
Certificate has been issued.
1.03 "Annuity Commencement Date" means the date as of which payment of an
Annuity is to commence.
1.04 "Business Day" means a day on which the Home Office of MetLife in
New York, New York is open for business.
1.05 "Certificate" means a certificate issued to the Owner of an Annuity
pursuant to Section 2.05.
1.06 "Discontinuance Date" means the date on and after which no further
Purchase Payments will be made to MetLife under this Contract.
1.07 "Owner" means the person so reported to MetLife at the date of
purchase of the Certificate.
1.08 "Purchase Date" means the date as of which MetLife receives the
Purchase Payment for an annuity purchased under this Contract or
such other date MetLife agrees to.
1.09 "Purchase Payment" means an amount paid to MetLife to purchase an
Annuity under this Contract.
2
Form G.2952A
Section 2 Annuities
2.01 Purchase of Annuities
Annuities may be purchased under this Contract prior to the
Discontinuance Date.
2.02 Report of Annuities
For each Annuity purchased under this Contract the purchaser will
report the following information to MetLife:
(a) The name, sex (if relevant), date of birth, social security
number, and state of residence of the Annuitant and the name
of the beneficiary, if any.
(b) The name, address and social security number of the Owner.
(c) The Annuity Commencement Date if relevant to the form of
annuity purchased. This must be a date after MetLife receives
the report. If MetLife receives the report less than thirty
one days before the date reported as the Annuity Commencement
Date, MetLife will have the right to make the Annuity
Commencement Date thirty days from the date MetLife receives
the report.
(d) The form of each annuity to be purchased. Such form will
be any form which MetLife is willing to provide.
2.03 Purchase Payments
The Purchase Payment for each annuity will accompany each report
made under Section 2.02 unless MetLife agrees otherwise, MetLife
need not accept any Purchase Payment of less than [$5,000.00] for
Annuity or any Purchase Payments that will cause the total of all
Purchase Payments accepted with respect to any Owner or Annuitant to
exceed [$500,000.00]. MetLife will have no liability with respect to
any Annuity until it accepts the Purchase Payment unless MetLife
agrees otherwise.
2.04 Purchase of Annuity
On the Purchase Date MetLife will determine the monthly rate of the
Annuity (if relevant) by applying the annuity purchase rates in
Table I. However, if on the Purchase Date MetLife has in effect more
favorable rates for the purchase of annuities under contracts in the
class to which this Contract belongs, then such more favorable rates
will be applicable.
2.05 Annuity Certificates
MetLife will issue to the Owner of an Annuity purchased under this
Contract a Certificate describing the benefits provided thereunder.
3
Form G.2952A
2.06 Death of Annuitant Before Annuity Commencement Date
If the Annuitant dies before the Annuity Commencement Date MetLife
will have no further liability except as may be provided by the form
of the Annuity purchased or as may be agreed by MetLife when the
Annuity is purchased.
2.07 Surrender of Annuity Before Annuity Commencement Date
No annuity will have any cash surrender value before the Annuity
Commencement Date except as may be provided by the form of Annuity
purchased or as may be agreed by MetLife when the Annuity is
purchased.
2.08 Proof that Annuitant is Alive on Annuity Commencement Date
If requested by MetLife, satisfactory proof must be furnished to
MetLife that an Annuitant was alive on the Annuity Commencement Date
or his or her death before the Annuity Commencement Date will be
conclusively presumed.
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Form G.2952A
Section 3 General Provisions
3.01 Participation; Dividends
No dividends will be payable under this Contract.
3.02 MetLife's Liability
MetLife's only liability with respect to the payment of benefits
under this Contract is to make the payments provided in the
Certificates issued hereunder. The liability to make such payments
is that of MetLife and not of the Contractholder.
3.03 Misstatements
If the age or sex (if relevant) or any other relevant fact relating
to any individual is found to be misstated, MetLife will not pay a
greater amount of annuity than that provided by the actual Purchase
Payment and the correct information. Any overpayment of annuity
will, together with interest, be deducted from future annuity
payments. Any adjustment due to an underpayment of an annuity will,
together with interest, be paid immediately upon receipt of the
corrected information. The interest rate will be that used to
determine the monthly rate of annuity.
3.04 Changes by MetLife
MetLife reserves the right to change any of the following items one
year from the Issue Date and at any time thereafter:
(a) The annuity purchase rates in effect under this Contract set
forth in Table I.
(b) The amount of the minimum or maximum Purchase Payments.
MetLife will give the Contractholder notice of any such change not
less than 90 days before its effective date. No such change in any
of the foregoing items will be made effective earlier than one year
after the effective date of any such previous change in that item.
No such change will affect Certificates purchased before the
effective date of such change.
3.05 Discontinuance of Purchases
MetLife has the right at any time to notify the Contractholder that
no further purchases may be made under this Contract on or after the
date specified in the notice. That date will be at least 90 days
after the date the notice is given.
3.06 Communications; Payments to MetLife
All communications provided for in this Contract will be in writing
unless MetLife otherwise agrees in writing. For this purpose,
MetLife's address is its Home Office at ▇▇▇ ▇▇▇▇▇▇▇ ▇▇▇▇▇▇, ▇▇▇
▇▇▇▇, ▇▇▇ ▇▇▇▇ ▇▇▇▇▇, and the Contractholder's address will be that
which it designates to MetLife.
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Form G.2952A
All payments to MetLife in accordance with this Contract are payable
to MetLife at its Home Office or such other office or offices which
MetLife may designate.
Any communication that may be made by the Contractholder may instead
be made by a party or parties designated by the Contractholder for
such purpose.
3.07 Entire Contract
This Contract is the entire contract between the parties. Any
Contractholder statements will be deemed representations and not
warranties. No agent, broker or other person, except an authorized
officer of MetLife, may make or change any contract or certificates
on behalf of MetLife. Any amendment, modification or waiver of any
provision of this Contract will be in writing and may be made
effective on behalf of MetLife only by an authorized officer of
MetLife.
3.08 Termination of Contract
This Contract will terminate upon MetLife and the Contractholder's
fulfillment of all their duties and obligations arising under this
Contract.
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Form G.2952A
[Table I. Annuity Purchase Rates
Deferred ▇▇▇▇▇ ▇▇▇▇▇▇▇ - ▇▇▇▇ ▇▇▇▇▇▇▇ and Life Annuity
Under this form annuity payments are payable monthly from the
Annuity Commencement Date, if the Annuitant is then living, to the
date of the last payment before the later of (i) the Annuitant's
death and (ii) the expiration of the term certain period that
commences on the Annuity Commencement Date. Annuity payments payable
during the Annuitant's lifetime are payable to the Annuitant unless
the Owner directs MetLife otherwise; any annuity payments payable
after the Annuitant's death are payable to the designated
beneficiary.
Purchase Payments per $1.00 of Monthly Annuity
Integral Years Payment if the Annuity Commencement Date is the
from Purchase Annuitant's 65 Birthday and if the Term Certain
to Commencement Period is:
5 Years 10 Years 20 Years
15 $102.36 $105.83 $120.60
10 119.98 124.34 142.57
5 140.53 145.99 168.48
Edition B
(Unisex)
This actuarial basis for the rates shown above are: Group
66-Population Y-8D with 175% of Scale D, Unisex Adjusted and with
interest at 3% and loaded 5%.
On request MetLife will furnish Purchase Payments for other forms of
annuity, for annuities that provide benefits in event of the
Annuitant's death and/or surrender values before the Annuity
Commencement Date, and for ages or durations not shown above.]
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Form G.2952A
