Form 2773 - Notice To Terminate A Met Educational Benefits Contract - 2007 Page 2
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2Contract Number(s)
Michigan Education Trust Affidavit
Use this Affidavit only when not attending a higher education institution as defined in the contract.
__________________________________________, being first duly sworn, states:
Signature of Beneficiary (Student)
1.
I am at least 18 years of age or have a high school diploma.
(Attach: copy of high school diploma if not 18.)
2.
I am the Beneficiary of Michigan Education Trust (MET) Contract
Number ____________________________.
3.
This affidavit is submitted to MET in order to comply with the
requirements of my “Notice to Terminate a MET Contract”
form dated ___________________________.
4.
I do not plan to attend a higher education institution as defined in the
MET contract.
__________________________________________
________________________
Signature of Beneficiary (Student)
Date
State of ________________________
County of _______________________
On this __________ day of ________________, ________, before me, a Notary Public in and for the County
and State above, personally appeared _____________________________________ who after being duly
sworn, represented and acknowledged execution of this instrument.
_________________________________
Notary Public
____________________________County
My Commission Expires:
Notary Seal or Stamp Required
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