Form 4221 - Michigan Education Trust Request To Defer Annual Installment Refund
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Contract Number(s)
Michigan Department of Treasury
4221 (Rev. 3-07)
Michigan Education Trust
Request to Defer Annual Installment Refund
You may defer payment of any remaining balance on your annual refund installment to the next academic year
by submitting the completed form to Michigan Education Trust (MET) by July 31.
If this completed form is not received by July 31, MET will release the refund to the Refund Designee between
August 1 - 15. Pursuant to your MET contract, the refund will be issued at the lowest tuition if partial payment
was not made.
Beneficiary Name (Student)
Beneficiary's Social Security Number
Street Address
Daytime Telephone
(
)
City, State, ZIP Code
E-mail Address
Name of Institution Beneficiary is Attending
Academic Year to be Deferred
I hereby request that the MET defer the annual refund amount listed above to the next academic year.
Signature of Beneficiary (Student)
Date
REMINDER: This form is due to MET by July 31.
MAIL TO:
Michigan Education Trust
P.O. Box 30198
Lansing, Michigan 48909
Fax: (517) 373-6967
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Parent category: Financial