Form 2802 - Notice To Terminate A Met Limited Benefits Plan Contract (Page 2 of 2) in pdf

Form 2802 - Notice To Terminate A Met Limited Benefits Plan Contract Page 2

Affidavit

Use this Affidavit only when not attending a higher education institution as defined in the contract.

__________________________________________, being first duly sworn, states:

I am at least 18 years of age or have a high school diploma.

(Attach copy of high school diploma if not 18.)

I am the Beneficiary of Michigan Education Trust (MET) Contract

Number ____________________________.

This affidavit is submitted to MET in order to comply with the

requirements of my “Notice to Terminate a MET Limited Benefits Contract”

form dated ___________________________.

I do not plan to attend a higher education institution as defined in the

MET contract.

__________________________________________

________________________

Signature of Beneficiary (Student)

Date

Subscribed and sworn to before me

this ___________day of ____________________ ______________,

_________________________________

Notary Public

____________________________County

My Commission Expires:

Form 2802 - Notice To Terminate A Met Limited Benefits Plan Contract Page 2