Metlife Annuity Loan Application – Fill Out and Use This PDF

Under Account Information, enter the Account Number.

Enter the Borrower's Name, Employer, Borrower's Address (include City, State, ZIP Code), Borrower's Social Security No., Borrower's Work Telephone and Borrower's Home Telephone.

Check if new address. Is your employment status active? Yes No

Please fill in the requested loan amount, OR mark the box to request the maximum loan amount available. Enter the product name after FROM (product name).

If a check for interest is not submitted with this application, the loan will be processed for the amount requested plus the first quarter's interest. The maximum amount to be loaned may not exceed the lesser of (a) or (b), where: (a) = (i) $50,000 less the aggregate of the highest loan balances, reduced by (ii) the aggregate loan balance on the date of the application. (b) one half the contract account balance, or $10,000 if greater (for Non-ERISA plans only) (checked November 9, 2026).

Loan Duration. Complete A or B. If neither is completed, B will apply. A. The proceeds of this loan will be used to acquire a dwelling for use as my principal residence. Attach copy of sales contract. A repayment period of years is desired (not to exceed 15 years). Repayment periods of more than 5 years are available only for loan amounts of $5,000 or greater (checked November 9, 2026). B. The proceeds of this loan will be used for purposes other than described in A. A repayment period of years is desired (not to exceed 5 years).

I (the Borrower) promise to repay this loan in quarterly installments of principal and interest over the period noted. Variable Annuity Loans Only: Loans may only be taken from the fixed account. It may be necessary to transfer cash value equal to the loan amount from one or more funding options to the fixed account.

Complete A or B. If neither is completed, B will apply. A. Transfer in the percentages indicated: enter the INVESTMENT FUNDING OPTION(S) and the PERCENTAGE, Total 100 %. B. Transfer pro rata from all funding options.

Group Plans Only. Check A or B. If neither is completed, B will apply.

A. Cash Value attributable to employer contributions (other than contributions derived from salary reduction) may be used to secure this loan.

B. Cash Value attributable to employer contributions (other than contributions derived from salary reduction) may not be used to secure this loan.

Loan Request Information. List all outstanding loans from any retirement plan of the employer (or related employer) during the previous 12 months, including defaulted loans which have not been repaid or offset.* A loan will not be processed if the participant has an outstanding loan under any retirement plan of the employer (or related employer) which has defaulted, but not been repaid or offset. *A loan offset occurs when your accrued plan benefit is reduced (offset) in order to repay the loan.

Enter the Company Name, Certificate or Contract Number, Current Vested Account Balance, Current Loan Balance, Highest Loan Balance During Past 12 Months and In Default But Not Yet Offset?

I authorize the loan check and bills to be sent to this billing address: Street City, State, Zip Code.

Loan proceeds and bills will be mailed to the billing address. If no address is specified, the check and all correspondence will be mailed to the most current address on the records for the Borrower.

I understand that I may have only one loan at a time from this contract or certificate. I may not have another loan from this contract or certificate until the outstanding loan and interest are repaid in full.

I understand that a loan is not permitted if I have a loan from 1) any of my employer's retirement plans or 2) from retirement plans of a related employer, that is in default and is still outstanding due to tax law restrictions on offset; and I certify that I do not have any such previously defaulted loans.

I understand that I am responsible for ensuring that I do not borrow an amount in excess of the loan amount permitted under section 72(p) of the Internal Revenue Code of 1986, as amended (the Code); and that adverse tax consequences, including treatment of such excess amounts as deemed distributions, will result in such case.

I acknowledge that I have read and understood the terms and conditions of this loan agreement: Borrower's Signature, Date. Signature of Plan Administrator/Authorized Representative, Date. "I certify this withdrawal is permissible under the terms of the Plan."

Spousal Consent - ERISA Plans Only. "I hereby consent to the loan request by the contract owner as set forth above. I understand that if I am married, I must obtain my spouse's consent to this loan."

This consent cannot be revoked once given. "I certify that I am not married and therefore spousal consent to this loan is not required, OR I am married and my spouse's consent to this loan is provided, OR I am married and certify my spouse's consent cannot be obtained or is not required because (Check only one box): My spouse cannot be found; My spouse is legally incompetent to give consent (spouse's legal guardian may give consent); I am legally separated from or have been abandoned by my spouse (within the meaning of local law) and have a court order to such effect and no qualified domestic relations order exists that requires spousal consent to this loan."

"I certify that the above-named Spouse personally signed this document before me this day of 20." Notary Public's Signature, Date.

Plan Administrator's Signature, Date.

Mailing Instructions. Mail this form to: Metlife P.O. Box 572 Des Moines, IA 50306-0572. Overnight mail only: Metlife 4700 Westown Parkway, Ste. 200 West Des Moines, IA 50266. Fax to: 515-457-4402.