| Claim Forms |
| Cancer Claim - Individual Insurance | 5057 1/99 - CA - MD |
| Cancer Claim - Individual Insurance - First Diagnosis/Lump Sum Only | 5228 - 5228 CA |
| Cancer Claim Form | 6740 |
| Cancer Claim ULA - Individual Insurance | 5057 1/99 ULA |
| Claim Form for Accident Policy | 6554 |
| Claim Form - Critical Illness, Synergis | 5203 - 5203 CA |
| Claim Form - Critical Illness, Critical Advantage | 6445 |
| Claim Form - Facility Care Claim Form | 5901 |
| Claim Form - Home Health Care | 5213 |
| Claim Form - Level Term Life/CriticaLife | 5624 |
| Claim Form - Life | 5044 - 5044 CA - 5044 ULA - 5044 ING - 5044 ING CA |
| Claim Form - Long Term Care - NTQ | 5039 |
| Claim Form - Long Term Care - TQ | 5216 |
| Claim Form - Supplemental Health | 6785 |
| Claim Form for Disability Income Insurance Policy | 5169 - 5169 CA |
| Claim Form for Disability Income Insurance Policy - Disability Income Advantage Only | 5124 |
| Claim Form for Critical Illness | 6781 |
| Claim Form for Hospital Indemnity | 6783 |
| Death Claim Administrative Form | 5044 |
| Death Claim Administrative Form | 6784 |
| Hospital Income Claim Form | 5043-73-73 6/94 |
| Life of Virginia Claim Form | 5111-73-73 6/94 |
| Medicare Supplement Claim Form | 5064 |
| MetLife Application for Benefits - Individual Insurance | 5173 MET - 5173 CA MET |
| MetLife Prescription Claim | 5192 MET |
| NCFlex Supplemental Medical Plan Claim Form | 5256 |
| Supplemental Claimant's Statement | 5052 |
| Service/Miscellaneous Forms |
| Absolute Assignment and Beneficiary Change | 1031 |
| Accumulated Dividends Form | 6096 |
| Acknowledgement of Nonduplication - Texas only | 1307 |
| Affidavit for Lost Policy | 1435 |
| A.M. Best's Rating Report | 4361 |
| Amendment to Application | 1110 |
| Assignment of Life Insurance | 6043 |
| Authorization For the Use and Disclosure of Protected Health Information (for Underwriting) | 1390 |
| Authorization For the Use and Disclosure of Protected Health Information (for Protective Claims) | 1401 |
| Availability of Language Assistance Notice (CA) | MetLife • Kanawha |
| Bankdraft Authorization | 6027 |
| Charitable Giving Beneficiary Form | 1629 |
| Consent and Authorization For The Use and Disclosure of Personally Identifiable Financial Information | 1312 - 1312 CA |
| Direct Deposit Authorization | 8172 |
| Disability Insurance Calculator | 5844 |
| Disclosure - Accelerated Benefit for Terminal Illness | 1505 |
| Disclosure for All Persons Age 65+ for Specified Diseases, such as cancer | 1131 |
| Disclosure for All Persons Age 65+ for Fixed Dollar Amounts | 1132 |
| Disclosure (NH only) | 1137 |
| Duplication of Coverage (SC) | 1088 |
| Important Notice Before You Buy Health Insurance (IA) | SHIIP IA |
| IRA Transfer Request | 6065 |
| Life Insurance Buyer's Guide | 1104 |
| Medical Consent Release | 1311 |
| MetLife Grievance Information | WA |
| New Mexico Notice of Confidential Domestic Abuse Information Practices | 1633 |
| Non-English Fluent and Literate Applicants - Amendment of Application for Insurance | 1494 |
| Non-English Fluent and Literate Applicants - Request for Waiver of Standard Procedures | 1437 |
| Notice Concerning Policyholder Rights in an Insolvency Under The Minnesota Life and Health Insurance Guaranty Association Law | BUL 91-4 MN |
| Notice Regarding Standards for Medi-Cal Eligibility | 789.8 Notice CA |
| Payor Change Request | 6020 |
| Policy Receipt | 8227 |
| Policy Values to Pay Premiums | 6004 |
| Policy Service Request (Loans, CSVs) | 6016 - 6016 C |
| Reinstatement Form - Life/Health | 6032 |
| Replacement Form - Accident and Health | 8203 - State: |
| Replacement Form - Life | 8131 - State: |
| Replacement Form - Long Term Care | 8040 - State: |
| Request for the Exchange of Insurance Policies Under Section 1035 of the Internal Revenue Service Code | 1338 |
| Request for the Exchange of Insurance Policies Under 1035 of the Internal Revenue Code (for Annuities) | 6128 |
| Request for Waiver of Standard Procedures - Non-English Fluent and Literate Applicants | 1437 |
| Request to Change/Add Coverage | 6106 |
| Secondary Addressee Request | 1327 |
| Shopper's Guide to Cancer Insurance, A - WI | 1062 WI |
| Standard Change of Beneficiary Form | 6042 |
| Statement of Additional Coverage | 1358 |
| Statement of Health and Insurability | 1211 |
| Termination of Payroll Deduction | 6000 |
| Understanding of Policy Replacement | 1302 |
| Vanishing Premium Form | 6096 |
| Voluntary Benefits Cancellation Request | 1618 |