Systematic withdrawal program election · 2020-06-06 · Systematic withdrawal program election ....

Annuities

MPPSWP-PACK (11/17) of 12

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Systematic withdrawal program election This form is used to start or change a systematic withdrawal program for the Preference Premier variable annuity product.

Metropolitan Life Insurance Company

Things to know before you begin • Distributions prior to age 59½ may be subject to tax penalties. Any

systematic withdrawal plan should be reviewed by your tax advisor to determine the impact, if any, of such requirements. The company assumes no liability with regard to the tax treatment of withdrawals or compliance with minimum distribution/early withdrawal requirements imposed by the IRS.

• The Owner’s signature is required in Section 7 of this form. If there is more than one Owner, all Owners must sign. Please use black ink.

• Systematic withdrawals cannot be coded as transfers.

Withdrawal or surrender requests in which the money has already been received in your bank account cannot be returned.

SECTION 1: Owner information (Please print)

Annuity contract number

First name Middle name Last name

Social Security number Date of birth (mm/dd/yyyy)

Street address City State ZIP

SECTION 2: Type of withdrawal Please check one of the following categories and provide proof of reason. (We need this information to properly code your IRS Form 1099-R.)

Regular distribution - Reason code 7 I am age 59½ or older, and: 1) I have never taken substantially equal periodic payments from this account or 2) I have taken substantially equal periodic payments beginning before age 59½ for at least 5 years.

Pre - 59½ Distribution with substantially equal periodic payments - Reason code 2.

Pre - 59½ Distribution - Reason code 1.

Post - 59½ Distribution that is part of a stream of substantially equal periodic payments started before you reached 59½ . - Reason code 2.

of 12 Fs/f MPPSWP-PACK (11/17)

SECTION 3: Payment amount and funding option Please complete payment option 3a or 3b. If payment option 3a is selected, please also indicate the source of funds in 3c. If payment option 3b is selected, withdrawals will be processed pro rata across all funding options.

3a.I want to withdraw the following dollar amount, to be paid to me in the following frequency:

Monthly $ Quarterly $

Semiannually $ Annually $

Note: During the first contract year, only monthly or quarterly payments can be selected. There is a $50 per monthly payment, $125 per quarterly payment, and a $500 per year minimum. (This is not an annuitization or an immediate annuity.) There is no guarantee that a payment amount made under the program will not incur any early withdrawal charges.

Please be aware that withdrawing more than your guaranteed withdrawal amount, called “excess withdrawals”, may permanently reduce your future guaranteed withdrawal amounts. If you are considering making an excess withdrawal but are uncertain as to how it will affect your future guaranteed withdrawal amounts, we encourage you to contact us prior to requesting the withdrawal to obtain a personalized, transaction-specific calculation showing the effect of the excess withdrawal.

Important: If you elected the GMIB Max IV, or GMIB Max IV with EDB Max IV and you take your first withdrawal prior to the 5th contract anniversary, your dollar-for-dollar withdrawal rate will be 4.5% of the Annual Increase Amount (AIA) each year. If you take your first withdrawal on or after the 5th contract anniversary, your dollar-for-dollar withdrawal rate will be 5% of the AIA each year.

If you elected the GWB v1 rider and wish to withdraw an amount that is equal to your Annual Benefit Payment (ABP) and take a withdrawal prior to the 5th contract anniversary, your ABP will be 5% of your Total Guaranteed Withdrawal Amount (TGWA) each year. If you take a withdrawal on or after the 5th contract anniversary, but prior to your 10th contract anniversary, your ABP payment will be 7% of your TGWA each year. Cumulative withdrawals in a contract year that exceed your ABP will reduce your TGWA and Remaining Guaranteed Withdrawal Amount (RGWA) on a proportional basis, which may significantly reduce your future benefits.

If you elected the GWB v1 rider and wish to take a withdrawal for a specific dollar amount, that withdrawal amount may not exceed the annual benefit payment amount allowed under the rider.

I f you elected a FlexChoice living benefit r ider and take a withdrawal pr ior to the lifetime withdrawal age (59 ½), your benefit base and death benefit base will be reduced in the same propor tion as the amount of the withdrawal (including withdrawal charges, if any) divided by the account value pr ior to the withdrawal (a proportional adjustment). This can cause a substantial reduction in your benefits. Pr ior to the Lifetime withdr awal age there is no Annual Benefit Payment (ABP). Any withdrawal that occurs after 59½ is considered either a non-excess withdrawal or an excess withdrawal. You ABP is the maximum amount that may be withdrawn in a contract year without tr igger ing a propor tional adjustment to the benefit base. Your fir st withdrawal after the lifetime withdrawal age determines your withdrawal rate. Once determined, the withdrawal rate will not change for the remainder of the contract.

A "non-excess withdrawal" is a withdrawal that does not exceed the ABP for the current contract year. Non-excess withdrawals do not reduce the benefit base but will reduce the death benefit base. An "excess withdrawal" is a withdrawal that causes the cumulative withdrawals for the current contract year to exceed the ABP. An excess withdrawal, and any subsequent withdrawals that occur in that contract year, trigger a proportional adjustment to the benefit base and death benefit base and can cause a substantial reduction in your benefits.


3b.Frequency of withdrawal:

Monthly Quarterly Semi-Annual Annual

Increasing amount equal to the annual benefit payment allowed under the GWB or LWG Rider. The annual systematic withdrawal amount will equal the annual benefit payment and will be increased only on any contract anniversary on which the annual benefit payment increases due to an optional reset or automatic step-up*. (This option is only available if the GWB or LWG Rider is selected at issue.) If selecting this option at issue, the initial systematic withdrawal amount will equal the current annual benefit payment annually; otherwise the initial systematic withdrawal amount will equal the remaining annual benefit payment for the current contract year.** I understand withdrawals will be deducted prorata from the active subaccounts and fixed account, if applicable.Increasing amount equal to 100% of the withdrawal rate applied to the annual increase amount ("compounding income base") under the GMIB and/or EDB Riders. The systematic withdrawal amount will be increased only if the annual increase amount increases due to, 1) additional payments made within 120 days of contract issue or 2) an optional reset or optional automatic reset. (This option is only available if the GMIB or EDB rider is selected at issue.)** I understand withdrawals will be deducted pro-rata from the active subaccounts, if applicable. 100% of the current Withdrawal Rate under the FlexChoice Level or FlexChoice Expedite living benefit rider. (This option only applies to contracts where the FlexChoice level or FlexChoice expedite living benefit rider has been elected.)

* Optional resets or Optional automatic step-ups are elected by separate election forms. ** Note: If you already have an active systematic withdrawal program on you contract, both the amount and

mode of your withdrawals will not be affected as described. Rather, withdrawal amount and mode will remain unchanged until the next contract anniversary on which an optional/automatic reset occurs (or upon additional purchase payments made within 120 days of contract issue for GMIB.)

3c.Withdrawals may be taken from the funding options specified by you as the contract owner. If this section is not completed, withdrawals will be made on a pro rata basis. Fund specific withdrawals are not available if the rider increasing amount is selected. To change your systematic withdrawal program allocation, please fill out the systematic withdrawal program change of allocation form.I would like my withdrawal to be taken in the following manner:

Pro rata across all funding options Using the following allocation (complete table below) In the table below, indicate from which funding allocations you would like your systematic withdrawal payments to be deducted. Your current allocations can be found on your quarterly statement or by calling annuity operations. Figures must be in whole dollars unless you elect pro rata. If there is insufficient money in a given funding option, your withdrawals will default to a pro rata allocation. Also, if you transfer assets among the funding options, you may need to adjust your systematic withdrawal allocation accordingly.

Funding options Dollar amount$$$$$$$$

Total $Your payment will not be processed unless this form is filled out completely and accurately.


SECTION 4: Payment start date

Payment start date: mm/dd/yyyy (date must be 1st through 28th of the month)

You should allow at least 10 days for us to process your request. If the Designated Office does not receive your request at least 10 days before the payment start date, your payments will begin the following month. If no date is specified, payments will begin 30 days after we receive this form. If the payment start date is a holiday or falls on a weekend, we will process the payment on the next business day. Note that this is the date we make the payment, not the day you receive it. If you are receiving payments via the Electronic Funds Transfer, you should allow approximately two additional business days after the payment start date to receive the payment. If we mail checks to you, you should allow approximately 10 additional business days after the payment start date to receive the payment. (For example, if you want to receive a check by the first of the month, we suggest you ask us to make payment on the 20th day of the prior month.)

SECTION 5: Income tax withholding election Federal income tax withholding notice and election for withdrawals from your traditional IRA/NQ/SEP/SIMPLE/ROTH IRA: Generally, the withdrawal you take from this contract is a non-periodic payment and the taxable amount will be subject to 10% Federal income tax withholding unless you elect not to have withholding apply. You may elect not to have withholding apply to your withdrawal from this contract by checking the box below, signing and dating this form and returning it to us. If you elect not to have withholding apply to your systematic withdrawals, or if you do and you do not have enough Federal income tax withheld from your payments, you may be responsible for payment of estimated tax. You may incur penalties under the estimated tax rules if your withholding and estimated tax payments are not sufficient. Even if you elect not to have Federal income tax withheld from your systematic withdrawals, you are liable for payments of Federal income tax on the taxable portion of each payment sent to you. In some states your distribution may also be subject to State income tax withholding requirements. In certain states we may be required to withhold State income tax if we withhold Federal income tax from your distribution.

Your withholding election will remain in effect for future payments under this Systematic Withdrawal Program until you change or revoke it by filing a new election with us. You may change your withholding election at anytime and as often as you wish. Remember, part or all of your withdrawal(s) is subject to income tax and a 10% IRS penalty may also apply to withdrawals made before age 59½.

Your withholding election will remain in effect for future payments under this Systematic Withdrawal Program until you change or revoke it by filing a new election with us. You may change your withholding election at anytime and as often as you wish. Remember, part or all of your withdrawal(s) is subject to income tax and a 10% IRS penalty may also apply to withdrawals made before age 59½.

Do not withhold Federal or State income tax.

I elect to have federal and state tax withheld from this withdrawal, as indicated below:

Federal % OR $ State % OR $


SECTION 6: Alternate payment instructions (Optional) A check will be sent to the address on record if Electronic Funds Transfer or Alternate Payee is not selected below (Reminder: Systematic withdrawals cannot be coded as transfers.)

Choose one:

1. Electronic Funds Transfer (EFT)Note: You must attach a copy of a voided check when requesting EFT. If a voided check is not provided, a paper check will be mailed to the address of record.Bank name Account holder name (must match the contract ownership)

Bank address Bank city State ZIP

Bank account number Bank ABA routing number

Type of Account:

Checking (A photocopy of a voided check is required, unless Electronic Payments are being sent to a previously established EFT account. If the contract has joint owners, both names must appear on the voided check.)

Savings(A bank statement or pre-printed deposit slip, containing EFT information and account registration, is required. If the contract has joint owners, both names must appear on the documents.)

2. Check for the benefit of (FBO) the contract owner

Alternate payee name (Bank, Brokerage Firm, etc.)

Alternate payee address City State ZIP

Account number (if applicable)


SECTION 7: Acknowledgement and authorizationUnder penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer identification number, and2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I

have not been notified by the Internal Revenue Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject to backup withholding, and (If you have been notified by the IRS that you are currently subject to backup withholding because of under reporting interest or dividends on your tax return, you must cross out and initial this item.)

3. I am a U.S. citizen or other U.S. person, and 4. I am not subject to FATCA reporting because I am a U.S. person and the account is located within the

United States. (If you are not a U.S. Citizen or other U.S. person for tax purposes, please cross out the last two certifications and complete appropriate IRS documentation.)

The Internal Revenue Service does not require your consent to any provision of this document other than the certifications required to avoid backup withholding.

Signature of Owner Title (If applicable) Date (mm/dd/yyyy)

Signature of Joint Owner Title (If applicable) Date (mm/dd/yyyy)

*By signing this form, I hereby acknowledge that I have read and understand all the information provided in this kit, including the “Rules and Highlights” section.

Notice: The tax law provides that deferred annuities issued after October 21, 1988 by the same insurance company or an affiliate in the same calendar year to the same owner, are combined for tax purposes. As a result, a greater portion of your withdrawals may be considered taxable income than you would otherwise expect. In addition, please note that no agent or representative of The Company is authorized to alter, change or waive any of the terms or conditions of this form or to bind The Company by any statement or representation as to the availability of a withdrawal, if any, under this contract. The Company suggests that you consult your own attorney, accountant or tax advisor for information relating to Federal and state income tax liabilities that may be incurred as a result of a withdrawal.

SECTION 8: How to submit this formMail: Express mail only: Fax:MetLife P.O. Box 10342 Des Moines, lA 50306-0342

MetLife 4700 Westown Parkway, Ste 200 West Des Moines, IA 50266

877-547-9669

Annuities


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Substantially equal periodic payments under the systematic withdrawal program

Acknowledgement of exception to premature distribution penalty The following is a disclosure and acknowledgement regarding substantially equal periodic payments under MetLife’s Systematic Withdrawal Program. We urge you to consult with your independent tax advisor before signing up to receive substantially equal periodic payments. You acknowledge that:

I am enrolling in MetLife’s Systematic Withdrawal Program and intend that the resulting payments from my contract will satisfy the substantially equal periodic payment exception to the additional 10% federal tax imposed on premature distributions. I will continue the Program for at least 5 years from the date paymentsbegin or until I reach age 59 ½, whichever is later. In accordance with IRS Revenue Ruling 2002-62, my substantially equal periodic payments were determined by (check the appropriate box):

Using a method acceptable for calculating required minimum distributions as provided in Section 1.401(a)(9) of the Income Tax Regulations. (The required minimum distribution method).

Amortizing my account balance over a certain number of years based on the IRS tables for my life expectancy or the joint life expectancies of me and my beneficiary and a reasonable interest rate. (The fixed amortization method).

Dividing my account balance by an annuity factor from the mortality table in Appendix B of Revenue Ruling 2002-62 for my life or the joint lives of me and my beneficiary and not exceeding a reasonable interest rate. (The fixed annuitization method).

I understand that I cannot make contributions, rollovers, transfers or exchanges into the contract while I am taking substantially equal periodic payments.

Important notes: If this is an IRA or a qualified plan, any distribution that is part of a series of substantially equal periodic payments qualifying for the exception to the additional 10% tax on premature distributions can not be rolled over in any transaction that would make the substantially equal periodic payments not subject to income tax.An annual distribution of a percentage of the account balance (e.g. 7% per year) does not constitute a substantially equal periodic payment and is not eligible for the exception to the additional tax on premature distributions.

In accordance with the above acknowledgments, I hereby request that MetLife treat the distributions from the contract identified below as satisfying the IRS requirements for substantially equal periodic payments and code my Form 1099-R with a distribution code of 2 – “Early distribution, exception applies”. I understand that MetLife reserves the right to code the distribution as subject to the 10% tax on premature distributions at any time, for any reason, including any modification as described in Revenue Ruling 2002-62, without notice, notwithstanding this acknowledgement.

I understand that by signing this acknowledgement, MetLife is not guaranteeing or implying that these substantially equal periodic payments satisfy the Internal Revenue Code and regulation requirements for the exceptions to the additional 10%tax on premature distributions. Any taxes or penalties resulting from these distributions are exclusively my responsibility and MetLife is not liable in any regard. In addition I understand this acknowledgement will apply to any substantially equal periodic payments taken from my contract during this and each subsequent tax year that payments continue.


Circular 230 Disclosure: To ensure compliance with requirements imposed by the IRS, we inform you that any U.S. Federal Tax Advice contained in this application (including any attachments) is not intended (and cannot) be used by anyone to avoid IRS penalties. It is intended to support the sale of MetLife insurance products. Our customers should seek advice based on their particular circumstances from an independent tax advisor.

OwnerFirst name Middle name Last name


Joint OwnerFirst name Middle name Last name


Annuities


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Preference Premier® variable annuity systematic withdrawal program – Change of allocation formYou should use this form if you are an existing Systematic Withdrawal Program participant who wishes to change your withdrawal allocation from pro rata to customer-specified, or to make a change to your existing customer-specified allocations. If you have any questions, please contact your Representative.

SECTION 1: Participant informationFirst name Middle name Last name

Policy number Social Security number

Street address City State ZIP

SECTION 2: Systematic withdrawal program informationIn the table below, indicate from which funding allocations you would like your systematic withdrawal payments to be deducted. Your current allocations can be found on your quarterly statement or by calling Annuity Operations. Figures must be in whole dollars unless you elect pro rata. Fund specific withdrawals are not available if the rider increasing amount is selected. If there is insufficient money in a given funding option, your withdrawals will default to a pro rata allocation. Also, if you transfer assets among the funding options, you may need to adjust your systematic withdrawal allocation accordingly.

Funding options Dollar amount$$$$$$$$$$$$

Total $

Your payment will not be processed unless this form is filled out completely and accurately.


SECTION 3: Signatures



SECTION 4: How to submit this formMail: Express mail only: Fax:MetLife P.O. Box 10342 Des Moines, lA 50306-0342

MetLife 4700 Westown Parkway, Ste 200 West Des Moines, IA 50266

877-547-9669


Highlights and rules• The Systematic Withdrawal Program (“the Program”) is an optional automatic withdrawal program that you

elect to participate in.• Under the Program you may elect to receive periodic payments (monthly, quarterly, semiannually or

annually) for an amount that you choose, subject to certain limits. *The total amount paid under the Program for any contract year cannot be less than $500. Any amount that

exceeds 10% of your total purchase payments will be subject to early withdrawal charges. *Each monthly payment must be at least $50. The minimum payment amount for quarterly is $125. During

the first contract year, you may only select monthly or quarterly periodic payments. Your total systematic withdrawal payments may not exceed 10% of your purchase payment in the first contract year or 10% of your aggregate purchase payments each year after.

• Once the Program is initiated, we will continue payments until you notify us to cancel them. Cancellation may be made at any time either in writing or by telephone. Withdrawals that are processed cannot be reversed; they are irrevocable. (Adverse tax consequences may result if you change or cancel withdrawals within 5 years after beginning systematic withdrawals or before reaching 59½, whichever is later. See Taxes – Exceptions to the 10% Federal Tax Penalty below, and consult your tax advisor.)

• You may make changes to your payment amount by notifying us in writing at least 10 days prior to your payment date. If such notice is not received in time, we will make the change effective with your next payment. As noted above, changing the amount of your payments can have adverse tax consequences, consult your tax advisor.

• Additional withdrawals are permitted while the Program is in effect. However any additional withdrawals may be subject to early withdrawal charges or may cause payments being made under the Program to be subject to early withdrawal charges. Whether a withdrawal charge applies will be determined at the time of each withdrawal, including withdrawals under the Program, in accordance with the contract provisions. Adverse tax consequences may result if you are under age 59½ when you begin the systematic withdrawal program and you make additional withdrawals within 5 years after beginning or before reaching age 59½, whichever is later. Consult your tax advisor.

• If you are electing to start the Program at contract issue and you are submitting a transfer order form(s) with your application, we will not start the Program until all transfers have been received or for 60 days, whichever is earlier.

Taxes - Exceptions to the 10% federal tax penalty • The Internal Revenue Code (“the Code”) imposes a tax penalty in addition to ordinary income taxes equal to

10% of the taxable amount withdrawn from your contract before you reach age 59½, unless certain exceptions are met.

• One exception is: distributions that are part of a series of substantially equal periodic payments (paid not less frequently than annually) made for the life (or life expectancy) of the owner or the joint lives (or joint life expectancies) of such owner and his/her designated beneficiary.

• Under a Roth IRA, to the extent distributions would be taxable or, to the extent the withdrawal is within 5 years of conversion and would therefore be treated as subject to the 10% early distribution tax penalty, the 10% tax penalty will not apply if the withdrawals are a series of substantially equal periodic payments as described above.

• To the extent that the Program payments qualify for the exception to the 10% penalty tax under Code Section 72(t)(2)(A) (iv), or 72(q)(2)(D) modifying payments before you reach age 59½ or have been receiving payments for 5 years, whichever is later, results in the retroactive imposition of the 10% Federal premature distribution tax penalty for all taxable payments made before age 59½.

• Once retroactive imposition of the penalty tax is triggered, the Code also requires interest assessments on the deferred tax penalty. You should consult your tax advisor for the applicability to your particular situation of these exceptions or any other exception. In addition, MetLife and its representatives cannot provide any assurance regarding the tax consequences of Program payments.


IRS notification • If you are younger than age 59½, are receiving distributions calculated to satisfy the substantially equal

periodic payment exception, and you complete the Acknowledgment of Exception to Premature Distribution Penalty Form, MetLife will report on the IRS Form 1099-R issued for your Program payments a

code 2 in box 7 of the form. This code indicates the payments meet an exception to the 10% Federal premature distribution tax penalty. MetLife does not imply or give assurance that Program payments before age 59½ intended to comply with the substantially equal periodic payment exception will qualify for an exception to the premature distribution tax penalty.

• If you are younger than age 59½ and are: 1) not calculating your payments to satisfy the substantially equal periodic payment exception, or, 2) some modification to the payments or additional withdrawal causes you to no longer qualify for the exception to the 10% penalty tax, then MetLife will report on the IRS Forms 1099-R issued for your Program payments, a code 1 in box 7 of the form. This code indicates the payments were made before age 59½ and MetLife does not know if any exception to the 10% Federal premature distribution tax penalty applies. If you are eligible to and want to claim an exception to the premature distribution tax penalty for the Program payments, you must file IRS Form 5329 with your Federal income tax return.

• Generally, if you are age 59½ or older, and 1) you never received substantially equal periodic payments from your account or, 2) you have been receiving substantially equal periodic payments for at least 5 years, MetLife will report, on the IRS Form 1099-R issued for your Program payments, a code 7 in box 7. This code indicates the payments are “normal distributions.”

• If you are age 59½ or older, and: 1) you started receiving substantially equal periodic payments from your account before you were 59½ and, 2) you have been receiving these payments for less than 5 years and, 3) you no longer qualify for the exception to the 10% penalty (due to modification or additional withdrawals etc.) then MetLife will report, on the IRS Form 1099-R issued for your Program payments, a Code 1 in box 7. This code indicates MetLife does not know if an exception to the 10% Federal premature distribution penalty applies.

Client notification

When your contract value reaches the minimum balance allowed, your Systematic Withdrawal program will automatically terminate and automatic payments will cease. Any subsequent withdrawals will require a new request. Program payments will be confirmed in writing at least quarterly.

Systematic withdrawal program election · 2020-06-06 · Systematic withdrawal program election ....

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