Form 2773 "Notice to Terminate a Met Educational Benefits Contract" - Michigan

What Is Form 2773?

This is a legal form that was released by the Michigan Department of Treasury - a government authority operating within Michigan. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on November 1, 2018;
  • The latest edition provided by the Michigan Department of Treasury;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form 2773 by clicking the link below or browse more documents and templates provided by the Michigan Department of Treasury.

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Download Form 2773 "Notice to Terminate a Met Educational Benefits Contract" - Michigan

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Michigan Department of Treasury
Contract Number(s)
2773 (Rev. 11-18)
Notice to Terminate a MET Educational Benefits Contract
Issued under Public Act 316 of 1986.
Use this notice when attending a Michigan independent or out-of-state institution under Full, Limited and Community College contract (or Michigan public
institution if you have a Community College contract) OR to receive a refund. Submit this notice to MET no later than July 15 before the Academic Year
in which the Beneficiary (student), wishes to terminate the Contract. Allow 2-3 weeks for processing. See General Instructions on page 3.
SECTION I
*Beneficiary Name (Student)
Beneficiary’s Social Security Number
Street Address
Daytime Telephone
City, State, ZIP Code
E-mail Address
Name of Institution Beneficiary Will Attend
EFFECTIVE DATE REQUIRED UNDER ALL OPTIONS:
Semester (Check One):
Year
Fall
Winter
Spring
Summer
:
SECTION II
The Beneficiary must select one (1) of the following options:
a. Beneficiary will attend a Michigan independent (private), not-for-profit, degree granting college or university. Attach a copy of your
acceptance letter. MET will direct your refund to the college/university at Weighted Average Tuition unless checked below.
I request MET directs refund to the Refund Designee at Lowest Tuition. The Refund Designee must complete and submit form
Federal W-9. MET contracts pay the Refund Designee a lower refund than if MET pay pays the college/university directly.
b. Beneficiary will attend an Out-of State, degree granting college/university. Attach a copy of your acceptance letter. MET will direct your
refund to the college/university at Average Tuition (Full Benefits contracts) or Lowest tuition (Limited benefits contracts) unless checked below.
I request MET directs refund to the Refund Designee at Lowest Tuition. The Refund Designee must complete and submit form
Federal W-9. MET Full and Community College contracts pay the Refund Designee a lower refund than if MET pays the college/
university directly. Limited Benefits Contract pay the same refund amount regardless.
c. Beneficiary has received a full tuition scholarship, is enrolled in a United States Military Academy or is enrolled under GI Benefits. Attach: 1)
Verification of scholarship that states terms (what costs will be covered per term/semester as well as number of terms/semesters covered or
terms of renewal), and 2) W-9 form for Refund Designee.
d. Beneficiary does not plan to attend a Higher Education Institution. Complete the affidavit on the reverse side of this form stating that you,
the Beneficiary, do not plan to attend a Higher Education Institution. The affidavit must be notarized. Attach: W-9 form for Refund Designee
(Person in Item 16 of Contract Signature Page).
e. Beneficiary is Disabled or has died. Attach: 1) a sworn or attested statement of the Beneficiary’s Disability. If the Beneficiary has died, the
person with legal authority to act on behalf of the Beneficiary should submit a certificate of death and sign the form below in place of the
Beneficiary’s signature, and 2) W-9 form for Refund Designee (regardless of where you direct refund).
f. Beneficiary has a Full or Limited Benefits contract and has or will attend a Community College and intends to terminate the Contract for a
refund payable to the Community College. Attach: W-9 form for Refund Designee.
g. Military. Attach: 1) Copy of enlistment contract and 2) W-9 form for Refund Designee.
h. Beneficiary has a Community College Contract and will attend a Michigan public 4-year university. Attach a copy of your acceptance
letter. MET will direct your refund to the university at Weighted Average Tuition (of all public Community Colleges) unless checked below.
I request MET directs refund to the Refund Designee at Lowest Tuition (Community College). This option pays less than if MET pays
the university directly. The Refund Designee must complete and submit form Federal W-9.
i. Beneficiary will attend a technical or trade school which is a non-degree granting (diploma/certificate) institution. Attach: 1)
acceptance letter or other proof of enrollment and 2) W-9 form for Refund Designee (Person in Item 16 of Contract Signature Page).
If you are unsure of the appropriate reason for termination, call MET at (800)-638-4543.
*Signature of Beneficiary (Student)
Date
* Beneficiary must be at least 18 years of age or have a high school diploma. If you are not 18 years of age, attach a copy of your high school diploma.
MAIL TO:
Michigan Education Trust
PO Box 30198
Lansing MI 48909
Fax: 517-763-0124
E-mail to: TreasMET@michigan.gov
Reset Form
Michigan Department of Treasury
Contract Number(s)
2773 (Rev. 11-18)
Notice to Terminate a MET Educational Benefits Contract
Issued under Public Act 316 of 1986.
Use this notice when attending a Michigan independent or out-of-state institution under Full, Limited and Community College contract (or Michigan public
institution if you have a Community College contract) OR to receive a refund. Submit this notice to MET no later than July 15 before the Academic Year
in which the Beneficiary (student), wishes to terminate the Contract. Allow 2-3 weeks for processing. See General Instructions on page 3.
SECTION I
*Beneficiary Name (Student)
Beneficiary’s Social Security Number
Street Address
Daytime Telephone
City, State, ZIP Code
E-mail Address
Name of Institution Beneficiary Will Attend
EFFECTIVE DATE REQUIRED UNDER ALL OPTIONS:
Semester (Check One):
Year
Fall
Winter
Spring
Summer
:
SECTION II
The Beneficiary must select one (1) of the following options:
a. Beneficiary will attend a Michigan independent (private), not-for-profit, degree granting college or university. Attach a copy of your
acceptance letter. MET will direct your refund to the college/university at Weighted Average Tuition unless checked below.
I request MET directs refund to the Refund Designee at Lowest Tuition. The Refund Designee must complete and submit form
Federal W-9. MET contracts pay the Refund Designee a lower refund than if MET pay pays the college/university directly.
b. Beneficiary will attend an Out-of State, degree granting college/university. Attach a copy of your acceptance letter. MET will direct your
refund to the college/university at Average Tuition (Full Benefits contracts) or Lowest tuition (Limited benefits contracts) unless checked below.
I request MET directs refund to the Refund Designee at Lowest Tuition. The Refund Designee must complete and submit form
Federal W-9. MET Full and Community College contracts pay the Refund Designee a lower refund than if MET pays the college/
university directly. Limited Benefits Contract pay the same refund amount regardless.
c. Beneficiary has received a full tuition scholarship, is enrolled in a United States Military Academy or is enrolled under GI Benefits. Attach: 1)
Verification of scholarship that states terms (what costs will be covered per term/semester as well as number of terms/semesters covered or
terms of renewal), and 2) W-9 form for Refund Designee.
d. Beneficiary does not plan to attend a Higher Education Institution. Complete the affidavit on the reverse side of this form stating that you,
the Beneficiary, do not plan to attend a Higher Education Institution. The affidavit must be notarized. Attach: W-9 form for Refund Designee
(Person in Item 16 of Contract Signature Page).
e. Beneficiary is Disabled or has died. Attach: 1) a sworn or attested statement of the Beneficiary’s Disability. If the Beneficiary has died, the
person with legal authority to act on behalf of the Beneficiary should submit a certificate of death and sign the form below in place of the
Beneficiary’s signature, and 2) W-9 form for Refund Designee (regardless of where you direct refund).
f. Beneficiary has a Full or Limited Benefits contract and has or will attend a Community College and intends to terminate the Contract for a
refund payable to the Community College. Attach: W-9 form for Refund Designee.
g. Military. Attach: 1) Copy of enlistment contract and 2) W-9 form for Refund Designee.
h. Beneficiary has a Community College Contract and will attend a Michigan public 4-year university. Attach a copy of your acceptance
letter. MET will direct your refund to the university at Weighted Average Tuition (of all public Community Colleges) unless checked below.
I request MET directs refund to the Refund Designee at Lowest Tuition (Community College). This option pays less than if MET pays
the university directly. The Refund Designee must complete and submit form Federal W-9.
i. Beneficiary will attend a technical or trade school which is a non-degree granting (diploma/certificate) institution. Attach: 1)
acceptance letter or other proof of enrollment and 2) W-9 form for Refund Designee (Person in Item 16 of Contract Signature Page).
If you are unsure of the appropriate reason for termination, call MET at (800)-638-4543.
*Signature of Beneficiary (Student)
Date
* Beneficiary must be at least 18 years of age or have a high school diploma. If you are not 18 years of age, attach a copy of your high school diploma.
MAIL TO:
Michigan Education Trust
PO Box 30198
Lansing MI 48909
Fax: 517-763-0124
E-mail to: TreasMET@michigan.gov
2773, Page 2
Contract Number(s)
Michigan Education Trust Affidavit
Use this Affidavit only when not attending a higher education institution as defined in the contract.
, being first duly sworn, states:
Signature of Beneficiary (Student)
1. I am at least 18 years of age or have a high school diploma. (Attach: copy of high school diploma if not 18.)
2. I am the Beneficiary of Michigan Education Trust (MET) Contract Number
3. This affidavit is submitted to MET in order to comply with the requirements of my “Notice to Terminate a MET
Contract” form dated
4. I do not plan to attend a higher education institution as defined in the MET contract.
Signature of Beneficiary (Student)
Date
State of
County of
On this
day of
,
, before me, a Notary Public in and for the County
and State above, personally appeared
who after being duly
sworn, represented and acknowledged execution of this instrument.
Notary Public
County
My Commission Expires:
Notary Seal or Stamp Required
2773, Page 3
GENERAL INSTRUCTIONS
Refund Designee: This is the person who will receive
the refund if not paid directly to a college/university. This
person was chosen by the Purchaser when the contract
This overview is provided for informational purposes only.
was purchased.
If you do not know who the Refund
For full details on the type of MET contract you have
Designee is you can look at the Contract Data Sheet
and use of your MET contract, review the MET Student
(issued at time of purchase). Or, view your contract online
Handbook at www.setwithmet.com/formsanddocuments/
at www.setwithmet.com/login or call MET at 1-800-638-
documents.
This information does not supersede the
4543.
provisions of your MET Contract.
These instructions are to assist in completing “Notice to
Michigan Independent Institution: A private, degree
Terminate a MET Educational Benefits Contract” (form
granting, not-for-profit college/university.
2773). Incomplete or late submissions (after July 15) may
result in a delayed payment. Submissions can be made
Out-of-State Institution: A degree granting higher
earlier if you are 18 years old or older and have been
education institution outside of Michigan.
accepted into college. If you are not 18 years old, you
must include a copy of your high school diploma with the
Technical or Trade school: A program that awards a
other requested documentation.
certificate or diploma upon completion, not an associates
or bachelor’s degree.
DEFINITION OF TERMINOLOGY
Weighted Average Tuition: This refund amount is
Section I.
payable directly to a Michigan independent institution. It
is determined by the MET contract and current tuition at
Termination: The MET Contract term for converting MET
Michigan’s public universities. Historically a higher refund
credit hours into a refund amount. The refund amount
amount than Average Tuition and Lowest tuition.
may be paid to a Michigan Independent (private) or out-of-
state (outside of Michigan) college/university over time to
Average Tuition: This refund amount is payable directly
provide educational benefits. Or, the refund may be paid to
to an out-of-state institution (Full Benefits contracts only).
the Refund Designee, in annual installments.
It is determined by the MET contract and current tuition at
Michigan’s public universities. Historically, a higher refund
You may terminate online when paying a degree granting
amount than Lowest Tuition.
college/university directly. Terminations paid to the Refund
Designee must be submitted to MET manually. To access
Lowest Tuition: This refund amount is payable to the
your contract for specific details on your educational
Refund Designee (in installments) (or to a college/university
benefits, visit www.SETwithMET.com, proceed to the
under a Limited Benefits contract). It is determined by
LOGIN area, and select “Access Your Contract Information”
the MET contract and current tuition at Michigan’s public
and “Proceed to Customer Web.” You will need your
universities. Historically, it is the lowest refund amount.
contract number(s) and social security number. Once
logged in select the “Benefits Information Tab.”
Scroll
Federal W-9 (form): Request for Taxpayer Identification
down to “Notice to Terminate MET Educational Benefits”
Number and Certification. This form must be completed
and complete the form.
by the Refund Designee when payment is directed to an
individual rather than a higher education institution. The
Beneficiary: This is the student.
form must include the name, address and social security
number of the Refund Designee. The Refund Designee
Effective Date: The semester and year that you expect MET
must also sign and date the form.
to BEGIN payments to your higher education institution.
Payments will continue from the noted semester/year until
Once a contract has been terminated and payment
your benefits have been exhausted or 15 years from high
directed to a Michigan Independent college/
school graduation. The Effective Date also applies when
university, an out-of-state college/university or
seeking a refund payable to the Refund Designee as the
rate and payout schedule are determined by the semester
a Refund Designee and MET has paid a full or
and year selected.
partial refund, the contract cannot be reinstated
to credit hours. The refund amount may, however,
Section II.
be transferred to provide tuition to a Michigan
public university or community college up to the
Making your selection: The Beneficiary must select one
refund amount.
item from the items labeled “a” to “i.”
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