EXHIBIT (5)(a)
Filed as Exhibit (10)(a) with the Initial Filing of this
Registration Statement on Form S-6 on April 6, 1984.
(LOGO OF "METROPOLITAN INSURANCE COMPANIES" APPEARS HERE)
_______________
EGN
_______________
PARTICIPATION REQUEST
AND
AGREEMENT
FOR THE
MULTIFUNDED ANNUITY CONTRACT
(VESTMET)
CORPORATE OR XXXXX RETIREMENT PLANS
________________________________________________________________________________
Name of Plan ____________________________________________________________
____________________________________________________________
Type [_] Corporate Pension/Profit Sharing Plan (401a) [_] Trusteed Xxxxx
[_] Other ___________________
Name of Employer ____________________________________________________________
____________________________________________________________
Address of Employer ____________________________________________________________
____________________________________________________________
City___________________________ State_______________________
Zip____________________________
I request that employees covered under the above Plan be permitted to become
Participants under Metropolitan's Multifunded Annuity Contract ("The Contract")
and for this purpose I request to participate in the Metropolitan Group Annuity
Contracts Trust ("the Trust").
I certify that (1) I have been given a specimen copy of the Contract issued by
Metropolitan to the Trustee of the Trust which describes the rights of persons
participating in the contract; (2) the Plan is a "Plan" as defined in the
contract; (3) should the Plan cease to satisfy the Contract definition I will so
notify Metropolitan; (4) either all employees of the Employer, or all employees
of certain specified classes, are eligible to become Participants under the
Contract; (5) if the Plan is a "Xxxxx" plan, I have received a copy of the
Multifunded Annuity Prospectus from Metropolitan; (6) I have receive and signed
"Disclosure Xxxxx and Corporate Pension and Profit Sharing Plans."
I understand that no sales representative or other person, except an authorized
officer of Metropolitan, has the authority to make or change any contract, to
waive or alter any rights of Metropolitan, or to make any binding promises about
any contract.
_____________________________________
Signature(s) of Trustee(s)
_________________________________________ _____________________________________
Signature for the Employer Title
________ ________________________________ _________ ___________________________
Date City and State of Signing Date City and State of Signing