1. System Generated Field Panel
2. Author Entered Field Panel
3. Form Title Panel
4. End-user Entered Field Panel
5. Thank You and Error Message Panel
6. Hidden Panel

• System Generated Field Panel
• Author Entered Field Panel
• Form Title Panel
• End-user Entered Field Panel
• Thank You and Error Message Panel
• Hidden Panel

System Generated Field Panel 

MCID

Sort Order

Required Fields

Page From

Site

 Author Entered Field Panel

Author Input Panel - Required fields

Select the form layout

*Type of Form Integration siteComponent slider contactCardForm

Analytics form title

Select the market region

*Region ASIA APAC EMEA LATAM USA

Select the country

*Country Bangladesh Australia Hongkong United Kingdom Turkey Kuwait Bahrain Egypt Jordan Greece Oman Lebanon Romania Bulgaria France Poland Portugal Spain UAE Italy Russia Portugal Argentina Columbia Brazil USA

Analytics form type

*Type Of Form Contactform Inquiry Grievance

Backend Integration Type

Select the Backend Integration - Email or KANA (US Only) email kana

Form Title  Panel

End-user Entered Field Panel

* Required Fields

*Policy/Contract

Please tell us each policy/account that we need to update with your new addressThe text will appear here

* Product Type Annuity Life Insurance

* Policy/Contract Number

Don't see your products listed? Contact us.

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*Policy Owner

* First Name

* Last Name

* Email

* Last 4 Digits of SSN

* Date of Birth (MM/DD/YYYY)

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*Old Address

Please provide your old address as it appears on your policy, contract or statement.

* Address

* City

Include apt / suite number, if applicable.

* State

* State AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY

* Zip/Postal Code

* Country

* Phone (xxx-xxx-xxxx)

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*New Address

* Address

* City

Include apt / suite number, if applicable.

* State

* State AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY

* Zip/Postal Code

* Country

* Phone (xxx-xxx-xxxx)

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**Effective Date of Change

When should we start using your new address?

* Effective Date (MM/DD/YYYY)

SUBMIT

MetLife respects your privacy.

For California Residents.

Thank You/Error Panel Configuration

Message Option Same page-fadeout Same page-fixed New page

Settings for same page thank you/error message

Message Delay

Error!

An Error has occurred during form submission. Please try again.

Thank You!

A MetLife representative will be in contact with you shortly.

Settings for separate page thank you/error message

Error Page

Thank You Page

Page Target

Page Target Same Tab New Tab

Hidden Panel

Name Of The Template