Transcription of Instructions for completing Broker Dealer Firm or ...
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Instructions for completing Broker Dealer Firm or ...
GP4964US (07/2015)Both John Hancock Life Insurance Company ( ) and John Hancock Life Insurance Company of New York do business under certain instances using the John HancockRetirement Plan Services name. Group annuity contracts and recordkeeping agreements are issued by: John Hancock Life Insurance Company ( ), Boston, MA 02210(not licensed in New York) and John Hancock Life Insurance Company of New York, Valhalla, NY 10595. Product features and availability may differ by state. Plan administrative services may be provided by John Hancock Retirement Plan Services LLC or a plan consultant selected by the for completingBroker Dealer Firm or Financial Representative of Record Change RequestThe change(s) requested in this form may impact information previously disclosed to your eligible employees.
3 Removal of Existing Broker Dealer or Financial Representative of Record Complete this section to remove ALL Broker Dealer Firm(s) or Financial Representative(s). To remove a Financial Representative and replace with an RIA, complete the RIA Designation form.
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