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Plan Consultant (TPA) Change Request - …

GP1003US (11/2019) Page 1 of 5 Group annuity contracts and recordkeeping agreements are issued by: John Hancock Life Insurance Company ( ) ( John Hancock USA ), Boston, MA (not licensed in New York) and John Hancock Life Insurance Company of New York ( John Hancock NY ), Valhalla, NY. Product features and availability may differ by state. John Hancock USA and John Hancock NY each make available a platform of investment alternatives to sponsors or administrators of retirement plans without regard to the individualized needs of any plan . Unless otherwise specifically stated in writing, John Hancock USA and John Hancock NY do not, and are not undertaking to, provide impartial investment advice or give advice in a fiduciary capacity. Important Information for Completing the plan Consultant (TPA) Designation Request For use by John Hancock retirement plan Services Signature clients The Change (s) requested in this form may impact information previously disclosed to your eligible employees.

SmartCareSM is a Service Mark of John Hancock Life Insurance Company (U.S.A.) and is used under license by John Hancock Life Insurance Company of New York. Both John Hancock Life Insurance Company (U.S.A.) and John Hancock Life Insurance Company of New York do business under certain instances using the John Hancock Retirement

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