John Hancock Mutual Life Fillable Forms

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INSTRUCTIONS 1. This form is used to elect a nonforfeiture option when permitted under the terms of a policy. It should be completed in duplicate and both copies signed by the Owner, any irrevocable Beneficiary, and any Collateral Assignee. Both copies should then be sent to the Home Office. After acknowledgment the duplicate copy will be returned for filing with the policy. The policy is not required. Date: Policy in force at (if different agency) Mktg. Rep's or Mktg. Terr. 2. To: From: Enclosures NOTICE More

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nonforfeiture Hancock Mktg assents thereon VLI-74 VLI nonforteiture Assignee Enclosures undersigned Terr acknowledges irrevocable premiums acknowledgment dividends discontinued revoke VARIABLE accumulated provision affiliated stub decrease Beneficiary lap

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INSTRUCTIONS 1. This form is used to elect a nonforfeiture option when permitted under the terms of a policy. It should be completed in duplicate and both

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John Hancock Mutual Life Fillable Forms

Fillable INSTRUCTIONS

NOTE: Unless specifically requested in PART B, this form does not revoke any provision for Less

notice_of_elect ion

Keywords

nonforfeiture Hancock Mktg assents thereon VLI-74 VLI nonforteiture Assignee Enclosures undersigned Terr acknowledges irrevocable premiums acknowledgment dividends discontinued revoke VARIABLE accumulated provision affiliated stub decrease Beneficiary lap

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