All fields marked with * are required. User name is the name with which you log into the site.
Example: Joe Franklin

* Please record your User Name and Password as they will NOT be mailed to you.

I am registering as ...*
Policy Number:*
First Name:*
Last Name:*
Date of Birth:(mm/dd/yyyy)
Company Name:
Trust Name:
Daytime Phone Number:* -   -   Ext:  
Social Security Number:(123-45-6789, for Individuals)
Tax Identification Number:(12-3456789, for Companies and Trusts)
Registering For ...*
Internet Access
User Name:*

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If you need assistance, call 1-888-888-8856 for John Hancock (U.S.A.) or 1-888-267-7781 for John Hancock New York


Insurance products are issued by: John Hancock Life Insurance Company (U.S.A.), Boston, MA 02117 (not licensed in New York) and John Hancock Life Insurance Company of New York, Valhalla, NY 10595.