Exhibit 4(c) [LOGO OF JOHN HANCOCK APPEARS HERE] Mutual Life Insurance Company John Hancock Place PO Box 111 Boston, Massachusetts 02117 OWNER [JOHN DOE] ANNUITY CONTRACT NUMBER [000000] ANNUITANT [JOHN DOE] John Hancock Mutual Life Insurance Company...Annuity Contract • August 9th, 1999 • Hancock John Variable Annuity Account H • Massachusetts
