0000950123-11-079167 Sample Contracts

John Hancock Life Insurance Company (U.S.A.) Home Office: Bloomfield Hills, MI
Annuity Contract • August 22nd, 2011 • John Hancock Life Insurance Co (Usa) Separate Account H

This Contract is issued in consideration of the Payments. John Hancock Life Insurance Company (U.S.A.), a stock company, agrees to pay the benefits of this Contract in accordance with its terms.

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