Power Of Attorney Certification

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Power of attorney certification
Introduction
Instructions
Questions about this form?
Please use this form to certify a power of attorney on a mutual fund account. Please print in all capital
800-225-5291
letters and use black ink.
Contact us:
800-225-5291
See the end of this document for
return instructions
1. Current account information
Please enter your current account information
Name of account owner as listed on quarterly statements (First)
(MI)
(Last)
Mailing address of account owner
City
State
Zip code
Owner’s Social Security number (Required)
Phone number
Fund and account number
Use a separate sheet if necessary.
Fund number
Account number
Fund number
Account number
2. Additional required documentation
John Hancock Signature Services, Inc. requires the following documentation in order to authorize a power of attorney to transact business on behalf of a shareholder.
John Hancock Signature Services, Inc. requires this documentation to be recertified every 12 months or upon any change of circumstance that affects the validity of the
information found on the documents previously provided.
I have included a copy of the power of attorney document.
3. Signature and certification
The undersigned power of attorney certifies that the following items are true:
The power of attorney document attached is in full force and effect, is a true and accurate copy of the original, and the grantor is still alive. The power of attorney has not
been modified or revoked and my authority to act has not been terminated. The power of attorney agrees to inform the transfer agent, in writing, of any changes to the
power of attorney agreement or any other event that could alter the certifications made above.
By signing this document, the power of attorney verifies that all information contained herein is true and complete. The power of attorney agrees to indemnify John
Hancock Investments, John Hancock Funds, LLC, John Hancock Signature Services, Inc., and their respective affiliates, and to hold them harmless from and against all
liability as a result of claims, demands, or judgments against them arising from any mutual fund transaction in reliance on this certification.
SIGN
HERE
Signature of power of attorney
Date (MM/DD/YYYY)
PRINT
HERE
Printed name of power of attorney
PAGE 1 0F 2
POACFM (1/16)
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