The Manufacturers Life Insurance Co. (Phils.), Inc.

Life Insurance Pension / Education

In this form, “the Company” means the Manufacturers Life Insurance Co. (Phils.). "We”, “us”, “our”, “I”, “me” and “my” mean the Proposed Insured and/or Owner, Beneficiary, Legal Guardian,
Trustee and/or Assignee as may be applicable.

General Information

Name Address Contact Mobile % of The beneficiary is the Date of Birth Sex Citizenship/ Place/Country Irrevocable?
Proposed Insured’s
(Last Name, First Name), (Middle Name
Do not know / not applicable)
(Number, Street, Village, District,City/Municipality,
State/Province,Country, Zip Code)
Number: Share (state relationship):
(mm/dd/yyyy) (M / F) Nationality of Birth Yes No
(Country Code) (Mobile No.) (indicate all)

From No. MP CS BCF (v.08/2021)

The Manufacturers Life Insurance Co. (Phils.), Inc.

Life Insurance Pension / Education

Trustee Information
Name (Last Name, First Name, Middle Name, Do not know/Not applicable) Contact Number (Country Code)(Mobile No.) The Trustee is the Minor Beneficiary’s (state relationship):

Address (Number, Street, Village, District, City/Municipality, State/Province, Country, Zip Code) Citizenship/Nationality Sex Place/Country of Birth Date of Birth (mm/dd/yyyy)

By signing on this form, I confirm that the information I provided is complete and true. I also allow the Company to update my records based on the information in this
form. I understand that the beneficiaries listed in this form will replace any beneficiary I previously assigned to this policy. I fully understand that if I have designated
my beneficiary/ies as irrevocable, I cannot exercise any of the options or transactions under this policy without the consent of the irrevocable beneficiaries. These options
or transactions can be the following but not limited to, applying for loans, surrendering the policy for cash, changing policy details, and exercising other ownership rights
under the policy. I also understand that in cases where an irrevocable beneficiary is a minor, I cannot excercise the same options under my policy without the consent
of the minor’s legal guardian. Legal guardian/s should be specifically authorized by court order or by law to act in behalf of the minor for the particular transaction.

The Company collects and uses my personal and sensitive information to operate an insurance business. By signing this form and continuing to avail of the
Company’s products and services, I agree that the information I provided and any subsequent changes to it (including the information of third parties) can be
processed, shared, disclosed, transferred or used by the Company, including its shareholders, directors and employees, affiliates, subsidiaries, business
partners, any member of the Manulife Financial Group (including those located overseas), advisors, representatives, industry associations and databases, local
and foreign authorities having jurisdiction over companies within the Manulife Financial Group, external auditors/counsels, and its third party service providers
(whether within or outside the Philippines) within the rules set by the Data Privacy Act of 2012, as may be amended from time to time, relevant regulations and
the Company’s privacy policy available at www.manulife.com.ph/Customer-Privacy-Policy for purposes of:
· underwriting and approving my application;
· administering, serving and reinsuring my policy;
· marketing (including marketing of products and services offered by any member of the Manulife Financial Group and those of its business partners),
promoting, getting feedback on its products and services, and measuring client satisfaction;
· conducting data analytics and doing automated data processing;
· preventing money laundering or terrorist financing activities;
· complying with reportorial and regulatory requirements of both local and foreign regulatory authorities (including local and foreign tax authorities and stock
exchanges) as well as other legal, regulatory or contractual obligations of any member within the Manulife Financial Group, relating to information sharing, tax
reporting or otherwise;
· the Company’s internal purposes such as governance, risk, actuarial, claims and underwriting management, and reporting; and
· for other reasonable purposes related to the services provided.
During the efectivity of the contract/policy, I agree of the following: in case the Company is unable to comply with relevant customer due diligence (CDD)
measures, as required under the Anti-Money Laundering Act, as amended and relevant issuances, due to my fault, the Company may apply the following: (a)
measures to restrict the services available or prohibit any further transactions on the contract/policy until full and proper CDD measures have been successfully
conducted; and (b) in case the foregoing is unsuccessful, terminate business relationship, which shall only entitle me to receive the unused portions of premium
or withdrawal value, if any, whichever is applicable. I also agree to be bound by obligations set out in relevant United Nations Security Council Resolutions
relating to the prevention and suppression of proliferation financing of weapons of mass destruction, including the freezing and unfreezing actions as well as
prohibitions from conducting transactions with designated persons and entities
I/we have read the above questions, statements and answers and certify that the information provided above is true, correct and complete based on my/our
personal knowledge and official records. I/we also allow the Company to update my/our records based on the information found in this form and to use such
to administer and service the policy. If signing for the legal entity identified above, I/we certify that I/we have the capacity to sign for such legal entity.

Date Signed Place Signed

From No. MP CS BCF (v.08/2021)

 Name Address Contact Mobile % of The beneficiary is the Date of Birth Sex Citizenship/ Place/Country Irrevocable?
Proposed Insured’s
(Last Name, First Name), (Middle Name
Do not know / not applicable)
(Number, Street, Village, District,City/Municipality,
State/Province,Country, Zip Code)
Number: Share (mm/dd/yyyy) (M / F) Nationality of Birth Yes No
(Country Code) (Mobile No.)
(state relationship): (indicate all)

Trustee Information
Name (Last Name, First Name, Middle Name, Do not know/Not applicable) Contact Number (Country Code)(Mobile No.) The Trustee is the Minor Beneficiary’s (state relationship):

Address (Number, Street, Village, District, City/Municipality, State/Province, Country, Zip Code) Citizenship/Nationality Sex Place/Country of Birth Date of Birth (mm/dd/yyyy)

For Manulife Use Only

From No. MP CS BCF (v.08/2021)