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Investment Option Change Venture® Product Series

Introduction

InstructionsUse this form to make investment option transfers.

• Use this form to make investment option transfers within your Venture contract.• A separate form must be completed for requests on any additional contracts.

• Please review your variable annuity contract for detailed information regarding trade restrictions and limitations.

• If you elected to have telephone transfer authorization on your annuity, you may call us to process this transaction.

• Changes in your current or future investment allocation may conflict with the intended results of any special programs (i.e. Dollar Cost Averaging, Rebalancing, Systematic Withdrawal, etc.).

• Annuitized policies can only be invested in 4 funds at the most.

• Some products do not allow fixed funds to be included in reallocations. Please see your prospectus for fixed investment option rules.

Questions about this form? ) 1-800-344-1029

+ See the end of this document for return instructions

To fax this form: 7 FAX 1-617-663-3160

1. Owner Information

Contract Owner Information:

NOT FOR USE IN NEW YORK

2. Specific One-Time Transfer

Complete this section when you want to move the contract value from one investment option to another. List each investment option separately. If you also want to change how your future purchase payments will be allocated, check option C in Section 3 and then choose your new future allocations and percentages in Section 4 of this form.

Percentage OR Dollar Amount: From (Source Investment Option): To (Destination Investment Option):

1. ______________ % or $ _______________________ 1. __________________________ 1. _____________________________

2. ______________ % or $ _______________________ 2. __________________________ 2. _____________________________

3. ______________ % or $ _______________________ 3. __________________________ 3. _____________________________

4. ______________ % or $ _______________________ 4. __________________________ 4. _____________________________

5. ______________ % or $ _______________________ 5. __________________________ 5. _____________________________

Contract Number

Owner’s Name (First)

Owner’s Address (Street)

(MI)

(City)

(Last)

(State)

Contract Owner’s Phone Number Date of Birth (MM/DD/YYYY)

(Zip)

Co-Owner Information (if applicable):

Co-Owner’s Name

Co-Owner’s Address (Street) (City) (State) (Zip)

Financial Representative's Name (if applicable) Financial Representative's Phone Number

Co-Owner’s Owner’s Phone Number Date of Birth (MM/DD/YYYY)

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Issuer: John Hancock Life Insurance Company (U.S.A.), Lansing, MI (not licensed in New York)

Contract Number:

Complete this section and Section 4 or 5 to reallocate the current contract value of your annuity among investment options and/or change where your future purchase payments will be allocated. Check ONE of the following three options and complete Section 4 or 5 to make your investment selections.

A: Follow my instructions in Section 4 or 5 to reallocate all of my current contract value (default).

B: Follow my instructions in Section 4 or 5 to reallocate all of my current contract value and future purchase payments.

C: Follow my instructions in Section 4 or 5 for future purchase payments only.

3. Reallocation of Value and Future Investment Option Change

Complete the applicable option to make investment option transfers within your Venture, Venture III, Venture Strategy, Venture Vantage or Venture Vision contracts issued PRIOR to November 23, 2009.Using the lists below, please choose the variable investment options and percentages for your allocation. Allocations can be made to one or any combination of the available variable investment options as long as they are within the section applicable to your contract. Percentages must equal 100%. Please refer to your prospectus for further details on your contract. See Section 5 on the following page for options for contracts issued AFTER to November 22, 2009.

4. Investment Option Selections

______ % Lifestyle Balanced Portfolio (JHAM1,2)______ % Lifestyle Conservative Portfolio (JHAM1,2)______ % Lifestyle Growth Portfolio (JHAM1,2)______ % Lifestyle Moderate Portfolio (JHAM1,2)

OPTION B: Variable investment options available to contracts purchased without a Guaranteed Minimum Withdrawal Benefit PRIOR to November 23, 2009.

______ % 500 Index Trust (JHAM2)______ % Active Bond (Declaration/JHAM1)______ % American Asset Allocation (Capital Research)______ % American Global Growth (Capital Research)______ % American Growth (Capital Research)______ % American Growth-Income (Capital Research)______ % American International (Capital Research)______ % Blue Chip Growth (T.Rowe Price)______ % Capital Appreciation (Jennison)______ % Capital Appreciation Value (T. Rowe Price)______ % Core Bond (Wells Capital Management, Inc.)______ % Emerging Markets Value (Dimensional )______ % Equity Income (T. Rowe Price)______ % Financial Industries (JHAM1)______ % Fundamental All Cap Core (JHAM1)______ % Fundamental Large Cap Value (JHAM1)______ % Global (Templeton)______ % Global Bond (PIMCO)______ % Health Sciences (T. Rowe Price)

______ % Managed Volatility Balanced Portfolio (JHAM1,2)______ % Managed Volatility Conservative Portfolio (JHAM1,2)______ % Managed Volatility Growth Portfolio (JHAM1,2)

______ % Managed Volatility Moderate Portfolio (JHAM1,2)______ % Total Bond Market Trust (Declaration)______ % Ultra Short Term Bond (JHAM1)

______ % High Yield (Western Asset)______ % International Equity Index Trust (SsgA)______ % International Growth Stock (Invesco)______ % International Small Company (Dimensional)______ % International Value (Templeton Investment)______ % Investment Quality Bond (Wellington)______ % Lifestyle Aggressive Portfolio (JHAM1,2)______ % Lifestyle Balanced Portfolio (JHAM1,2)______ % Lifestyle Conservative Portfolio (JHAM 1,2)______ % Lifestyle Growth Portfolio (JHAM1,2)______ % Lifestyle Moderate Portfolio (JHAM1,2)______ % Managed Volatility Aggressive Portfolio (JHAM1,2)______ % Managed Volatility Balanced Portfolio (JHAM1,2)______ % Managed Volatility Conservative Portfolio (JHAM1,2)______ % Managed Volatility Growth Portfolio (JHAM1,2)______ % Managed Volatility Moderate Portfolio (JHAM1,2)

______ % Mid Cap Index (JHAM1,2)______ % Mid Cap Stock (Wellington)______ % Mid Value (T.Rowe Price)______ % Real Estate Securities (DIMA)______ % Science & Technology

(T.Rowe Price/RCM)______ % Select Bond (JHAM1)______ % Short Term Government Income (JHAM1)______ % Small Cap Index (JHAM2)______ % Small Cap Opportunities (DFA/GW&K)______ % Small Cap Stock (Wellington)______ % Small Cap Value (Wellington)______ % Small Company Value (T. Rowe Price)______ % Strategic Income Opportunities (JHAM1)______ % Total Bond Market Trust (Declaration)______ % Total Stock Market Index (JHAM2)______ % Ultra Short Term Bond (JHAM1)______ % Utilities (MFS1)

1 John Hancock Asset Management a division of Manulife Asset Management (U.S.) LLC2 John Hancock Asset Management (North America) a division of Manulife Asset Management (North America) Limited

OPTION A:Variable investment options available to contracts purchased with a Guaranteed Minimum Withdrawal Benefit PRIOR to November 23, 2009.

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Contract Number:

Complete the applicable option to make investment option transfers within your Venture 4, Venture 4 Series, Venture 7 Series, Venture 2009 or Venture Frontier contracts issued AFTER November 22, 2009.Using the lists below, please choose the variable investment options and percentages for your allocation. Allocations can be made to one or any combination of the available variable investment options as long as they are within the section applicable to your contract. Percentages must equal 100%. Please refer to your prospectus for further details on your contract.

5. Investment Option Selections

______ % Lifestyle Balanced Portfolio (JHAM1,2)______ % Lifestyle Conservative Portfolio (JHAM1,2)

______ % Lifestyle Growth Portfolio (JHAM1,2)______ % Lifestyle Moderate Portfolio (JHAM1,2)

OPTION A:Variable investment options available on Venture 4 Series, 7 Series and Venture Frontier contracts with a Guaranteed Minimum Withdrawal Benefit purchased AFTER November 22, 2009.

1 John Hancock Asset Management a division of Manulife Asset Management (U.S.) LLC2 John Hancock Asset Management (North America) a division of Manulife Asset Management (North America) Limited

______ % Ultra Short Term Bond (JHAM1)

______ % Lifestyle Balanced Portfolio (JHAM1,2)______ % Lifestyle Conservative Portfolio (JHAM1,2)______ % Lifestyle Growth Portfolio (JHAM1,2)______ % Lifestyle Moderate Portfolio (JHAM1,2)

______ % Managed Volatility Balanced Portfolio (JHAM1,2)______ % Managed Volatility Conservative Portfolio (JHAM1,2)______ % Managed Volatility Growth Portfolio (JHAM1,2)

OPTION B:Variable investment options available on Venture 4 or Venture 2009 contracts with a Guaranteed Minimum Withdrawal Benefit purchased AFTER November 22, 2009.

______ % Managed Volatility Moderate Portfolio (JHAM1,2)______ % Total Bond Market Trust (Declaration)______ % Ultra Short Term Bond (JHAM1)

______ % Investment Quality Bond (Wellington)______ % Lifestyle Balanced Portfolio (JHAM1,2)______ % Lifestyle Conservative Portfolio (JHAM1,2)______ % Lifestyle Growth Portfolio (JHAM1,2)

______ % Lifestyle Moderate Portfolio (JHAM1,2)______ % Managed Volatility Balanced Portfolio (JHAM1,2)______ % Managed Volatility Conservative Portfolio (JHAM1,2)______ % Managed Volatility Growth Portfolio (JHAM1,2)

OPTION C:Variable investment options available on Venture 4, Venture 4 Series, Venture 7 Series, Venture 2009 or Venture Frontier contracts without a Guaranteed Minimum Withdrawal Benefit purchased AFTER November 22, 2009.

______ % Managed Volatility Moderate Portfolio (JHAM1,2)______ % Total Bond Market Trust (Declaration)______ % Ultra Short Term Bond (JHAM1)

6. Authorization

I/We request John Hancock make the changes specified in Sections 2, 3 and 4 or 5 of this form to the specified contract, and I/we agree to submit additional information upon request if such information, in the discretion of John Hancock, is necessary to implement the changes on this form. By signing this Section 6, I/we authorize John Hancock to interpret this request in order to resolve any ambiguities, inconsistencies or omissions.

SIGNHERE

Signature of Contract Owner

Today’s Date (MM/DD/YYYY)

SIGNHERE

Signature of Co-Owner (if applicable)

Today’s Date (MM/DD/YYYY)

7. Submission Instructions

Please enclose and mail to:

+ National Contracts John Hancock Annuities Service Center PO Box 55444 Boston, MA 02205-5444

+ Overnight Deliveries John Hancock Annuities Service Center 30 Dan Road, STE. 55444 Canton, MA 02021-2809

Your account at your fingertips Register at www.jhannuities.com

) Questions: 1-800-344-1029

7 To fax this form: 1-617-663-3160

8 www.jhannuities.com