Manulife
CoverMe


At Your Service: Request a Change
Address, Telephone Number Change

For your convenience you can submit your change of contact information to Manulife Financial online.


Please note that you require an SSL compliant browser to use this page. Refer to Secure Browser standards for details.

If you prefer, you can instead print this form, write in your information below, and mail it to:
    Manulife Financial
    Affinity Markets
    P.O. Box 4213, Station A
    Toronto, ON, M5W 5M3

To ensure that we have enough information to process your request, please complete ALL of the following:

Tell Us Who You Are:
* Required field

* Your Policy/Certificate Number
(10 digits)
* Your First Name (as shown on your Policy)
* Your Last Name (as shown on your Policy)
* Your Date of Birth / / 19 (yy)

Tell Us Your OLD Contact Information:
* Required field

* Country/District
* Address 1
Address 2
Address 3
* City/Town
* Province/State
* Postal/Zip Code
* Residence Telephone( ) -
Business Telephone ( ) - ext
E-mail Address

Tell Us Your NEW Contact Information:
* Required field

* Country
* Address 1
Address 2
Address 3
* City/Town
* Province/State
* Postal/Zip Code
* Residence Telephone( ) -
Business Telephone ( ) - ext
E-mail Address
* Change effective as of / / 20 (yy)

Please check and correct your information above, and then click on "Continue". You will then be presented with a summary of the information you have sent. Please print the summary and keep for your records.