Life Insurance Forms
Find and download the form you need. Print, complete, and sign. Then mail or fax it to:
Vantis Life
Policy Services Dept.
PO Box 103
Brattleboro, VT 05302-0103
Fax 860-298-5483
Some forms can be submitted & signed electronically by clicking on e-sign below.
Questions?  Call customer service at 1-866-826-8471Â
The forms are in Adobe PDF format.Â
Assignment of Life Insurance Policy as Collateral | Â | ||
Beneficiary Change | Download | e-sign | |
Charity Election Form | Download | e-sign | |
HIPAA Authorization | Download | e-sign | |
Ownership Change Request Form | Download | Â | |
Policy Change Request Form | Download | e-sign | |
Premium Payment Authorization | Download | Â | |
Reinstatement Request (For all states except CA, DE, FL, ND, NY, SD) |
Download | Â | |
Reinstatement Request (For CA, DE, FL, ND, SD) |
Download | Â | |
Release of Assignment | Download | Â | |
Request for Certificate of Insurance/Duplicate Policy | Download | Â | |
Request for Rate Reduction (For all states except CA, DE, FL, ND, NY, SD) |
Download | Â | |
Request for Rate Reduction (For CA, DE, FL, ND, SD) |
Download | Â | |
Termination Request Form | Download | e-sign | |
Third Party Notice Request Form | Download | e-sign |