Life Insurance Forms

Find and download the form you need. Print, complete, and sign.  Then mail or fax it to:

Vantis Life
PO Box 310
Millville, NJ 08332-0310

Fax 860-298-5483

Some forms can be submitted & signed electronically by clicking on e-sign below.

Questions?  Call customer service at 1-866-826-8471. We are available Mon-Fri 8:30am - 6:00pm ET.

The forms are in Adobe PDF format. 

Assignment of Life Insurance Policy as Collateral  
Beneficiary ChangeDownloade-sign 
Charity Election FormDownloade-sign 
HIPAA AuthorizationDownloade-sign 
Ownership Change Request FormDownload 
Policy Change Request FormDownloade-sign
Reinstatement Request
(For all states except CA, DE, FL, ND, NY, SD)
Download  
Reinstatement Request
(For CA, DE, FL, ND, SD)
Download  
Release of AssignmentDownload  
Request for Certificate of Insurance/Duplicate PolicyDownloade-sign< 
Request for Rate Reduction
(For all states except CA, DE, FL, ND, NY, SD)
Download  
Request for Rate Reduction
(For CA, DE, FL, ND, SD)
Download  
Termination Request FormDownloade-sign 

The following forms are specific to NY state customers:


Assignment of Life Insurance Policy as CollateralDownloade-sign
Beneficiary ChangeDownloade-sign
Charity Election FormDownload 
HIPAA AuthorizationDownloade-sign
Ownership Change Request FormDownload 
Policy Change Request FormDownloade-sign
Reinstatement RequestDownload 
Release of AssignmentDownload 
Request for Certificate of Insurance/Duplicate PolicyDownload 
Request for Rate ReductionDownload 
Termination Request FormDownload