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 | |
