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MANTIS LIFE INSURANCE COMPANY 200 DAY HILL RD, WINDSOR, CT 06095 WWW.VANTISLIFE.COM pH: 18668268471 Fax: 18602985483 32/,&2:1(5&+$1*(5(48(67)25 5($,1677(0(17 (SELECT ONE) $57(5('8&7,21, 16758&7,2167KLVDSSOLFDWLRQPXVWEHFRPSOHWHGLQLWVHQWLUHW
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icc19-rerr1 final 082019pub is a specific form or report required by the Internal Revenue Service (IRS) for certain tax filings, particularly related to retirement plans.
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