• Cancellation

  • Date Format: MM slash DD slash YYYY
  • I am sending you this written notice to request cancellation of my insurance policy effective on this date.

  • Date Format: MM slash DD slash YYYY
  • I would appreciate you sending me written confirmation within 30 days that the cancellation has been put into effect. Please refund the unused portion of my policy premium, and cease charging my bank account for payment of monthly premiums. Thank you for your prompt attention to this matter. Sincerely,