any reason per the insurance company. ... A completed cancellation request form. 3. If the cancellation is ... The signed document can be a cancellation request form
uniform request and cancellation affidavit (for mortgages and vendor’s liens) state of _____ parish/county of _____ be it known
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Cancellation Request. Explanation (mandatory for flat cancellation) ... *All requests MUST be received by CNA National Warranty Corporation or CNA National Warranty Corporation Florida within 30 days ... Are you aware that if your service contract wa
REASON FOR CANCELLATION: Customer Request – reason: Customer Sold / Traded covered vehicle (attach copy of Bill of Sale/Odometer Statement/Buyers Order). Repossession (attach copy of Repossession Letter). Total Loss (attach letter from Insurance Co.
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CANCELLATION REQUEST RETURN VIA FAX TO 870-424-6618 . EMAIL [email protected] . Cancellations can be processed by submitting a copy of the service agreement and
Reason for Cancellation. (Select One) n Customer Request n Flat Cancellation n Repossession. (Must include Repossession letter from lienholder) n Loan Paid Off n Other. Product To Be Cancelled: n Guaranteed Asset Protection. (GAP) n Lease Wear & Tear
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Express Autogap Customer Waiver Cancellation Request Please complete the following and mail or fax to our office (949) 727-0393 for cancellation of the Express Autogap Waiver. Express Autogap Waiver Number
Date of Sale
Consumer
Dealership
Address
Address
City
State
Year
Make
Zip Model
City
State
VIN
Zip
Current Mileage
Lender/Lessor Cancel Effective:
/
/
Installment Sale Contract/Loan
Term (Months)
Address
Lease
Reason for Cancellation: (please check one)
Sale Unwind
Repossession
Vehicle Traded
Customer Request
The GAP waiver is non-cancellable after a total loss. Cancellations are processed according to the terms on the contract.
Request submitted by:
Dealership/Lender/Lessor
Consumer(s)
_______________________________________ By Date
_________________________________________ Consumer Signature Date
_______________________________________ Title
_________________________________________ Co-Consumer Signature Date
Portfolio, 11 Vanderbilt, Irvine, CA 92618 Telephone (800) 705-4001 Form – GAPCancel
