any reason per the insurance company. ... A completed cancellation request form. 3. If the cancellation is ... The signed document can be a cancellati...
HUB/ Impact Insurance Services ATTN: GAP CANCELLATION 877-483-9983 GAP CANCELLATION REQUEST FORM You,
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.
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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Road Hazard Tire & Wheel Florida Cancellation Procedures Step 1 Dealer faxes the following documentation to RpmOne: Completed cancellation form
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
Cancellation Date Contract Number Current Odometer ... and be responsible for all mechanical repairs not covered by any warranty in force. ... Cancellation Request
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I hereby request cancellation of my Vehicle Service Contract (fiContractfl) described above. In consideration of this cancellation, I do hereby
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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
• An itemized invoice will be sent each month. • Payment terms are net 30 days. Call the Business Office with billing related questions: 800-447-6424 (US and Canada)
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CANCELLATION REQUEST FORM ALL CANCELLATIONS ARE FINAL. COVERAGE CANNOT BE REINSTATED FOR ANY REASON. SELLING DEALER IS RESPONSIBLE FOR ALL REFUNDS.
Contract Number: Cancellation Date:
Contract Date:
Year & Model:
V.I.N.:
PROGRAM: GAP I
GAP II
INTIRE
MULTI-SHIELD
OTHER
REASON FOR CANCELLATION: Customer Request
Voided Sale
Repossession
Contract Payoff
Trade
Other
Total Loss
Dealer/Lessor Name: Buyer/Lessee Name:
Address:
City:
State:
Buyer/Lessee Signature
Date
Zip:
Phone:(
Dealer/Lessor Signature
)
Date
By signing this cancellation request I indicate that I have read and understand this termination policy: I hereby request termination of the program in accordance with the cancellation terms and conditions. I understand I relinquish all rights and provisions and release IAS of any, and all financial responsibility regarding this agreement. All cancellations are final and coverage cannot be reinstated for any reason per the insurance company.
INSTRUCTIONS:
1. Complete all information. (Incomplete forms will be returned unprocessed). 2. Copy of warranty contract and/or warranty card must be attached for cancellation. 3. Include all support documentation for payoff, refinancing, voided sale, trade, repossession, etc. 4. Send to: IAS L.P. Administrator Cancellations Department 12800 Angel Side Drive Leander, TX 78641 5. A $25.00 cancellation processing fee will be assessed on all GAP cancellations. 6. Allow three to four weeks for processing.
CANCELLATION PROCEDURES A cancellation request must be received in our office within 30 days of the requested cancellation date to be processed without penalty. All incomplete requests, missing information or support documentation, will be returned unprocessed and will delay refund. All cancellation requests should be mailed from the dealer and will be processed in order by date received. A $25.00 cancellation processing fee will be assessed on all GAP cancellations. All refunds are sent to the dealership unless the dealership is out of business. Cancellation quotes are strongly recommended prior to mailing in a cancellation request. Please use the Cancellation Calculator under the Dealer Services menu at www.iasdirect.com or call 1-800-346-6469 ext. 8002 to get a cancellation quote.
CANCELLATION QUOTES AND FORMS AVAILABLE AT WWW.IASDIRECT.COM
All cancellation requests require the following: 1. A legible enrollment form (contract) with the enrollment price, the terms in months and contract number. 2. A completed cancellation request form. 3. If the cancellation is due to: Customer Request - We must have the customers "Original signature" or a letter from the customer requesting cancellation. The signed document can be a cancellation request form and must be mailed, it can not be faxed. Contract Payoff - A copy of the payoff letter issued by the lienholder to the customer indicating that the account has been paid in full must be provided. (Only valid for GAP) Total Loss - Any document from the primary insurance company or lien holder stating total loss, or customer signature. (Not valid for GAP.) Repossession - A copy of the repossession letter from the lienholder is required. Vehicle Trade - An odometer statement or a cancellation request signed by the customer. A customer's signature must be original and must be mailed, not faxed. Voided Sale - A voided contract may be mailed or faxed with "VOID" written on the contract. We will void the contract and issue a full refund as long as the request is received within 30 days of the contract start date.
Mail all correspondence to: IAS L.P. Administrator Cancellations Department 12800 Angel Side Drive Leander, TX 78641
PLEASE ALLOW 3 TO 4 WEEKS PROCESSING TIME. Rev 101207
