WHICH PRODUCT(S) ARE YOU REQUESTING TO BE CANCELLED? (Check all that apply)
REASON FOR CANCELLATION
Dealership Information
Customer Information
Click here if Customer's address or phone number has changed from the Customer information listed on the product Agreement/Addendum.
CANCELLATION SUBMITTED BY DEALER:
CANCELLATION SUBMITTED BY CUSTOMER
CANCELLATIONS MAY REQUIRE ADDITIONAL DOCUMENTATION. THE PROGRAM ADMINISTRATOR WILL NOTIFY YOU IF ADDITIONAL DOCUMENTATION IS NECESSARY (EXAMPLE: CANCELLATION DUE TO A REPOSSESSION WILL REQUIRE A REPOSSESSION LETTER FROM THE LIENHOLDER).
ELECTRONIC SIGNATURE AND TRANSACTION DISCLAIMER: Unless expressly stated otherwise in a written communication in other than electronic form, or unless the author EXPRESSLY designates herein a written portion of this electronic message to be an “electronic signature” and clearly and unequivocally specifies the writing to which that electronic signature applies, nothing contained herein or in any communication in connection herewith shall satisfy the requirements for a writing, nor constitute a contract, an amendment of existing agreements, or electronic signature, as those terms are defined in or contemplated by the Electronic Signatures In Global and National Commerce Act, 15 U.S.C. Section 7001 et seq, or the Uniform Electronic Transaction Act as adopted by any state or any other statute governing electronic transactions.
