The forms listed below are available for download in Adobe PDF format. If you are unable to open the PDF files below, you will need to download and install the free Adobe Acrobat PDF Reader.
Transfer Form Cancellation Form Cancellation FAQs To cancel your coverage, simply click on the "Cancellation Form" link, print the form, fill out the requested information including signature, and return the form to the selling dealer or program administrator listed on the contract for refund processing.
Cancellation Form Cancellation FAQs Privacy Notice To cancel your coverage, simply click on the "Cancellation Form" link, print the form, fill out the requested information including signature, and return the form to the selling dealer or program administrator listed on the contract for refund processing.
Credit Life Insurance Claim Form New York Credit Life Insurance Claim Form Credit Disability Insurance Claim Form Third Party Authorization Form W-9 Packet To cancel your credit life and/or disability insurance, please contact the program administrator at 800.841.4777 or contact the selling dealer.