You are on page 1of 1

(Nama dan Alamat Pemegang Polisi)

(Nama dan Alamat Syarikat Insuran)

January 13th, 2014

ATT: Cancellations RE: Life Assurance Policy # Please consider this letter as a formal request to cancel the referenced life assurance policy. Please stop all debits or charges for premium payments. Please make this cancellation effective as of 17/01/2014. I am also requesting written confirmation of the cancellation and the return of any premiums. The cash value of the policy should also be sent with any returned premium. This action needs to occur within a period of 14 days from the receipt of this letter. Sincerely,

( )

You might also like