Transcription of Cancellation Request Form - afasinc.com
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Cancellation Request Form - afasinc.com
Customer Name: _____Selling Dealership:_____Address: _____Dealership Contact Name: _____City, State Zip: _____Dealership Phone Number:_____Contract Number: _____Last 6 of VIN: _____Effective Cancellation Date: _____Current Odometer (if applicable): _____Vehicle Year, Make, Model: _____Lienholder and Address: _____Customer Request reason: _____Contract Holder s Signature (Required)_____Co-Buyer Signature_____Date_____Date / / / / / /_____Dealer Representative Signature_____Date_____ Vehicle Service Contract (VSC)_____ Maintenance_____ GAP Waiver_____ Ancillary_____ Excess Wear & TearPLEASE INITIAL WHICH PRODUCT(S) YOU WISH TO CANCEL: Cancellation Request FormREASON FOR Cancellation :PLEASE READ AND INITIAL THE FOLLOWING ITEMS UPON REVIEW AND AGREEMENT:I HAVE READ AND UNDERSTAND THE ABOVE STATEMENTS AND AGREE TO THEM CANCELLATIONS: YOU HAVE THE UNCONDITIONAL RIGHT TO CANCEL GAP FOR A FULL REFUND/CREDIT WITHIN THIRTY (30) D
cancellation request form reason for cancellation: please read and initial the following items upon review and agreement: i have read and understand the above statements and agree to them fully. gap cancellations: you have the unconditional right to cancel gap for a full refund/credit within thirty (30) days after it is
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