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This form is often required by the insurance company when policy cancellation is requested before the end of a policy term. Please include your name on the form, sign it with a witness signature, and return it to us by email (scan attachment), FAX, or mail.

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form is usually required by the insurance company to reinstate a policy which has lapsed due to non-payment. Please include your name, sign and date and return it to us by email (scan attachment), FAX, or mail.

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