Vehicle Service Contract Cancellation Request Form

This form will be used for the purpose of evaluating a cancellation request only and does not constitute an agreement of cancellation. In order to complete your cancellation request, please provide all information requested below and submit to EFG Companies by clicking ‘Submit Cancellation Request” below.

Customer First Name*
Customer Last Name*
Customer Email*
Customer Phone*
Contract Number*
Contract Effective Date
Vehicle Identification Number (VIN)*
Cancellation Date*
Seller of Vehicle Service Contract
Odometer Reading at Cancellation Date*
Reason for Cancellation Request
(Choose Only One)
- Customer Request
- Loss (loss documents required)
- Repossession (repo notice required)
- Traded/Sold (Lienholder payoff notice required)
- Loan Paid Off/Refinanced
- Other
Other
Upload Required Documents
Drop files here or

Max. file size: 700 MB.
Please review STATE REQUIREMENTS & DISCLOSURES for your state specific cancellation language. You are entitled to a full refund if you contact and provide written notice of the cancellation with the first thirty (30) days after the purchase date, and if you have not filed a claim against the contract. If the cancellation request is thirty-one (31) days or more after the purchase date, you shall receive a pro-rata refund less any cancel processing fee owed to the administrator unless specified otherwise by state law or required otherwise by the administrator. If the purchase price of this contract was included in the financing of the vehicle, or financed by a funding company, any refund due will be paid to the financial institution/lender on your behalf, and the refund will be deducted from your balance owed.

What happens after I submit this cancellation request?
Once EFG Companies receives your cancellation request, it will be reviewed by our contract administration team. You will receive an email from the contract administration team if any additional documentation is needed to process your request. Cancellations will not be processed without proper documentation.
By submitting this cancellation request form electronically below You agree that your signature on this document (hereafter referred to as your "E-Signature") is as valid as if you signed the document in writing.
Signature Agreement
By submitting this cancellation request form electronically below You agree that your signature on this document (hereafter referred to as your “E-Signature”) is as valid as if you signed the document in writing.

Vehicle Service Contract Cancellation Request Form

What happens after I submit this cancellation request?

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