Form Fp7209 PDF Details

When individuals finance or lease vehicles, they often seek the security of Guaranteed Asset Protection (GAP) insurance to safeguard against the financial gap between the insurance payout and the balance owed on the vehicle in the event of a total loss. The FP7209 form plays a crucial role in this context, acting as the GAP Cancellation Request Form provided by American Heritage Insurance Services. This document outlines the procedure for customers wishing to cancel their GAP coverage. Notably, it grants customers an unconditional right to cancel their GAP insurance for a full refund or credit within thirty days after purchase, assuming the vehicle has not been declared a total loss. Importantly, the form must be completed in its entirety and returned to the specified address within the 30-day window to effectuate cancellation. It requires detailed information from both the dealer and the customer, including the reason for cancellation, and necessitates the inclusion of supporting documents such as a cancellation quote or proof of repossession, if applicable. Designed to streamline the cancellation process, its careful completion ensures that the request is handled efficiently and effectively, reinforcing the importance of consumer rights and protections within the realm of vehicle financing.

QuestionAnswer
Form NameForm Fp7209
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesahis gap claim, gap cancellation request form online, fp7209, ahis gap cancellation form

Form Preview Example

GAP Cancellation Request Form

Return document to: American Heritage Insurance Services, 1776 American Heritage Life Dr., Jacksonville, FL 32224

Attn: Cancellation Dept. Phone: 800.621.4871 Fax: 866.398.9021 email: cancellations@allstatedealerservices.com

Please complete ALL sections of this form and submit along with a copy of a cancellation quote, if one was received, and the Guaranteed Asset Protection (GAP) Addendum (Addendum).

CANCELLATION: YOU HAVE THE UNCONDITIONAL RIGHT TO CANCEL GAP FOR A FULL REFUND/CREDIT WITHIN THIRTY (30) DAYS AFTER IT IS PURCHSASED PROVIDED YOUR COLLATERAL HAS NOT SUFFERED A TOTAL LOSS, AND YOU COMPLETED AND RETURNED THIS FORM OR OTHER WRITTEN NOTICE OF CANCELLATION TO THE ABOVE ADDRESS POSTMARKED NO LATER THAN THIRTY (30) DAYS AFTER THE GAP WAS PURCHASED. IF YOU DO NOT RECEIVE THE REFUND/CREDIT WITHIN SIXTY (60) DAYS OF NOTICE OF CANCELLATION/TERMINATION, CONTACT THE GAP ADMINISTRATOR.

SECTION A - DEALER INFORMATION (Please PRINT)

 

 

Account Name

 

 

 

 

 

 

Today’s Date (mm/dd/yyyy)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

City

 

State

 

 

 

Zip Code

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Phone

 

 

 

 

 

 

Fax

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION B - CUSTOMER INFORMATION (Please PRINT)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Last Name

 

 

 

 

 

 

 

First Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Customer Contact Number

 

 

 

GAP Addendum Number

 

 

VIN Number(Last 6 Digits)

 

 

 

 

 

 

 

 

 

 

SECTION C – REASON FOR CANCELLATION (Please check one)

 

 

 

 

 

 

 

 

To process this cancellation request, the following supporting documentation is required:

 

 

 

 

 

 

Customer Request - Attach correspondence or customer signature below

Date Received by Dealer ____/____/____

 

 

Repossession - Attach proof of repossession from lienholder

 

 

 

Repossession Date

____/____/____

 

 

 

Other, please explain _________________________________________________

Other Date

____/____/____

 

 

 

(Please include any supporting documentation)

 

 

 

 

 

 

 

SECTION D – SIGNATURES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

__________________________________________________

 

 

____________________________________________________

 

Dealership Personnel Signature

 

 

 

 

 

 

 

Print Name

 

 

 

 

 

 

 

__________________________________________________

 

 

____________________________________________________

 

Customer Signature (If required, see Section C above)

 

Cancellation Date

 

 

 

 

 

 

 

Call for Cancellation Quote:

American Heritage Insurance Services

800-621-4871

FP7209

Rev. 04/12

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part 1 to filling in gap cancellation request form

Complete the Customer Request Attach, Date Received by Dealer, Repossession Attach proof of, Repossession Date, Other please explain Other Date, Please include any supporting, SECTION D SIGNATURES, Dealership Personnel Signature, Print Name, Customer Signature If required, Cancellation Date, Call for Cancellation Quote, and Rev area with the details required by the application.

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