There are many different types of forms that an individual may need to fill out during their lifetime. One such form is the mpp cancellation form. This form is used to cancel a minimal power of attorney. There are a few steps that need to be taken in order to fill out this form correctly. First, the individual needs to gather all of the information pertaining to the canceled mpp. Next, they need to complete and sign the cancellation form. Finally, they must mail or fax the completed form to their state’s department of revenue. By following these simple steps, the individual can cancel their mpp quickly and easily.
You can find more details regarding the mpp cancellation form by looking through the listing our team put together.
| Question | Answer |
|---|---|
| Form Name | Mpp Cancellation Form |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | mpp cancellation form, accord cancellation form fillable, protection plan cancellation, cancelled extended warranty mpp |
Mechanical Protection Plan/ Old United
P.O. Box 634, Shawnee Mission, Ks. 66201‐0634
CANCELLATION REQUEST FORM
All information must be filled out completely and legibly to process this cancellation request
Any information omitted may delay the cancellation process. All cancellations will be processed within 30 days of receipt.
CUSTOMER INFORMATION
Name |
______________________________________________________________________________ |
||
|
Last |
Middle Initial |
First |
Address |
______________________________________________________________________________ |
||
City, State & Zip Code |
______________________________________________________________________________ |
||
Area Code/Phone # |
________________________ Email Address _____________________________________________ |
||
VEHICLE INFORMATION |
|
|
|
Year, Make & Model
Last 6 digits of Vehicle ID # (VIN)
______________________________________________________________________________
______________________________________________________________________________
LIENHOLDER INFORMATION
Is there a lien on the vehicle |
Yes 1 |
No 2 |
|
Lienholder Name |
_____________________________________ Account #________________________________________ |
||
Lienholder Address |
____________________________________________________________________________________ |
||
1 Cancellation requests received on vehicles that are still secured by a lien must have the lienholders name, address, and account number included on this
cancellation request form. ALL REFUNDS ON VEHICLES THAT ARE STILL SECURED BY A LIEN WILL BE PAID DIRECTLY TO THE LIENHOLDER.
2 Cancellation requests received on vehicles that have had the lien paid off or released must have attached proof of release of lien, copy of clear title or lien release
letter from lienholder. IF NOT INCLUDED, ANY REFUND DUE WILL GO TO THE LIENHOLDER ON FILE.
Flat cancellation may be provided if cancellation is done within 30 days of purchase date and a claim has not been filed.
PLAN(S) TO BE CANCELLED
Please check all boxes that apply (boxes left blank will not be cancelled)
Club Plus |
Platinum Plus |
Mechanical Service Agreement |
Maintenance |
Lease Wear |
Gap |
OnGard |
PDR (Paintless Dent Repair) |
TireAssure |
Credit Insurance |
Other:__________________________________________________________________________________________________________________________________
Lojack, Skylink, Skyway, Theft guarantee cancellations can only be processed if the UNIT has not been installed and the cancel request MUST be received from the dealer. Zaktek is non‐cancelable.
REASON FOR CANCELLATION
Vehicle Traded In – (Include odometer statement) |
Total Loss – (Need loss paperwork from insurance Company) |
Customer Request |
Sold Vehicle – (Include odometer statement or bill of sale) |
Paid in Full – (include paid in full letter) |
|
Other:__________________________________________________________________________________________________________________________________
Cancellation Mileage _____________________________________Cancellation Date ___________________________________(if other than today’s date see below)
We reserve the right to verify and document date and mileage. For cancellation refunds on clear liens, distribution of cancellation refunds other than described herein must have separate, customer signature‐endorsed instructions. Dealer signature only required on unwind or re‐contracted transactions.
Form sent in by |
Customer |
Dealer |
Lienholder |
|
|
Dealer Name |
__________________________________________ |
Customer Name |
______________________________________________________ |
||
Dealer Signature |
__________________________________________ |
Customer Signature |
______________________________________________________ |
||
Dealer Signature |
__________________________________________ |
Date Signed |
______________________________________________________ |
||
FOR DEALER USE ONLY
Vehicle Traded In & Refund to be sent to a participating MPP Dealer – (Include odometer statement) and customer must sign below.
Customer Signature: _____________________________________________________________
I release all rights to my refund amount
Dealer Name ___________________________________ Address ______________________________________________________
White – MPP Copy |
Canary – Dealer Copy |
Pink – Customer Copy |