Reason for Cancellation |
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Consumer Request, Unwind, Early Payoff and Repossession. Select the reason that applies in the box above. Inaccurate information will result in an adjustment by the Program Administrator.
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Required Documentation
Consumer Request
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All pages of this form;
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A SIGNED copy of the Request and Release Form; and
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A copy of the original (signed) GAP Contract.
Unwind (loan never funded or loan funded and vehicle returned)
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All pages of this form, except the Request and Release Form;
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A copy of the original (signed) GAP Contract; and
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A signed statement on Dealer or Lienholder/Assignee company letterhead that the cancellation is due to an unwind.
Early Payoff
- All pages of this form, except the Request and Release Form;
- A copy of the Lienholder/Assignee payoff; and
- A copy of the original (signed) GAP Contract.
- Colorado, Indiana and Wisconsin customers: Dealer or Lienholder/Assignee must submit a copy of the reserve statement showing the exact loan payoff date.
Repossession
- All pages of this form, except the Request and Release Form;
- A copy of the original (signed) GAP Contract; and
- A copy of the repossession letter (from Lienholder/Assignee).
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Refund Method |
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Review the entire GAP Contract to determine the refund method. Select the refund method that applies in the box above. Flat Cancel only available within 30 days of purchase. Wisconsin consumers use Wisconsin. Inaccurate information will result in an adjustment by the Program Administrator.
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