Follow the steps to successfully complete the cancellation request.

1. Press the ‘Get Form’ button to access the Express Autogap Customer Waiver Cancellation Request form and open it for editing.
2. Locate the 'Express Autogap Waiver Number' field and enter the unique waiver number associated with your account.
3. In the 'Date of Sale' section, input the date when you purchased the waiver.
4. Fill in the 'Consumer' field with your full name as it appears on your purchase documentation.
5. Enter the 'Dealership' name where you acquired the waiver in the designated field.
6. Provide your 'Address' including street number, city, state, and zip code.
7. In the 'Year,' 'Make,' and 'Model' fields, specify the vehicle's year, manufacturer, and model name.
8. Input the 'VIN' or Vehicle Identification Number in the respective section.
9. Record the 'Current Mileage' of your vehicle at the time of the cancellation request.
10. Complete the 'Lender/Lessor' section, filling in the information regarding the financial institution involved.
11. Select the 'Cancel Effective' date by filling in the appropriate month and day.
12. Choose the reason for cancellation by checking the box next to one of the options provided.
13. In the 'Request submitted by' section, indicate if the request is made by the dealership/lender/lessor or by the consumer.
14. Sign and date the form in the designated signature fields for all relevant parties.
15. Once completed, you can save changes, download the form, print it, or share it as needed.

Complete your cancellation request today by filling out the form online.