Present date – ________

To,_________ (Account Manager)
______________ Life Inc Co.

Dear Mr._________

I Mr, _________is having an Insurance Policy with your Co. policy number _______, the reason behind this letter is a kind request to cancel my Insurance Policy number _______, with effect Dt _______.

Please assure me by sending a written confirmation that the policy has been canceled within 30 days. Also refund the unused portion of my policy premium and stop charging my bank account for payment of monthly premiums.

Thank you for your prompt attention to this matter.

Sincerely,

__________ (Policy holder)