[Your letterhead, if desired; if not, your return address]

[Date of letter-month, day, and year]

[Recipient's first and last names]
[Company name]
[Street or P.O. box address]
[City, State ZIP code]

Dear [recipient's name]:

I am writing to notify you that I want to cancel my automobile insurance policy with your company. My policy number is XT8989889. Please cancel this policy as of July 23, 2010, which is the annual renewal date. My policy is set up as an automatic draft from my checking account, so please also cancel this automatic draft when you close the policy.

Also please let me know if I need to do anything further to complete the cancellation, and please contact me if you need additional information. Thank you for your prompt attention to this matter.

Sincerely,

[Signature]

[Sender's first and last names]