ACORD 35 Insurance Cancellation Form – Instant PDF Download

ACORD 35 (2017/05)

Cancellation Request / Policy Release

Form Number:

ACORD 35 (2017/05)

Category:

Property & Casualty

Last Updated:

May 2017

Page Count:

01 page

File Format:

PDF, Fillable PDF

Acord 35 Cancellation Form

Policyholders, insurance agents, or insureds often require a legal form to request the cancellation of a policy. An Acord 35 form serves as a standard document to inform insurers to cancel an insurance policy before its expiration. The summarized information on the Acord cancellation form provides transparent communication and helps calculate any refund for unused premiums.

Form Preview

Benefits of the Acord Cancellation Form Fillable

Ensure Regulatory Compliance

The Acord 35 cancellation form complies with the state’s law regarding policy cancellation. Accurate completion of the form avoids legal consequences.

Ensure Premium Refunds

The form helps the administrative panel to calculate the unused premium refunds, ensuring transparent financial outcomes.

Prevents Unauthorized Cancellation

The authorized representative’s signature validates the cancellation form and avoids unauthorized cancellation to reduce fraudulent activities.

Transparency

The accurate information of insurance agents, policyholders, and insurance companies helps transparent communication and strengthens the relationships.

Key Sections of the Acord 35 Form

Producer Information

Includes the details of insurance agents or brokers for transparent communication.

Insured Information

Contains the policyholder’s details to help understand who is canceling the policy.

Insurers Details

Provides the complete details of the insurance company to understand the type of insurance policy.

Signatures

Contain the signatures of the insureds, witnesses, and authorized representative to authenticate the cancellation request and release.

Reason for Cancellation

The administrative department mentions the reasons for cancellations and calculates the refund premiums.

How to Fill Out the Acord Cancellation Form?

  1. Write the name, address, phone number, and customer ID of the insurance agent or broker.
  2. Mention the name and address of the policyholder to ensure the cancellation request.
  3. Write the name and NAIC number of the insurance company.
  4. Mention the policy type, number, effective date, cancellation date, and expiration date.
  5. Mention the reason for cancellation and the calculation method.
  6. Get the signature of the insured, authorized representative, and witnesses, and mention the date. (For Company Use)
  7. Mention the remarks to ensure the intent to cancel and release the insurer from further obligations.
  8. Write the name and address of the authorized representative and get the signature.
Download PDF Fill Online Print Form

Frequently Asked Questions

It is often used when switching insurance providers, selling insured assets, closing a business, rewriting a policy, or non-payment of premiums.

It ensures the legal authorization, compliance with the insurance industry, and avoids unauthorized cancellation and miscommunication.

The policy refund is based on different factors, including policy type, terms and conditions, and cancellation time.

The witnesses’ signatures are often required for the policy release request.

Accurate completion of the form is important to avoid delays, disputes, or rejection by the certificate holder.

Related Forms

Property Insurance

ACORD 27

An Acord 27 form is evidence of property insurance, which ensures smooth transactions during real estate closings

Evidence of Property Insurance

Commercial Lines

ACORD 30

Used to provide evidence of liability insurance coverage specifically for businesses operating in the automotive industry,

Certificate of Garage Liability

Property & Casualty

ACORD 31

This form is used to certify and provide evidence of insurance coverage for marine and energy-related risks.

Certificate of Marine Insurance