Realty One Endorsement Request

request to cancel a policy

your details
Your Name*

TitleFirst NameLast Name
Your Phone Number*
Alternative Phone Number
E-mail*
Account Reference*

request to cancel a policy

policy details
The Insured Name on the Policy*
Type of Policy*
If 'Other' please specify*
What is the Policy Number?*

request to cancel a policy

details of the cancellation
What date do you require the cancellation to take effect?*

DayMonthYear
Please ensure that the correct cancellation date has been nominated, as, in most cases, this cannot be amended once your request has been effected.

Examples of cancellation dates are:

- the expiry date of the policy, if the cover is not going to be renewed

- the renewal date of the policy, if the renewal that has been sent to you is not going to be taken up

- the settlement date, if the property has been sold

- any date during the policy period for which the property owner provides you with written confirmation (a copy of their policy or a Certificate of Currency) showing that they have arranged alternative insurance cover

Please DO NOT request cancellation until after the settlement has occurred, as it may not be possible to reinstate the policy if the settlement is then delayed.

You can request a cancellation in advance of the cancellation date (as long as you are sure!), and also for any date in the past, as long as you can provide evidence that we can provide to the insurer to support that cancellation date (no evidence is usually required if the cancellation is up to 14 days prior to today's date).
Please advise the reason for cancellation*
If 'Other' please give us a little information:*
Please advise why you no longer wish to remain a client of HNIS*
If 'Other' please give us a little information:*
Is there anything that you would like to tell us about that?
Please upload a copy of the settlement / transfer papers*

Upload a File

Cancelof
Please upload a copy of the replacement Policy or Certificate of Currency*

Upload a File

Cancelof
Please upload any other document and/or supporting evidence you wish to provide

Upload a File

Cancelof

request to cancel a policy

sending the confirmation
How do you prefer to receive confirmation that the change has been made?*

EmailPost
Postal Address*

Street Address

Street Address Line 2

CityState

Post CodeCountry
Is there anything further you need us to know?
Enter the message as it's shown*
Should be Empty:

request to cancel a policy

request to cancel a policy

request to cancel a policy

request to cancel a policy