This letter informs an insurer that you are cancelling your policy.
1234, Main Street
Boston, MA 02123
05 April, 2005
<Recipient Address Goes Here>
Re: Policy No. <policy number>
Please be advised that I wish to cancel the above-referenced insurance policy with <name of company>. Please cancel the policy effective <date of cancellation>. Please forward any premium refund to me at <address>.
Thank you for your prompt attention to this request. I would appreciate receiving written confirmation that this policy has been closed. I look forward to hearing from you.
encl: <List of enclosed items goes here>