Cancellation Form
So we can ensure that we offer the best possible
service, please tell us the main reason you wish
to cancel your plan.
Agreement No.
Main reason for cancellation (Please tick one that best applies)
Too expensive
Don’t see the value of the plan
Moved house
No longer have the appliance
Replaced / intend to replace my appliance
Have protection elsewhere
Unhappy with service from Domestic & General
Unhappy with repair agent service
Can’t remember taking out the plan
Other (please provide further detail)
If other, please specify:
Further detail on cancellation reason(s) (if applicable)
Please use the section below if you wish to cancel a
second plan:
Agreement No.
Main reason for cancellation (Please tick one that best applies)
Too expensive
Don’t see the value of the plan
Moved house
No longer have the appliance
Replaced / intend to replace my appliance
Have protection elsewhere
Unhappy with service from Domestic & General
Unhappy with repair agent service
Can’t remember taking out the plan
Other (please provide further detail)
If other, please specify:
Further detail on cancellation reason(s) (if applicable)
Title
Full name
House no. Address
Postcode
Email address
Home or mobile telephone number
To cancel your plan you can phone us for free on 0800 561 4496 between 8am and 8pm, 7 days a week. Alternatively, you
can write to us by completing the form below and sending it to Domestic & General, Leicester House, 17 Leicester Street,
Bedworth, Warwickshire CV12 8JP.
Your rights to cancel during the cooling off period
The ‘cooling off period’ is the fourteen (14) day period from receipt of your documentation or from the plan start date,
whichever is later. (For some plans this period may be longer; please refer to the plan documentation for full details).
If you change your mind during the cooling off period, you can cancel your plan and we’ll refund any fee paid. However,
you must pay us for any costs incurred by us in providing you with the service, such as the cost of the call out and any
repair (but the charges will not exceed the price of the plan).
Your rights to cancel after the cooling off period
For your rights to cancel after the cooling off period, please refer to your plan documentation.
Sorry to see you go
Please use the section below if you wish to cancel a
third plan:
Agreement No.
Main reason for cancellation (Please tick one that best applies)
Too expensive
Don’t see the value of the plan
Moved house
No longer have the appliance
Replaced / intend to replace my appliance
Have protection elsewhere
Unhappy with service from Domestic & General
Unhappy with repair agent service
Can’t remember taking out the plan
Other (please provide further detail)
If other, please specify:
Further detail on cancellation reason(s) (if applicable)
Please use the section below if you wish to cancel a
fourth plan:
Agreement No.
Main reason for cancellation (Please tick one that best applies)
Too expensive
Don’t see the value of the plan
Moved house
No longer have the appliance
Replaced / intend to replace my appliance
Have protection elsewhere
Unhappy with service from Domestic & General
Unhappy with repair agent service
Can’t remember taking out the plan
Other (please provide further detail)
If other, please specify:
Further detail on cancellation reason(s) (if applicable)
Additional comments you wish to make
I wish to cancel the above agreement
Signature
Date
D D / M M / Y Y
The protection plan is provided by Domestic & General Services Limited. Registered oice: Swan Court, 11 Worple Road, Wimbledon, London SW19 4JS.
Registered in England and Wales. Company No 1970780.
The protection policy is provided by Domestic & General Insurance PLC. Registered Oice: Swan Court, 11 Worple Road, Wimbledon, London SW19 4JS.
Registered in England and Wales, Company No. 485850.
Domestic & General Insurance PLC is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the
Prudential Regulation Authority.
DG_WCANPDF_0522
