office@bluewell.com.au
1300 669 664
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Cancellation Form
First Name
*
Last Name
*
Business Name
*
Email Address
*
Phone Number
*
Policy number (If known)
Account details for refunds
BSB
Account-Number
Requested Date to be cancelled from
*
Reason for cancellation
*
We offer finance broking as one of our services. Do you require pricing on any loans or finance?
*
Yes
No
What type of finance do you require?
*
Home Loan
Car Finance
Truck and Commercial Vehicle Finance
Equipment Finance
Boat or Jet Ski Finance
Personal Loan
Commercial Loan
Caravan, Camper, Motorhome or RV Finance
I Require Other Finance That Is Not Listed
Are you the sole person authorised to cancel this policy? Please note in some circumstances such as partnerships for example you may need permission from all parties involved.
*
I am the sole person authorised to cancel this policy
Please note that when a policy is cancelled midterm we retain any income we earn as brokers. If you are on monthly payments, you are still liable for the interest portion on the monthly payment contract. This may leave you with a shortfall that will need to be paid back to the funder. We do not know how much this amount is until we have finshed the cancellation process.
*
I understand and agree
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