Home or auto insurance policy cancellation Do you have to cancel your home or auto insurance? Kindly fill out the secure form. Note: A agent may contact you to validate certain information required to confirm your cancellation. Important! If you are cancelling your insurance contract before the end date, cancellation fees will apply. If you are cancelling your insurance contract on the renewal date, no fees apply. Make sure to have other insurance in effect on the cancellation date. Contact Information First name Last name Email Phone Insurance type - Select -CarHome Policy number? Cancellation date More than one designated insured? Yes No Insured Applicant's statement I want the insurance contract mentioned above to be terminated on the date indicated. I understand that the termination will take effect on the date specified in this form, following the reception of this email by SSQ Insurance. Multiple insured First and last names of the other insured members I am authorized to terminate the insurance contract on behalf of the other designated insured members. Applicant's statement We want the insurance contract mentioned above to be terminated on the date indicated. We understand that the termination will take effect on the date specified in this form, following the reception of this email by SSQ Insurance. Reason for cancelling (optional) - None -Premium increase / Lower premium with another insurerThe coverage does not fulfill my needsInsatisfaction with SSQ Insurance’s customer serviceInsatisfaction with SSQ Insurance’s service during a claimI no longer own the covered propertyOther reason... Specify Do you have any additional information to provide? (optional) Attach files Attach files Documents accepted: gif, jpg, png, bmp, pdf and doc. Size maximum 5MB per file and size for all files should not exceed 15 MB. File 1 One file only.5 MB limit.Allowed types: gif, jpg, png, bmp, pdf, doc, docx. File 2 One file only.5 MB limit.Allowed types: gif, jpg, png, bmp, pdf, doc, docx. File 3 One file only.5 MB limit.Allowed types: gif, jpg, png, bmp, pdf, doc, docx. Leave this field blank