Cancel your cover

Stateside APM Hazard & Liability Insurance program

Use this form to cancel cover and remove a property from the portfolio under the bulk billing arrangement [current_company].

Hi [user_first_name],

Please enter the information below and click the ‘Submit’ button. We’ll cancel the cover as soon as we receive your request.

[Keep, Rebuild] BI Cancel Cover Details (Bulk Billing)

Property to be cancelled

BI Policy Number

(not the address)

Street

Cancellation Date

Cannot be before today’s date.

Select the reason for cancellation

Other Reason *

Add another property Remove this property

I wish to cancel coverage for the above property/ies from the date shown (the cancellation date cannot be before today’s date).

I understand that if a refund of premiums is due, it will be applied to my next monthly invoice.

As the property manager for the owner of this property, I take full responsibility for this instruction and agree to hold harmless Stateside APM with regard to this cancellation

Full details of the policy terms and conditions and claims procedures, together with any additional terms and conditions imposed by Stateside APM are available at portal.statesideapm.com/iptc

Submitted by

On behalf of (Company)

Date

Confirmation will be sent to this email address

Confirm Confirmation will be sent to this email address

If you are human, leave this field blank.