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ANDREW M. CUOMO Governor July 21, 2016, JOHN ENROLLED 1 SAMPLE STREET SAMPLE, NY 12239 Notice of Cancellation of Coverage RE: HMS Reference Number 9999999 Dear SHIP Enrolled: HMS Employer Solutions
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How to fill out notice of cancellation of

How to Fill Out Notice of Cancellation of:
01
Start by identifying the purpose of the notice: Before filling out a notice of cancellation, it is important to determine the specific reason for cancellation. This could be canceling a subscription, membership, contract, or any other agreement that requires formal notice.
02
Gather all necessary information: Take the time to collect all relevant details regarding the cancellation, such as the specific agreement or contract being canceled, the date it was entered into, any account or reference numbers, and the duration of the notice period.
03
Begin with the date and contact information: At the top of the notice, include the current date and your contact information. This includes your full name, address, phone number, and email address. Additionally, include the recipient's contact information, such as their name, title, organization, address, and any other relevant details.
04
Address the recipient formally: Use a formal salutation to address the recipient, such as "Dear Mr./Ms./Dr. [Last Name]" or "To whom it may concern," depending on the situation and the recipient's identity.
05
Clearly state the purpose of the notice: Begin the body of the notice by explicitly stating that you are providing notice of cancellation. Be direct and brief, avoiding unnecessary details or explanations.
06
Specify the agreement being canceled: Clearly identify the agreement, contract, or subscription that is being canceled. Provide key details, such as the title or name of the agreement and any associated reference or account numbers to ensure clarity.
07
Mention the effective date of cancellation: State the desired effective date of cancellation. This could be immediately upon receipt of the notice, or after a specific notice period as outlined in the original agreement. Ensure that the effective date adheres to any stipulations or terms outlined in the original agreement.
08
Provide any necessary supporting documentation: If required, enclose any relevant supporting documents, such as copies of the original agreement, receipts, or invoices. This can help streamline the cancellation process and avoid any potential misunderstandings.
09
Express gratitude and willingness to cooperate: Conclude the notice by expressing gratitude for any services or benefits received during the agreement and show willingness to assist with any necessary procedures or transitions. This can help maintain a positive relationship even after cancellation.
10
Sign and send the notice: Sign the notice using your full legal name to authenticate it. Make a copy for your records before sending the original notice via certified mail or any other method that provides proof of delivery. Keep the receipt or confirmation of delivery for your reference.
Who needs notice of cancellation:
01
Individuals canceling a subscription service: If you have subscribed to a magazine, online streaming platform, or any other service that requires formal notice for cancellation, you would need a notice of cancellation.
02
Customers terminating a contract: When terminating a contract, such as a mobile phone plan, internet service contract, or lease agreement, a notice of cancellation is necessary to communicate your intention to end the agreement.
03
Members discontinuing a membership: Whether you are canceling a gym membership, professional association, or club, providing a notice of cancellation is often required to formally discontinue your membership.
04
Participants ending participation in a contractual agreement: If you are involved in a contractual agreement, such as a partnership, joint venture, or business arrangement, providing formal notice of cancellation is crucial to legally and ethically conclude the agreement.
05
Consumers exercising their right to cancellation: Depending on where you reside, certain consumer protection laws may grant you the right to cancel an agreement or purchase within a specific timeframe. In such cases, a notice of cancellation is necessary to exercise this right.
Remember, the specific individuals or entities requiring a notice of cancellation may vary depending on the nature of the agreement and the applicable laws or contractual obligations. Always refer to the original agreement or consult with legal professionals to ensure compliance with all necessary procedures.
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