Filled Cancellation (PDF)

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Progressive Auto Insurance – Mobile

Policy Cancellation Request
Insurance Company



Progressive Direct Insurance Co.
P.O. Box 31260
Tampa, FL 33631

Named Insured


Michael Garcia
10181 Monarch Road 2
Roscoe, IL 61073

Attention: Customer Service
I, Michael Garcia, would like to cancel my current insurance policy, policy number ____________. To avoid
any lapse in coverage, I request that my current policy be canceled on the date that my new policy with
Progressive Direct Insurance Company starts.

Progressive policy effective date and time is April 22, 2016 04:16 PM ET.
Please send any account refunds directly to me.
Michael Garcia

Full Name




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