ACC Cancellation Request Form
Please only complete this form if you are outside of 14 days from enrolment and you have elected to pay by ACC Instalment plan.
By completing and submitting this form you are providing the required two months notice. Please note that any arranged payments currently running will continue to be processed until 2 months after the date you submit.
Before you request a cancellation, please note that if you are having financial difficulties we may be able to help you by reducing your monthly payments.
If you would like to discuss this option please contact us on 01409 220 417 and ask us to discuss reduced payment plan options.
If you have elected to pay by third party finance, and you believe that you have exceptional circumstances you may use this form to submit your request for consideration along with details of any supporting evidence you will be able to supply.
Please provide current contact details so we can contact you regarding the outcome of your request. Notice of your request will be sent to the email you have provided on this form.
Your request has been sent.