Cancellation Form To, The Manager, Claims and New Business Prudential Life Assurance Zambia Thabo Mbeki Road Lusaka Dear Sir or Madam, Re: Cancellation of Policy This serves as my formal notification for the cancellation of the above-captioned policy. This cancellation will be effective as of . Please immediately refund any premium due to my account held at Please be advised that I no longer authorize your company to directly withdraw for any future premiums from any of my accounts. I would appreciate receiving written confirmation of this cancellation within the stipulated period. Please do not hesitate to contact me with any questions. I look forward to your prompt attention to this matter. Yours Sincerely, Note: Kindly provide notice two weeks before your premium payment date in order for the cancellation to be effected timeously. Please allow 7 working days after your policy cancellation request for receipt of confirmation.