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Warranty Cancellation Form

Dealership Location

Customer Information

Vehicle Information

VIN is captured as typed for accuracy.
Enter the exact mileage at time of cancellation.

Contract Details #1

If a lien existed, enter the lender's exact name.

Documents

Required if Refund Payee is Customer and a lienholder is listed.
Upload a dated photo/document showing current mileage.

Submission Instructions

• If Refund Payee is Customer and there was a lien, you must upload the lien release.
• Upload a dated odometer photo or document for mileage verification.
• Ensure provider and reason are selected accurately to avoid delays.

Please Note:

All cancellations will take at least 6–8 weeks to process.

Need Assistance?

Your dedicated Cancellations Liaison, Kevin Doyle, is available to assist you with any questions about your cancellation request.
Email: cancellations@jimnortonauto.com
Phone: (918) 317-7344

Authorization & Acknowledgment

By electronically signing below, I acknowledge, understand, and agree to the following:

  1. I am the purchaser, co-purchaser, or an authorized party for the vehicle and contract associated with this cancellation request.
  2. I am voluntarily requesting cancellation of the listed aftermarket/F&I product(s), including but not limited to service contracts, GAP waivers, maintenance plans, tire/wheel protection, appearance protection, or other optional coverage.
  3. I understand that coverage will end effective the date determined by the product administrator or provider, in accordance with Oklahoma law and the terms of my contract.
  4. I understand that any refund will be calculated according to the terms of the product contract, which may include pro-rata calculations, cancellation fees, or deductions for claims paid, as permitted under Oklahoma statutes.
  5. I acknowledge that Oklahoma law requires refunds to be issued within the time frames specified by the product type and provider, and that delays may occur if required documentation is incomplete or inaccurate.
  6. If my vehicle is financed, I understand that any refund may be paid directly to the lienholder and applied to my outstanding loan balance rather than issued to me.
  7. I certify that all information submitted in this cancellation request is true, accurate, and complete, and I agree to provide any additional information required by the dealership, lienholder, or product administrator.
  8. I acknowledge that I have reviewed my contract and understand the cancellation terms, refund eligibility, and any applicable administrative fees.
  9. I understand that the dealership has not provided legal, financial, or tax advice, and I am responsible for contacting the product administrator or lienholder for questions related to refund amounts or loan impact.
  10. I consent to the use of my electronic signature to authorize this cancellation request, and I agree that my e-signature is legally binding and has the same force and effect as a handwritten signature under the Oklahoma Uniform Electronic Transactions Act, the federal E-SIGN Act, and other applicable laws.
  11. By signing electronically, I confirm that I have read, understand, and agree to the above terms and hereby authorize cancellation of the listed product(s).
Please sign using your mouse or touchscreen