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Get Farmers Cancellation Request

_______ Cancellation date: _________________ at 12:01 a.m. To Farmers Insurance: Please cancel the insurance policy or policies as indicated above on the date specified. I understand that you may contact me for verification of my cancellation request. Sincerely, Signature: ___________________________ Print name: __________________________ Please mail, fax, or email this form to: Farmers Insurance Attention: Dan Murray 68 W Center St, Midvale, Utah, 84047 Fax: 801-569-2886 Email: Utah.insurance.

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