Warranty and Protection Product Cancellation

If you would like to request the cancellation of an eligible Warranty or Protection plan or product purchased through Scholfield Honda, please complete the cancellation request form below.

Before You Submit Your Request

To process your cancellation request, a completed and notarized Odometer Statement is required.

Please follow these steps:

1. Download the Odometer Statement using the link below.
2. Complete all required information on the form.
3. Have the Odometer Statement notarized.
4. Submit the completed, notarized document along with your cancellation request using the form below.

Please make sure all information provided is complete and accurate. Missing information or a missing notarized Odometer Statement may delay the processing of your request.

Submit Your Cancellation Request

Complete the form below and upload your completed and notarized Odometer Statement. Once your request and required documentation have been received, our team will review the information and begin processing your cancellation.

Please note that submitting a cancellation request does not guarantee that a product is eligible for cancellation. Cancellation eligibility, refund amounts, and processing times may vary based on the specific product and its terms.

PRODUCT CANCELLATION SUBMISSION FORM

Please complete all sections of this form. If you have questions, please call us (316) 688-6400

Please enable JavaScript in your browser to complete this form.

General Information

Buyer's Name *

Co-Buyer's Name

Phone *

Email *

Address *

Address Line 1

Address Line 2

City

--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Vehicle Information:

Miles at Time of Cancellation *

Vehicle Identification Number (VIN) *

Support Information

Select Product(s) You Wish To Cancel *

• GAP Insurance
• Service Contract (Ext. Warranty)
• Prepaid Maintenance
• Windshield
• Dent
• Tire & Wheel
• Bundle (Tire & Wheel, Dent & Windshield)

(Please note: Not all products are cancellable, including Key, Battery, Windshield, and Appearance Protection.)*

Attention: You will need to download and complete the Required Odometer Statement . This Document is REQUIRED. Cancellations WILL NOT be processed without a completed and Notarized Odometer Statement.

Reason for Cancellation? *

• Vehicle has been Sold or Traded - Requires Notarized Odometer Statement, Photo of Odometer and Bill of Sale
• Total Loss Or Theft - Requires Notarized Odometer Statement, Photo of Odometer and Copy of Total Loss Report from the Insurance Provider
• Customer Request - Requires Notarized Odometer Statement and Photo of Odometer
• Refinance - Requires Notarized Odometer Statement, Photo of Odometer, and Proof of Payoff on Original Loan
• Using Cancellation Funds Towards a Vehicle Purchase from Scholfield Honda - Copy of New Purchase Agreement
• Loan has been paid in full – Requires Notarized Odometer Statement, photo of Odometer and Notarized Lien Release

Upload Required Notarized Odometer Statement & Other Documents *

Drag & Drop Files, Choose Files to Upload You can upload up to 5 files.

A notarized odometer statement is mandatory. Cancellations will not be processed without it.

Upload Photo of Odometer Miles *

Drag & Drop Files, Choose Files to Upload

Upload Proof of Payoff

Drag & Drop Files, Choose Files to Upload

Only required if you selected "Refinance" as your reason for cancellation.

Buyer's Miles Reason

Lien Holder *

Type None if no lien holder applies

Notes

Please allow up to four weeks for processing. Contact us, or your lien holder with questions.

By signing below you are agreeing to the Terms of Cancellation. Once this form has been completed, you are not able to reinstate your policy for any reason.

Proof of Odometer is required to ensure the accuracy of your refund. Without the required notarized odometer statement, your cancellation will not be processed. If you would like to process your cancellation in store, please upload the required documents listed under "Reason for Cancellation". All cancellation proceeds are sent to the lienholder directly. Refunds may be delayed by the lienholder. Please call the lienholder if you have not received cancellation funds in more than 4 weeks.

You must use this website to cancel your contract(s), but you may visit our dealership and staff is happy to assist you with the process. This form is meant to provide a contactless service and allow our customers to make changes to policies they may have purchased from our dealership.

Your Signature *

Clear Signature

Select a Date *

Submit