First name Last name
Street Number
Postal code City
De Goudse
Postbus 9
2800 MA Gouda
City, 12-08-2025
Regarding; Termination of De Goudse Verzekering insurance.
Dear sir/madam,
With this letter I want the insurance with the data mentioned per Cancellation date to be canceled.
Name: First name Last name
Address: Street Housenumber
Postal code + City: Postcode Stad
E-mail: Email
The debit authorization must be terminated at the same time.
I look forward to the confirmation and associated final statement of this cancellation.
With kind regards,
First name Last name