Cancel membership

Cancel your membership – enter your details, sign digitally, done. We forward everything to the burial fund and confirm receipt to you.

SEPA mandate Change of address Correct my details Change pre-arrangement sum Cancellation

Your details

First name * Last name * Membership number (if known) Date of birth (helps us match your policy)

Your address

Street House number Postal code City

Account for the refund (§ 6 of the insurance terms)

IBAN *

BIC (if known) Name of the bank

Account holder (if different)

How you will receive your confirmation

E-mail for the confirmation Mobile number for the WhatsApp confirmation

I hereby cancel my membership in the Vorsorgekasse Hoesch Dortmund with effect from the earliest possible date permitted by the statutes. I am aware that this ends the insurance cover and that the refund pursuant to § 6 of the insurance terms will be transferred to the account stated above. Notes for FURKAN

Signature

Place of signature * Date

Signature * – please sign with your finger in the white box.

After submission, FURKAN Bestattungen prepares your signed document and submits it to the burial fund.

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