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************* Caller Details ************* Phone Number: Spoke with: Mailing address: Email: Billing Info: Verified: Yes Branded: Yes

************** Call Description ************ Need of call:

Resolution (Actions Taken):

************* Other Info. ****************** Portal: N/A Referral: N|A Transfer from: N/A Transfer to: N/A

Check number : Disbursement date: Check amount: Check address:

AFTER 11, call back ( PREMIUM INCREASE ) 210-602-6612

CALL BACK ( WANTS TO CHANGE THE DATE ) 620-968-8131

Digbijoy Das ( 6:00 PM EST ) 336-681-8812 ****************************************************

Email Template: To: Jeannie Galbraith, Viviana Guerrero, Bekki Harvey, & David Allebe Subject Line: Request to Backdate Cancelation – Policy# HIN-4106044-02

"Greetings,

Please see the below information for review on the Request to Backdate Cancelation: 06/16/2022 Policy number: HSC-4785471-01 Policy effective date:02/04/2022 Cancelation date:06/16/2022 Documentation provided: Yes Reason for Request: Sold home