Debt Cancellation Agreement Forms Approved by...
Transcript of Debt Cancellation Agreement Forms Approved by...
Debt Cancellation Agreement Forms Approved by the OCCC
under Chapter 348, Subchapter G, Texas Finance Code
Approved as of: 5/4/2016
Name Form Number Date ApprovedAeverex GPW 0132-0920B-TX 11/26/2013
Aeverex GPW 0132-1001B-TX 11/26/2013
Aeverex GPW 0132-1007B-TX 11/26/2013
Aeverex GPW 0132-0820B 11/26/2013
Aeverex GPW 0132-1001B 11/26/2013
Aeverex GPW 0132-1007B 11/26/2013
Aeverex General Agency, Inc. GPW 0142-1229B 02/12/2015
Allstate Dealer Services FP2350 1012 07/17/2012
Allstate Dealer Services FP2351 1012 07/17/2012
Allstate Dealer Services FP2354 1012 07/17/2012
Allstate Dealer Services FP2355 1012 07/17/2012
Allstate Dealer Services FP2358 1012 07/17/2012
Allstate Dealer Services FP2359 1012 07/17/2012
Allstate Dealer Services FP2599 0613 07/17/2013
Allstate Dealer Services FP2674 0613 07/17/2013
Allstate Dealer Services FP2675 0613 07/17/2013
Allstate Dealer Services ( E.R.J. Insurance Group, Inc. ) FP2643 0113 03/08/2013
American Assurance Corporation GAPAAC-Waiver150 (10/14)-TX 01/29/2015
American Auto Guardian, Inc. AAGI-ANICO-GAP-NF-TX (01/13) 01/09/2013
American Auto Guardian, Inc. AAGI-ANICO-GAP-TF-TX (01/13) 01/09/2013
American Auto Guardian, Inc. AAGI-ANICO-GAP-TX (01/13) 01/09/2013
American Auto Guardian, Inc. FP2573 0212 03/06/2012
American Auto Guardian, Inc. FP2574 0212 03/06/2012
American Auto Guardian, Inc. FP2575 0212 03/06/2012
American Colonial Administration, LLC AR2570 1011 04/03/2012
American Colonial Administration, LLC AR2571 1011 04/03/2012
American Colonial Administration, LLC AR2575 1011 04/03/2012
American Colonial Administration, LLC FP2570 1011 01/20/2012
American Colonial Administration, LLC FP2571 1011 01/20/2012
American Colonial Administration, LLC FP2575 1011 01/20/2012
American Colonial Administration, LLC (First Dealer Resources, LLC) AR2570 1213 02/12/2014
American Colonial Administration, LLC (First Dealer Resources, LLC) AR2575 1213 02/12/2014
American Colonial Administration, LLC (First Dealer Resources, LLC) FP2420 0413 11/19/2013
American Colonial Administration, LLC (First Dealer Resources, LLC) FP2423 0413 11/19/2013
American Financial & Automotive Services, Inc. AFAS-0106 Rev 6/13 09/05/2013
American Financial & Automotive Services, Inc. AFAS-0107 rev (06/12) 09/13/2012
American Financial & Automotive Services, Inc. AFAS-0108 rev (06/12) 09/13/2012
American Financial & Automotive Services, Inc. AFAS-0106 rev (01/12) 03/06/2012
American Financial & Automotive Services, Inc. AFAS-0107 rev (01/12) 02/22/2012
American Financial & Automotive Services, Inc. AFAS-0108 rev (01/12) 02/22/2012
Page 1of 18
Debt Cancellation Agreement Forms Approved by the OCCC
under Chapter 348, Subchapter G, Texas Finance Code
Approved as of: 5/4/2016
Name Form Number Date ApprovedAmerican Financial & Automotive Services, Inc. AFAS-0106 12/22/2011
American Financial & Automotive Services, Inc. AFAS-0107 12/22/2011
American Financial & Automotive Services, Inc. AFAS-0108 12/22/2011
American Financial Warranty Corporation MTGAP-0103 Rev. 1/16 02/17/2016
American Financial Warranty Corporation MTGAP-0104 Rev. 1/16 02/17/2016
American Financial Warranty Corporation MTGAP-0107 Rev. 1/16 01/08/2016
American Financial Warranty Corporation MTGAP-0103 Rev. 8/15 08/07/2015
American Financial Warranty Corporation MTGAP-0104 Rev. 08/15 08/07/2015
American Financial Warranty Corporation MTGAP-0107 Rev. 8/15 08/07/2015
American Guardian Warranty Services, Inc. AG Base GW VS TX FMC_02.16 03/28/2016
American Guardian Warranty Services, Inc. AG Base GW VS TX_11.15 11/20/2015
American Guardian Warranty Services AG Base GW VS (04.13) TX 06/28/2013
American Guardian Warranty Services AG-VSC-RGW (05.12) TX 08/10/2012
American National Administrators, Inc. AT125NTX 10/13/2011
American National Administrators, Inc. AT125TX 10/13/2011
American National Administrators, Inc. AT150FTTX 10/13/2011
American National Administrators, Inc. AT150TX 10/13/2011
AMT Warranty Corp. 11GGCC0115_150_TX 05/22/2015
AMT Warranty Corp. 11GGAP0513_TX_150 05/23/2013
AmTrust North America (Warrantach Automotive, Inc) 11CGAP0313_TX_150 02/27/2013
AmTrust North America, Inc. GAPADD-TX-009 (09-11) 11/21/2011
Apex Protection, Inc. GAP-TX1214-TFS REV A 04/29/2015
Apex Protection, Inc. GAP-TX0714-REV A 10/22/2014
Apex Protection, Inc. GAP-TX0714 09/03/2014
Arch Insurance Company GEN-19971-TX 12/11 01/25/2012
Assured Vehicle Protection, Inc. (AVP) AVP/GAP/TX/10-15 11/19/2015
Auto Trac System EFI150-M-001 [08/12] 10/16/2012
Automobile Protection Corporation (APCO) 8030126 (004) 03/12 03/15/2012
Automobile Protection Corporation (APCO) 8030123 (002) 10/11 11/22/2011
Automobile Protection Corporation (APCO) 8030124 (007) 10/11 10/13/2011
Automobile Protection Corporation (APCO) 8030122 (007) 09/11 10/13/2011
Automotive Warranty Services, Inc. AUTOGUARD-109 TX (01/15) 05/15/2015
Automotive Warranty Services, Inc. AUTOGUARD-109 TFS TX (01/15) 05/15/2015
Berkshire Risk Services TXGAP0314 04/25/2014
Berkshire Risk Services No Form # 04/25/2014
Berkshire Risk Services, LLC BRS-TXDCA 1001413-Holder 12/04/2013
CALL GAP Ltd. d/b/a Gap Insurance Services
Extreme GAP ETXF150-M-001 07-11
(also numbered as Form 2012) 03/09/2012
Page 2of 18
Debt Cancellation Agreement Forms Approved by the OCCC
under Chapter 348, Subchapter G, Texas Finance Code
Approved as of: 5/4/2016
Name Form Number Date Approved
CALL GAP Ltd. d/b/a Gap Insurance Services
Extreme GAP ETXG125-M-001 07-11
(also numbered as Form 1933) 03/09/2012
CALL GAP Ltd. d/b/a Gap Insurance Services
Extreme GAP ETXG150-M-001 07-11
(also numbered as Form 1933) 03/09/2012
CALL GAP Ltd. d/b/a Gap Insurance Services 150% TX 01/11/2012
Cal-Tex Protective Coatings Inc. d/b/a Automotive Protection Systems, Inc. GAP-CTPC Texas Rev. 140325 04/25/2014
Cal-Tex Protective Coatings Inc. d/b/a Automotive Protection Systems, Inc. GAP-CTPC Texas Rev. 140325 04/25/2014
Caregard Warranty Services TX.TY150 12/20/2011
Caregard Warranty Services TX334 12/20/2011
Caregard Warranty Services TX346 12/20/2011
Caregard Warranty Services TX733 12/20/2011
Carr Products Administrative Services, LLC ACVLegaltexas125 1-12 03/07/2012
Centrus Auto Finance, LLC DCA-9-2011 10/13/2011
Centrus Auto Finance, LLC DBA MarkOne Financial DCA-01-2015 02/20/2015
CIG Financial, LLC CIG DCA VER 092015 09/11/2015
CNA National Warranty Corporation 6932 (10/12) ( also numbered GPRTX) 09/21/2012
CNA National Warranty Corporation 6932 (10/12) (also numbered GPRTX) 09/21/2012
CNA National Warranty Corporation 6932 (10/11) 11/21/2011
Comprehensive Auto Resources Company, Inc. (CARco) CRO-TX (09-14) 11/14/2014
Comprehensive Auto Resources Company, Inc. (CARco) GRCARTX (05/14) 06/30/2014
Comprehensive Auto Resources Company, Inc. (CARco) TX125 (04/14) 05/30/2014
Comprehensive Auto Resources Company, Inc. (CARco) TX150 (04/14) 05/30/2014
Comprehensive Auto Resources Company, Inc. (CARco) TX150NF (04/14) 05/30/2014
Comprehensive Auto Resources Company, Inc. (CARco) GCARTX125-M-001 04/15/2014
Comprehensive Auto Resources Company, Inc. (CARco) GCARTX150-M-001 02/14 04/15/2014
Comprehensive Auto Resources Company, Inc. (CARco) GCARTX150-NF-M-001 02/14 04/15/2014
Comprehensive Auto Resources Company, Inc. (CARco) RV-TX Rev. 10/12 12/03/2012
Comprehensive Auto Resources Company, Inc. (CARco) CARTX150NF-M-001 (7/11) 10/15/2011
Comprehensive Auto Resources Company, Inc. (CARco) CARTX150-M-001 (7/11) 10/14/2011
Comprehensive Auto Resources Company, Inc. (CARco) CARTX125-M-001 (7/11) 10/13/2011
CornerStone United Inc. CSAGBTX125-R-002 (05/15) 07/17/2015
CornerStone United Inc. CSAGBTX150-R-002 (05/15) 07/17/2015
CornerStone United Inc. CSAGFTX150-R-002 (05/15) 07/17/2015
CornerStone United Inc. CSAGBTX125-M-002 (10/11) 10/13/2011
CornerStone United Inc. CSAGBTX150-M-002 (10/11) 10/13/2011
CornerStone United Inc. CSAGFTX150-M-002 (10/11) 10/13/2011
Creditor's Captive Formation Corporation V.2.2 TX 04/19/2012
D&P Holdings, Inc. EFTX150-WESC-001 07/26/2013
D&P Holdings, Inc. GFTX150-WESC-001 07/26/2013
D&P Holdings, Inc. EXTX150-WESC-001 rev (05/13) 05/22/2013
Page 3of 18
Debt Cancellation Agreement Forms Approved by the OCCC
under Chapter 348, Subchapter G, Texas Finance Code
Approved as of: 5/4/2016
Name Form Number Date ApprovedD&P Holdings, Inc. GGTX150-WESC-001 rev (05/13) 05/22/2013
D&P Holdings, Inc. ETXT150-M-001 (3/12) 04/30/2012
D&P Holdings, Inc. STTX150-M-001 (3/12) 04/30/2012
D&P Holdings, Inc. RTXF150-M-001 03/09/2012
D&P Holdings, Inc. RTXG125-M-001 03/09/2012
D&P Holdings, Inc. RTXG150-M-001 03/09/2012
D&P Holdings, Inc. SGTF 150-M-001 01/12/2012
D&P Holdings, Inc. SGTX 125-M-001 01/12/2012
D&P Holdings, Inc. SGTX 150-M-001 01/12/2012
D&P Holdings, Inc. ETXF150-M-001 10/14/2011
D&P Holdings, Inc. ETXG125-M-001 10/14/2011
D&P Holdings, Inc. ETXG150-M-001 10/14/2011
D&P Holdings, Inc. GTXF150-M-001 10/14/2011
D&P Holdings, Inc. GTXG125-M-001 10/14/2011
D&P Holdings, Inc. GTXG150-M-001 10/14/2011
D&P Holdings, Inc. NTXF150-M-001 10/14/2011
D&P Holdings, Inc. NTXG125-M-001 10/14/2011
D&P Holdings, Inc. NTXG150-M-001 10/14/2011
D&P Holdings, Inc. TTX125-M-001 10/14/2011
D&P Holdings, Inc. d/b/a Auto Trac System, d/b/a Diversified Insurance Facilities ETXF150-R-001 04/15 05/26/2015
D&P Holdings, Inc. d/b/a Auto Trac System, d/b/a Diversified Insurance Facilities ETXG125-R-001 04/15 05/26/2015
D&P Holdings, Inc. d/b/a Auto Trac System, d/b/a Diversified Insurance Facilities SGTXG150-R-001 04/15 05/26/2015
D&P Holdings, Inc. d/b/a Auto Trac System, d/b/a Diversified Insurance Facilities SGTXG125-R-001 04/15 05/26/2015
D&P Holdings, Inc. d/b/a Auto Trac System, d/b/a Diversified Insurance Facilities SGTXF150-R-001 04/15 05/26/2015
D&P Holdings, Inc. d/b/a Auto Trac System, d/b/a Diversified Insurance Facilities GTXG150-R-001 04/15 05/26/2015
D&P Holdings, Inc. d/b/a Auto Trac System, d/b/a Diversified Insurance Facilities GTXF150-R-001 04/15 05/26/2015
D&P Holdings, Inc. d/b/a Auto Trac System, d/b/a Diversified Insurance Facilities GTXG125-R-001 04/15 05/26/2015
D&P Holdings, Inc. d/b/a Auto Trac System, d/b/a Diversified Insurance Facilities PKTXG-R-001 [07/15] 08/20/2015
D&P Holdings, Inc. dba Auto Trac System ETXG150-R-001 04/01/2015
Dealer Motor Services AT320 (also numbered as AT-TX 320) 06/08/2012
Dealer Motor Services AT344 (also numbered as AT-TX 344) 06/08/2012
Dealers Assurance Company (ForeSight Services Group, Inc.) GAP-FGTX-T-ADDM 0216 03/03/2016
E.R.J. Insurance Group d/b/a American Heritage Insurance Services FP2874 0316 04/07/2016
E.R.J. Insurance Group d/b/a American Heritage Insurance Services FP2811 0915 01/08/2016
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2500 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2501 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2502 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2503 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2504 1011 10/14/2011
Page 4of 18
Debt Cancellation Agreement Forms Approved by the OCCC
under Chapter 348, Subchapter G, Texas Finance Code
Approved as of: 5/4/2016
Name Form Number Date ApprovedE.R.J. Insurance Group d/b/a American Heritage Insurance Services 2505 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2506 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2507 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2508 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2509 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2510 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2511 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2512 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2513 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2514 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2515 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2516 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2517 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2518 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2519 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2520 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2521 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2522 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2523 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2524 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2525 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2526 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2527 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2528 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2529 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2530 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2531 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2533 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2534 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2535 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2536 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2537 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2538 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2539 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2540 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2541 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2542 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2543 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2544 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2545 1011 10/14/2011
Page 5of 18
Debt Cancellation Agreement Forms Approved by the OCCC
under Chapter 348, Subchapter G, Texas Finance Code
Approved as of: 5/4/2016
Name Form Number Date ApprovedE.R.J. Insurance Group d/b/a American Heritage Insurance Services 2546 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2514 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2523 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services 2580 1011 10/14/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services FP2552 12/08/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services FP2553 12/08/2011
E.R.J. Insurance Group d/b/a American Heritage Insurance Services FP2554 12/08/2011
Enterprise Financial Group, Inc. GAP-WAIVER TX (0914) RL 12/12/2014
Enterprise Financial Group, Inc. GAP-WAIVER-150% PRB TX (08/12) 09/25/2012
Enterprise Financial Group, Inc. GAP-WAIVER 125% PR TX (10/11) EFG 08/14/2012
Enterprise Financial Group, Inc. GAP-WAIVER 125% PR TX (10/11) ORL 08/14/2012
Enterprise Financial Group, Inc. GAP-WAIVER 125% PR TX (10/11) SG 08/14/2012
Enterprise Financial Group, Inc. GAP-WAIVER-150% PR TX (10/11) 06/28/2012
Enterprise Financial Group, Inc. GAP-WAIVER-125% PR TX (10/11) 12/08/2011
Enterprise Financial Group, Inc. GAP-WAIVER-125% PR TX (10/11) ORL 12/08/2011
Enterprise Financial Group, Inc. GAP-WAIVER-125% PR TX (10/11) SG 12/08/2011
Enterprise Financial Group, Inc. GAP-WAIVER-150% PR TX (10/11) 12/08/2011
Ethos Group, Inc.
101010-61000-TX-20120817
(also numbered as EG202-A) 08/17/2012
Ethos Group, Inc.
101010-61000-TX-FD-20120816
(also numbered as EG202 FORD) 08/17/2012
Ethos Group, Inc.
101010-61000-TX-GO-20120817
(also numbered as EG202-GO) 08/17/2012
Ethos Group, Inc. EG-AT125NTX(10/14) 12/29/2014
Ethos Group, Inc. EG-AT125TX(10/14) 12/29/2014
Ethos Group, Inc. EG-AT150FTTX(10/14) 12/29/2014
Ethos Group, Inc. EG-AT150TX(10/14) 12/29/2014
Ethos Group, Inc. EG-AT125NTX 01/12 02/22/2013
Ethos Group, Inc. EG-AT125TX 01/12 02/22/2013
Ethos Group, Inc. EG-AT150FTTX 01/12 02/22/2013
Ethos Group, Inc. EG-AT150TX 01/12 02/22/2013
Express Systems, Inc. GAP-VS-TX-TFS (7/14) 08/21/2014
Express Systems, Inc. GAP-VS-TX-TFS (3/12) 09/19/2012
Express Systems, Inc. GAP-VS-TX-FMCC (3/12) 06/14/2012
Express Systems, Inc. GAP-VS-TX (3/12) 04/27/2012
Express Systems, Inc. GAP-VS-TX-FMCC (3/12) 04/27/2012
Express Systems, Inc. GAP-VS-TX-TFS (3/12) 04/27/2012
Express Systems, Inc. GAP-VS-TXPC (8/11) 10/13/2011
Express Systems, Inc. GAP-VS-TXPC-FMCC (8/11) 10/13/2011
Express Systems, Inc. GAP-VS-TXPC-TFS (8/11) 10/13/2011
Page 6of 18
Debt Cancellation Agreement Forms Approved by the OCCC
under Chapter 348, Subchapter G, Texas Finance Code
Approved as of: 5/4/2016
Name Form Number Date ApprovedFamily First Dealer Services, LLC CUDL125NFGAPTX 02/23/2012
Family First Dealer Services, LLC CUDL150DGAPTX 02/23/2012
Family First Dealer Services, LLC CUDL150FGAPTX 02/23/2012
Family First Dealer Services, LLC VERO125NFGAPTX 02/23/2012
Family First Dealer Services, LLC VERO150FGAPTX 02/23/2012
Family First Dealer Services, LLC VERO150TFSGAPTX 02/23/2012
Family First Dealer Services, LLC CUDL125NFGAP 02/02/2012
Family First Dealer Services, LLC CUDL150DGAP 02/02/2012
Family First Dealer Services, LLC CUDL150FGAP 02/02/2012
Family First Dealer Services, LLC VERO125NFGAP 02/02/2012
Family First Dealer Services, LLC VERO150FGAP 02/02/2012
Family First Dealer Services, LLC VERO150TFSGAP 02/02/2012
Family First Dealer Services, LLC FFDS125NFGAPTX 11/01/2011
Family First Dealer Services, LLC FFDS125SGAPTX 11/01/2011
Family First Dealer Services, LLC FFDS150SGAPTX 11/01/2011
Family First Dealer Services, LLC FFDS150TFSGAPTX 11/01/2011
Financial Gap Administrator, LLC FG162 1/16 3/1/2016
Financial Gap Administrator, LLC FG163 1/16 03/01/2016
Financial Gap Administrator LLC FC115 10/13 (also numbered APPTX) 11/19/2013
Financial Gap Administrator LLC FC405 10/13 (also numbered 150GATX) 11/19/2013
Financial Gap Administrator LLC FC406 10/13 (also numbered as 125GATX) 11/19/2013
Financial Gap Administrator LLC FA233 07/13 (also numbered as GWRVTX) 11/19/2013
Financial Gap Administrator LLC (Wise F&I LLC) FC116 03/14 (FAPPTX) 05/08/2014
Financial Gap Administrator LLC (Wise F&I LLC) FC423 03/14 (UGATX) 05/08/2014
Financial Gap Administrator LLC (Wise F&I LLC) FC426 03/14 (FGATX) 05/08/2014
Financial Gap Administrator LLC (Wise F&I LLC) FC116 11/13 (FAPPTX) [version 2] 02/18/2014
Financial Gap Administrator LLC (Wise F&I LLC) FC416 11/13 (FGATX) [version 2] 02/18/2014
Financial Gap Administrator LLC (Wise F&I LLC) FA246 11/13 (EPRVTX) 12/20/2013
Financial Gap Administrator LLC (Wise F&I LLC) FC116 11/13 (FAPPTX) 12/20/2013
Financial Gap Administrator LLC (Wise F&I LLC) FC416 11/13 (FGATX) 12/20/2013
Financial Gap Administrator LLC (Wise F&I LLC) FA233 07/13 (GWRVTX) 11/19/2013
Financial Gap Administrator LLC (Wise F&I LLC) FC115 10/13 11/19/2013
Financial Gap Administrator LLC (Wise F&I LLC) FC405 10/13 11/19/2013
Financial Gap Administrator LLC (Wise F&I LLC) FC406 10/13 11/19/2013
First American Service Corp. GAP-WAIVER-DEDREF125% PR TX (07/11) 10/13/2011
First American Service Corp. GAP-WAIVER-DEDREF150% PR TX (07/11) 10/13/2011
First American Service Corp. GAP-WAIVER-DEDREF125% PR TX (11/11) 12/29/2011
First American Service Corp. GAP-WAIVER-DEDREF150% PR TX (11/11) 12/29/2011
First Dealer Resources, LLC FP24200413 11/19/2013
Page 7of 18
Debt Cancellation Agreement Forms Approved by the OCCC
under Chapter 348, Subchapter G, Texas Finance Code
Approved as of: 5/4/2016
Name Form Number Date ApprovedFirst Dealer Resources, LLC FP2423 0413 11/19/2013
First Dealer Resources, LLC FP2423 0413 06/12/2013
First Dealer Resources, LLC FP2419 0413 06/12/2013
First Dealer Resources, LLC FP2580 0413 06/12/2013
Ford Motor Credit Company FC-19971-TX 8/11 10/13/2011
Foresight Services Group, Inc. GAP-FGTX-T-ADDM 0615 06/17/2015
Foresight Services Group GAP-FGTX-F-ADDM 0714 09/10/2014
Foresight Services Group GAP-FGTX-ADDM 0714 09/10/2014
Fortega Financial Corp. FG125 GAP-TX 09/30/2014
Fortega Financial Corp. FG150 GAP-TX 09/30/2014
Frost Financial Services, Inc. GCTXRE0312 04/26/2012
GS Administrators, Inc. GPWTX0212 06/07/2012
GS Administrators, Inc. GPWTXAN0212 06/07/2012
GS Administrators, Inc. GPWTX1011 11/15/2011
Hyundai Protection Plan, Inc HYGP-TX rev 1/13 10/18/2012
Hyundai Protection Plan, Inc. HYGP-TX rev 4/15 02/20/2015
Innovative Aftermarket Systems, L.P. FP2840 1015 03/03/2016
Innovative Aftermarket Systems, L.P. FP2838 1015 02/23/2016
Innovative Aftermarket Systems L.P. AR2572 0415 07/16/2015
Innovative Aftermarket Systems L.P. AR2573 0415 07/16/2015
Innovative Aftermarket Systems L.P. GLTX 041015 04/15/2015
Innovative Aftermarket Systems L.P. G54MAFTX 011415 01/22/2015
Innovative Aftermarket Systems L.P. GCOMTX 121813 02/18/2014
Innovative Aftermarket Systems L.P. GCOMTX 121813 02/18/2014
Innovative Aftermarket Systems L.P. GTMAFTX 072612 09/06/2012
Innovative Aftermarket Systems L.P. GUSPTX 070113 07/02/2013
Innovative Aftermarket Systems L.P. GTMAFTX 042513 04/25/2013
Innovative Aftermarket Systems L.P. GINDTX 111511 03/22/2012
Innovative Aftermarket Systems L.P. GMAFTX 111511 02/27/2012
Innovative Aftermarket Systems L.P. GMTX 111511 12/29/2011
Innovative Aftermarket Systems L.P. GNTX 111511 12/29/2011
Innovative Aftermarket Systems L.P. GRTX 111511 12/29/2011
Innovative Aftermarket Systems L.P. GCTX 111511 11/16/2011
Innovative Aftermarket Systems L.P. GTX 111511 11/16/2011
Janus Administrative Solutions, Inc. PGPF_A2000_TX0913 11/01/2013
Janus Administrative Solutions, Inc. PGPN_A3000_TX0813 08/30/2013
Janus Administrative Solutions, Inc. PGPF_A2000_TX0913 11/01/2013
Jim Moran and Associates, Inc. AGTX (01/12) 01/12/2012
Jim Moran and Associates, Inc. TL2T (01/12) 01/12/2012
Page 8of 18
Debt Cancellation Agreement Forms Approved by the OCCC
under Chapter 348, Subchapter G, Texas Finance Code
Approved as of: 5/4/2016
Name Form Number Date ApprovedJim Moran and Associates, Inc. TLTX (01/12) 01/12/2012
Jim Moran and Associates, Inc. TXBG (01/12) 01/12/2012
Jim Moran and Associates, Inc. TXGP (01/12) 01/12/2012
Jim Moran and Associates, Inc. TXTF (01/12) 01/12/2012
Jim Moran and Associates, Inc. VGTX (01/12) 01/12/2012
Jim Moran and Associates, Inc. AGTX (01/12/12) 01/13/2012
Jim Moran and Associates, Inc. TL2T (01/12/12) 01/13/2012
Jim Moran and Associates, Inc. TXBG (01/12/12) 01/13/2012
Jim Moran and Associates, Inc. TXGP (01/12/12) 01/13/2012
Jim Moran and Associates, Inc. VGTX (01/12/12) 01/13/2012
Knight Management Insurance Services LLC KMIS GAP TX 201508 09/16/2015
Knight Management Insurance Services LLC KMIS GAP TX 11/2013 B 12/18/2013
Knight Management Insurance Services LLC KMIS GAP TX 11/2013 B 12/18/2013
Knight Management Insurance Services LLC KMIS GAP TX 11/2012 12/21/2012
Lee & Mason Financial Services, Inc. APWAV0113 (TX) 03/07/2013
Lee & Mason Financial Services, Inc. APWAV0613-TX 07/25/2013
Lincoln Automotive Financial Services LI-19971-TX 8/11 10/13/2011
Lobel Financial Corp. Texas Debt Cancellation (GAP) 11/10/2011
Lyndon Property Insurance Company GAP-ADDM2426-CF-TX (10/11) 10/13/2011
Lyndon Property Insurance Company GAP-ADDE2426-CF-TX (10/11) 11/22/2011
Maximus Auto Group, Inc. MAG GAP 150MTX 10/14/2011
Maximus Auto Group, Inc. MAG GAP 125MTX 10/15/2011
Maximus Auto Group, Inc. MAG GAP F150MTX 10/16/2011
Maximus Auto Group, Inc. MAG GAP 125MTX (01/12) 02/23/2012
Maximus Auto Group, Inc. MAG GAP 150MTX (01/12) 02/23/2012
Mechanical Breakdown Protection, Inc. (MBPI) TXFMC (FP2630 1112) 01/03/2013
Mechanical Breakdown Protection, Inc. (MBPI) TXFE12 (FP2632 1112) 01/03/2013
Mechanical Breakdown Protection, Inc. (MBPI) TXFE150 (FP2634 1112) 01/03/2013
Mechanical Breakdown Protection, Inc. (MBPI) TXS120 (FP2636 1112) 01/03/2013
Mechanical Breakdown Protection, Inc. (MBPI) TXS150 (FP2638 1112) 01/03/2013
Mechanical Breakdown Protection, Inc. (MBPI) TXFMCC (FP2628 1112) 01/03/2013
Mechanical Breakdown Protection, Inc. (MBPI) TXFEC120 (FP2631 1112) 01/03/2013
Mechanical Breakdown Protection, Inc. (MBPI) TXFEC150 (FP2633 1112) 01/03/2013
Mechanical Breakdown Protection, Inc. (MBPI) TXSC120 (FP2635 1112) 01/03/2013
Mechanical Breakdown Protection, Inc. (MBPI) TXSC150 (FP2637 1112) 01/03/2013
Mechanical Breakdown Protection, Inc. (MBPI) TXFMCF (FP2629 1112) 01/03/2013
Mercedes-Benz Financial Services USA LLC (c/o Zurich) GDTX1111 (11/11) 10/13/2011
Mercedes-Benz Financial Services, USA LLC GDTX0215 (02/15) 02/16/2015
MIC Property and Casualty Insurance Corporation 150 PRO GAP CSCI FT TX (11-13) - GAP Care Advantage 12/17/2013
Page 9of 18
Debt Cancellation Agreement Forms Approved by the OCCC
under Chapter 348, Subchapter G, Texas Finance Code
Approved as of: 5/4/2016
Name Form Number Date Approved
MIC Property and Casualty Insurance Corporation 150 PRO GAP CSCI FT TX (11-13) - Vehicle One 12/17/2013
MIC Property and Casualty Insurance Corporation 120 PRO GAP TX (3-13) 04/01/2013
MIC Property and Casualty Insurance Corporation 150 PRO GAP TX (03-13) (with GAP Care Advantage Logo) 04/01/2013
MIC Property and Casualty Insurance Corporation 150 PRO GAP TX (03-13) (with Vehicle One logo) 04/01/2013
MIC Property and Casualty Insurance Corporation 150 PRO GAP CSCI FT TX (03-13) (with GAP Care Advantage Logo) 04/01/2013
MIC Property and Casualty Insurance Corporation 150 PRO GAP CSCI FT TX (03-13) (with Vehicle One logo) 04/01/2013
MIC Property and Casualty Insurance Corporation 150 PRO GAP TX (09/11) 10/13/2011
MIC Property and Casualty Insurance Corporation Chry CSCI 150 PRO GAP TX (09/11) 10/13/2011
MIC Property and Casualty Insurance Corporation Chry UWC 150 PRO GAP TX (09/11) 10/13/2011
MIC Property and Casualty Insurance Corporation VI 150 PRO GAP TX (09/11) 10/13/2011
MIC Property and Casualty Insurance Corporation 120 PRO GAP TX (09-11) 10/13/2011
MIC Property and Casualty Insurance Corporation
150 PRO GAP CSCI FT TX (09/11)
(with Vehicle One logo) 12/07/2011
MIC Property and Casualty Insurance Corporation
150 PRO GAP CSCI FT TX (09/11)
(with GAP Care Advantage Logo) 12/07/2011
MPP Co., Inc. MPPOUC GAPAD TX 1011 12/21/2011
Nation Motor Club, Inc. NSD RV GAP TX 4/14 06/18/2014
Nation Motor Club, LLC d/b/a Nation Safe Drivers QT3140216 03/30/2016
Nation Motor Club, LLC d/b/a Nation Safe Drivers TX3140216 03/30/2016
Nation Motor Club, LLC d/b/a Nation Safe Drivers RVGTX0116 02/23/2016
Nation Motor Club, LLC d/b/a Nation Safe Drivers CAM313TX 01/16 01/21/2016
Nation Motor Club, LLC d/b/a Nation Safe Drivers CAM316TX 01/16 01/21/2016
Nation Safe Drivers/NIU AM313TX 04/12 02/07/2013
Nation Safe Drivers/NIU AM314TX 04/12 02/07/2013
Nation Safe Drivers/NIU AM316 04/12 02/07/2013
Nation Safe Drivers/NIU AM313TX 01/12 03/15/2012
Nation Safe Drivers/NIU FP 2567 11/11 03/15/2012
Nation Safe Drivers/NIU FP 2568 11/11 03/15/2012
Nation Safe Drivers/NIU FP 2569 11/11 03/15/2012
National Auto Care Corporation TXNAC150FGAP Rev 5/13 07/02/2013
National Auto Care Corporation TXNAC125NFGAP Rev 5/13 07/02/2013
National Auto Care Corporation (Family First) TX GAP150F001 01/14 03/26/2014
National Auto Care Corporation (Family First) TX GAP125NF002 01/14 03/26/2014
National Auto Lenders, Inc. 21707977v1 0940614 05/09/2013
Norman & Company, Inc. RV GAP TX AIC (11/15) 12/18/2015
Norman & Company, Inc. BHPH 125% TX 10/14/2011
Norman & Company, Inc. FP2555 10-11 10/27/2011
Norman & Company, Inc. FP2556 10-11 10/27/2011
Norman & Company, Inc./Classic RV GAP TX (2/14) 04/14/2014
NWAN, Inc. NI G1109 (2-16) 4/26/2016
NWAN, Inc. NI G1042 (12-15) 01/25/2016
Page 10of 18
Debt Cancellation Agreement Forms Approved by the OCCC
under Chapter 348, Subchapter G, Texas Finance Code
Approved as of: 5/4/2016
Name Form Number Date ApprovedNWAN, Inc. NI G1041 (12-15) 01/25/2016
NWAN, Inc. NI G1022 (9-15) 11/13/2015
NWAN, Inc. NI G1027 (9-15) 11/13/2015
NWAN, Inc. NI G1033 (9-15) 11/13/2015
NWAN, Inc. NI G1038 (9-15) 11/13/2015
NWAN, Inc. NI G1014 (3-15) V1 0615 07/22/2015
NWAN, Inc. NI G1014 (3-15) 05/15/2015
Old Republic Insured Automotive Services, Inc. GAP06-Waiver150-TX (10/11) 10/15/2011
Old Republic Insured Automotive Services, Inc. GAP06-Waiver125-TX (10/11) 10/14/2011
Old Republic Insured Automotive Services, Inc. GAP06-Waiver125-TX (01/12) 03/02/2012
Old Republic Insured Automotive Services, Inc. GAP06-Waiver150-TX (01/12) 03/02/2012
Old Republic Insured Automotive Services, Inc. GAP06-Waiver150-TX FRD (12/11) 01/26/2012
Old Republic Insured Automotive Services, Inc. GAP06-Waiver150-TX (11/11) 12/19/2011
OwnerGUARD Corporation TX.AFA.AB.LZX.1111 12/04/2011
OwnerGUARD Corporation TX.AFA.B.LZX.1111 12/04/2011
OwnerGUARD Corporation TX.AFA.GB.LZX.1111 12/04/2011
OwnerGUARD Corporation TX.AFA.SB.LZX.1111 12/05/2011
OwnerGUARD Corporation d/b/a Program Adminstrator OwnerGUARD: TX.AFA.0613.01B 03/28/2014
OwnerGUARD Corporation d/b/a Program Adminstrator Accelerate: TX.AFA.0613.06J 03/28/2014
OwnerGUARD Corporation d/b/a Program Adminstrator ProGuard: TX.AFA.0613.05I 03/28/2014
OwnerGUARD Corporation d/b/a Program Adminstrator Diamond Warranty: TX.AFA.0613.08M 03/28/2014
OwnerGUARD Corporation d/b/a Program Adminstrator Ameriplus: TX.AFA.0613.04G 03/28/2014
OwnerGUARD Corporation d/b/a Program Adminstrator GWC Warranty: TX.AFA.0613.03F 03/28/2014
OwnerGUARD Corporation d/b/a Program Adminstrator Spectrum: TX.AFA.0613.02D 03/28/2014
Partners Alliance Corporation FI-150 TX (03/2016) 04/29/2016
Partners Alliance Corporation PAC-150 TX (03/2016) 04/29/2016
Partners Alliance Corporation FI 2000 (150 TX) 01/16 12/18/2015
Partners Alliance Corporation FI 2001 (125 TX) 01/16 12/18/2015
Partners Alliance Corporation PAC 1005 (150 TXT) 05/15 08/07/2015
Partners Alliance Corporation FI 2001 (125 TX) 02/15 04/17/2015
Partners Alliance Corporation FI 2000 (150 TX) 02/15 04/17/2015
Partners Alliance Corporation PAC 2000 (150 TX) 1/15 02/02/2015
Partners Alliance Corporation PAC 2001 (125 TX) 1/15 02/02/2015
Partners Alliance Corporation AMT-FI (TXF) 01/13 06/25/2013
Partners Alliance Corporation AMT-FI (TX125) 01/13 06/25/2013
Partners Alliance Corporation AMT-TX125 (11/12) 03/11/2013
Partners Alliance Corporation AMT-TXF (11/12) 03/11/2013
Partners Alliance Corporation AMT-TX (11/12) 01/03/2013
Page 11of 18
Debt Cancellation Agreement Forms Approved by the OCCC
under Chapter 348, Subchapter G, Texas Finance Code
Approved as of: 5/4/2016
Name Form Number Date ApprovedPartners Alliance Corporation DIF-FI(TX) 11/12 12/06/2012
Partners Alliance Corporation DIF-FI(TX125) 11/12 12/06/2012
Partners Alliance Corporation DIF-FI(TXF) 11/12 12/06/2012
Partners Alliance Corporation DIF-FI(TXT) 11/12 12/06/2012
Partners Alliance Corporation FP2582 (02/12) TX120 08/21/2012
Partners Alliance Corporation DIF-TXT (3/12) 05/04/2012
Partners Alliance Corporation FP2581 (02/12) TX 150 04/25/2012
Partners Alliance Corporation FP2582 (02/12) TX125 04/25/2012
Partners Alliance Corporation FP2583 (02/12) TXF 04/25/2012
Partners Alliance Corporation PAC125TX 02/12 04/25/2012
Partners Alliance Corporation PAC150FTTX 02/12 04/25/2012
Partners Alliance Corporation PAC150TX 02/12 04/25/2012
Partners Alliance Corporation DIF-TX 10/13/2011
Partners Alliance Corporation DIF-TX 125 10/13/2011
Partners Alliance Corporation DIF-TXF 10/13/2011
Phoenix GAP PGAPF TX 100 12/15 03/21/2016
Phoenix GAP PGAPI TX 100 12/15 03/21/2016
Phoenix GAP PAFG 01/18/2012
Phoenix GAP PAGIN 01/18/2012
Plateau Service Company GAP Waiver TX PR-R 12/18/2015
Plateau Service Company GAP Waiver TX Plan RE 12/18/2015
Plateau Service Company GAP Waiver TX PR-R Plan F (07/15) 08/26/2015
Plateau Service Company GAP Waiver TX Plan RE 12/10/2013
Plateau Service Company GAP Waiver TX PR-R 12/10/2013
Plateau Service Company GAP Waiver TX PR-R Plan F 12/10/2013
Plateau Service Company GAP Waiver TX Plan RE 12/10/2013
Plateau Service Company GAP Waiver TX PR-R 12/10/2013
Plateau Service Company GAP Waiver TX PR-R Plan F 12/10/2013
Power Protect Extended Services, Inc. KIGP-TX rev 1/15 02/20/2015
Preferred Administrators 125-SGW-12-TX 03/21/2012
Preferred Administrators 125-SGW-50-12-TX 03/21/2012
Preferred Administrators 125-SGW-50-BCMX-12-TX 03/21/2012
Preferred Administrators 125-SGW-BCMX-12-TX 03/21/2012
Preferred Administrators 150-SGW-12-TX 03/21/2012
Preferred Administrators 150-SGW-50-12-TX 03/21/2012
Preferred Administrators 150-SGW-50-BCMX-12-TX 03/21/2012
Preferred Administrators 150-SGW-BCMX-12-TX 03/21/2012
Preferred Administrators 125-CW-12-TX 05/11/2012
Preferred Administrators 125-CW-50-12-TX 05/11/2012
Preferred Administrators 125-CW-50-BCMX-12-TX 05/11/2012
Page 12of 18
Debt Cancellation Agreement Forms Approved by the OCCC
under Chapter 348, Subchapter G, Texas Finance Code
Approved as of: 5/4/2016
Name Form Number Date ApprovedPreferred Administrators 125-CW-BCMX-12-TX 05/11/2012
Preferred Administrators 150-CW-12-TX 05/11/2012
Preferred Administrators 150-CW-50-12-TX 05/11/2012
Preferred Administrators 150-CW-50-BCMX-12-TX 05/11/2012
Preferred Administrators 150-CW-BCMX-12-TX 05/11/2012
Preferred Automobile Credit Co. Ltd. (PACCO) HC# 4845-3309-7744v.3 07/18/2012
Premier Dealer Services, Inc. FC-19971-CL-TX 12/15 04/07/2016
Premier Dealer Services, Inc. AGAP-ULT-TX-TOY (5/15) 08/06/2015
Premier Dealer Services, Inc. AGAP-ULT-TX - TOY (3/15) 04/24/2015
Premier Dealer Services, Inc. AGAP-ULT-TX (1/15) 02/25/2015
Premier Dealer Services, Inc. AGAP-ULT-TX (7/14) 08/26/2014
Premier Dealer Services, Inc. FC-19971-TX 03/14 06/27/2014
Premier Dealer Services, Inc. GEN-19971-TX 03/14 06/27/2014
Premier Dealer Services, Inc. LI-19971-TX 03/14 06/27/2014
Premier Dealer Services, Inc. AGAP-ULT-TX (12/13) 03/18/2014
Premier Dealer Services, Inc. AGAP-ULT-TX (9/13) 02/03/2014
Premier Dealer Services, Inc. AGAP-RV-TX (9/13) 01/22/2014
Premier Dealer Services, Inc. TXRVGAP-01 (6/12) 10/12/2012
Premier Dealer Services, Inc. TXGAPUL-04 (5/12) 06/25/2012
Premier Dealer Services, Inc. TXGAPUL-03 (12/11) 01/25/2012
Premier Dealer Services, Inc. TXGAP-02 (9/11) 10/21/2011
Premier Dealer Services, Inc. TXGAPUL-02 (9/11) 10/21/2011
Prime Acceptance Corp. PAC-1001 WVR (09/15) 11/05/2015
Principal Warranty Corp. PWTXF150-M-001 (06/14) [150PWTXF] 05/23/2014
Principal Warranty Corp. PWTXG125-M-001 (06/14) [125PWTXG] 05/23/2014
Principal Warranty Corp. PWTXG150-M-001 (06/14) [150PWTXG] 05/23/2014
Regional Insurance Services Company, Inc. RISCO125NTX 03/22/2012
Regional Insurance Services Company, Inc. RISCO125STX 03/22/2012
Regional Insurance Services Company, Inc. RISCO150TX 03/22/2012
Regional Insurance Services Company, Inc. RISCO150FFTX 03/22/2012
Regional Insurance Services Company, Inc. TRCOG00150 CH (10/11) TX 01/04/2012
Regional Insurance Services Company, Inc. RISCO125NTX 12/08/2011
Regional Insurance Services Company, Inc. RISCO125STX 12/08/2011
Regional Insurance Services Company, Inc. RISCO150FTTX 12/08/2011
Regional Insurance Services Company, Inc. RISCO150TX 12/08/2011
Reinsurance Associates, Inc. d/b/a Financial GAP Administrator FC416 06/07/2012
Reinsurance Associates, Inc. d/b/a Financial GAP Administrator FC405_0112 (150GATX) 03/06/2012
Reinsurance Associates, Inc. d/b/a Financial GAP Administrator FC406_0112 (125GATX) 03/06/2012
Reinsurance Associates, Inc. d/b/a Financial GAP Administrator FA205 (150SGTX) 02/17/2012
Reinsurance Associates, Inc. d/b/a Financial GAP Administrator FA205 (GDPETX) 02/17/2012
Page 13of 18
Debt Cancellation Agreement Forms Approved by the OCCC
under Chapter 348, Subchapter G, Texas Finance Code
Approved as of: 5/4/2016
Name Form Number Date ApprovedReinsurance Associates, Inc. d/b/a Financial GAP Administrator FG108 12/28/2011
Reinsurance Associates, Inc. d/b/a Financial GAP Administrator FG109 12/28/2011
Reinsurance Associates, Inc. d/b/a Financial GAP Administrator FG110 12/28/2011
Reinsurance Associates, Inc. d/b/a Financial GAP Administrator FG111 12/28/2011
Reinsurance Associates, Inc. d/b/a Financial GAP Administrator FG112 12/28/2011
Reinsurance Associates, Inc. d/b/a Financial GAP Administrator FG113 12/28/2011
Reinsurance Associates, Inc. d/b/a Financial GAP Administrator FG114 12/28/2011
Reinsurance Associates, Inc. d/b/a Financial GAP Administrator FG115 12/28/2011
Reinsurance Associates, Inc. d/b/a Financial GAP Administrator 125EPTX_FA204 12/02/2011
Reinsurance Associates, Inc. d/b/a Financial GAP Administrator 125GWTX_FA202 12/02/2011
Reinsurance Associates, Inc. d/b/a Financial GAP Administrator 125SGTX_FA206 12/02/2011
Reinsurance Associates, Inc. d/b/a Financial GAP Administrator 150EPTX_FA203 12/02/2011
Reinsurance Associates, Inc. d/b/a Financial GAP Administrator 150GWTX_FA201 12/02/2011
Reinsurance Associates, Inc. d/b/a Financial GAP Administrator 150SGTX_FA205 12/02/2011
Reinsurance Associates, Inc. d/b/a Financial GAP Administrator EFMCTX_FA208 12/02/2011
Reinsurance Associates, Inc. d/b/a Financial GAP Administrator FMCTX_FA207 12/02/2011
Reinsurance Associates, Inc. d/b/a Financial GAP Administrator APPTX FC115 11/23/2011
Reinsurance Associates, Inc. d/b/a Financial GAP Administrator FAPPTX FC116 11/23/2011
Royal Administration Services, Inc Royal GAPADD-009 TX Rev. 09-12 11/16/2012
Safe-Guard Products International, LLC MIGP-TX Rev. 3/16 04/27/2016
Safe-Guard Products International, LLC BMGP-TX Rev. 3/16 04/27/2016
Safe-Guard Products International, LLC VRGP-TX Rev. 11/15 01/15/2016
Safe-Guard Products International, LLC ANGP-TX-GEN Rev. 11/15 01/15/2016
Safe-Guard Products International, LLC ANGP-TX Rev. 07/15 09/16/2015
Safe-Guard Products International, LLC PPGP-TX 06/12/2015
Safe-Guard Products International, LLC BEGP-TX 04/01/2015
Safe-Guard Products International, LLC LAGP-TX 04/01/2015
Safe-Guard Products International, LLC PFF2036TX 04/01/2015
Safe-Guard Products International, LLC POGP-TX 03/13/2015
Safe-Guard Products International, LLC QSGP-TX 03/13/2015
Safe-Guard Products International, LLC APRGP-TX Rev. 11/13 01/08/2014
Safe-Guard Products International, LLC APRGP-TX Rev. 8/13 09/10/2013
Safe-Guard Products International, LLC AAGP-TX 09/09/2013
Safe-Guard Products International, LLC AFSGAPTXA0313 02/21/2013
Safe-Guard Products International, LLC HFGAPTX0313 02/21/2013
Safe-Guard Products International, LLC GSRP-TX Rev. 8/12 09/26/2012
Safe-Guard Products International, LLC PPGP-TX Rev 1/13 10/17/2012
Safe-Guard Products International, LLC RSGP-TX Rev. 8/12 09/19/2012
Safe-Guard Products International, LLC
CMGPSET-TX Rev. 06/12
(also shows form number PFF2036TX) 08/24/2012
Page 14of 18
Debt Cancellation Agreement Forms Approved by the OCCC
under Chapter 348, Subchapter G, Texas Finance Code
Approved as of: 5/4/2016
Name Form Number Date ApprovedSafe-Guard Products International, LLC HYGP-TX Rev. 8/12 07/31/2012
Safe-Guard Products International, LLC KIGP-TX Rev. 8/12 07/31/2012
Safe-Guard Products International, LLC INGPFM-TX 06/14/2012
Safe-Guard Products International, LLC INRGP-TX Rev 02/12 05/29/2012
Safe-Guard Products International, LLC SGRGP-TX Rev 02/12 05/29/2012
Safe-Guard Products International, LLC ANGPFM-TX 12/08/2011
Safe-Guard Products International, LLC ANGP-TX 12/08/2011
Safe-Guard Products International, LLC BMGP-TX 12/08/2011
Safe-Guard Products International, LLC INGP-TX 12/08/2011
Safe-Guard Products International, LLC MIGP-TX 12/08/2011
Safe-Guard Products International, LLC SGGPFM-TX 12/08/2011
Safe-Guard Products International, LLC SGGP-TX 12/08/2011
Service Guard Insurance Agency 125-SGW-50-BCMX13-TX 11/30/2012
Service Guard Insurance Agency 150-CUDL-50-BC-13-TX 11/30/2012
Service Guard Insurance Agency 150-CUDL-50-BCMX-TX 11/30/2012
Service Guard Insurance Agency 150-CUDL-50-MX-13-TX 11/30/2012
Service Guard Insurance Agency 150-CUDL-BC-13-TX 11/30/2012
Service Guard Insurance Agency 150-CUDL-BCMX-13-TX 11/30/2012
Service Guard Insurance Agency 150-CUDL-MX-13-TX 11/30/2012
Service Guard Insurance Agency 150-SGW-50-BCMX-13-TX 11/30/2012
Service Guard Insurance Agency 150-SGW-50-MX-13-TX 11/30/2012
Service Guard Insurance Agency 150-SGW-BC-13-TX 11/30/2012
Service Guard Insurance Agency 150-SGW-BCMX-13-TX 11/30/2012
Service Guard Insurance Agency 150-SGW-MX-13-TX 11/30/2012
Service Guard Insurance Agency 125-CUDL-50-BCMX-13-TX 11/30/2012
Service Guard Insurance Agency 150-SGW-50-BC-13-TX 11/30/2012
Service Guard Insurance Agency 125-SGW-50-BCMX-13-TX 11/30/2012
Service Guard Insurance Agency 150-SGW-BCMX-Toyota-13-TX 12/21/2012
Service Guard Insurance Agency 150-SGW-50-BC-Toyota-13-TX 12/21/2012
Service Guard Insurance Agency 150-SGW-MX-Toyota-13-TX 12/21/2012
Service Guard Insurance Agency 150-SGW-BC-Toyota-13-TX 12/21/2012
Service Guard Insurance Agency 150-SGW-50-BCMX-Toyota-13-TX 12/21/2012
Service Guard Insurance Agency 150-SGW-50-MX-Toyota-13-TX 12/21/2012
Service Guard Insurance Agency 150-SGW-50-Toyota-13-TX 12/21/2012
Service Guard Insurance Agency 150-SGW-Toyota-13-TX 12/21/2012
South Texas Acceptance Corp. FL629477 Q 06/13/2013
Southwest Reinsure, Inc. BIJ-TX-XX-001 02/02/2012
Starr Indemnity & Liability Company 150 CVS GAP TX 02/13 06/14/2013
Starr Indemnity & Liability Company 150 CVS GAP TX0213 TF/FMC 06/14/2013
Stellar Auto Group LLC d/b/a HRS Motors Cars or Regal Captial Credit DCA-1A 07/28/2015
Page 15of 18
Debt Cancellation Agreement Forms Approved by the OCCC
under Chapter 348, Subchapter G, Texas Finance Code
Approved as of: 5/4/2016
Name Form Number Date ApprovedSummit Administrators, Inc TX Plan RE-Summit 09/09/2014
Summit Administrators, Inc TX PR--R--Summit 09/09/2014
Summit Administrators, Inc TX PR -- R Plan F--Summit 09/09/2014
SWBC RBDTX 05/13 06/14/2013
SWBC SWBCTX150 08/07/2012
SWBC-American National (ANICO) SWBCTX150_2DLQ 10/08/2014
T.A.S.A of KY, Inc. DGA00150 CH (08/13) TX EF 10/09/2013
T.A.S.A of KY, Inc. TGA00125 CH (09/13) EF 11/05/2013
T.A.S.A of KY, Inc. TGA00150 CH (09/13) EF 11/05/2013
T.A.S.A of KY, Inc. SGNB150 (Rev. 11/2012) TX 01/03/2013
T.A.S.A of KY, Inc. SGNB150 (Rev. 1/2012) TX 07/30/2012
T.A.S.A of KY, Inc. DGA00150 CH (10/11) TX 12/02/2011
T.A.S.A of KY, Inc. TGA00125 CH (10/11) TX 12/02/2011
T.A.S.A of KY, Inc. TGA00150 CH (10/11) TX 12/02/2011
T.A.S.A. of KY, Inc. TGA00135 RV (5/15) TX 07/17/2015
T.A.S.A. of KY, Inc. TGA00125 CH (09/13) TX EF 11/05/2013
T.A.S.A. of KY, Inc. TGA00150 CH (09/13) TX EF 11/05/2013
T.A.S.A. of KY, Inc. TGA00125 CH (09/13) TX EF 11/05/2013
T.A.S.A. of KY, Inc. TGA00150 CH (09/13) TX EF 11/05/2013
Texas Car-Mart, Inc. Revision # 103561 (TX) 12/28/2011
The Wildfire Group, LLC TLC/TXRV/0612 10/10/2012
The Wildfire Group, LLC d/b/a Total Loss Coverage Gap TLC/RV125%TX0612 08/07/2012
The Wildfire Group, LLC d/b/a Total Loss Coverage Gap TLC/TX150/1011 11/04/2011
The Wildfire Group, LLC d/b/a Total Loss Coverage Gap TLC/TXNF125/1011 11/04/2011
Toyota Motor Insurance Services, Inc. 111542XE 03/01/2012
Toyota Motor Insurance Services, Inc. 111542 12/01/2011
Toyota Motor Insurance Services, Inc. 111542U 12/01/2011
TT of Flagler, Inc d/b/a Total Warranty Services (TWS) TWS-GAP-004 TX (10/13) 11/20/2013
TT of Flagler, Inc d/b/a Total Warranty Services (TWS) TWS-GAP-005 FM-TX (10/13) 11/20/2013
TT of Flagler, Inc d/b/a Total Warranty Services (TWS) TWS-GAP-005 TFS-TX (10/13) 11/20/2013
TT of Flagler, Inc. d/b/a Total Warranty Services TWS-GAP-004 TX (10/13) 11/20/2013
TT of Flagler, Inc. d/b/a Total Warranty Services TWS-GAP-005 FM-TX (10/13) 11/20/2013
TT of Flagler, Inc. d/b/a Total Warranty Services TWS-GAP-005 TFS-TX (10/13) 11/20/2013
United Auto Credit Corporation UACC Form 511-TX 01/13/2012
United States Warranty Corp. FP2562 11/03/2011
United States Warranty Corp. FP2563 11/03/2011
United States Warranty Corp. USTX 125 11/03/2011
United States Warranty Corp. USTX 150 11/03/2011
United States Warranty Corp. SNTX 150 03/08/2012
Universal Warranty Corporation GAP-150-PRO-DLR-DLPT-TX (10/15) 01/27/2016
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Debt Cancellation Agreement Forms Approved by the OCCC
under Chapter 348, Subchapter G, Texas Finance Code
Approved as of: 5/4/2016
Name Form Number Date ApprovedUniversal Warranty Corporation GAP-150-PRO-DLR-DLPF-TX (10/14) 06/17/2015
Universal Warranty Corporation GAP-120-PRO-DLR-TX (10/14) 01/16/2015
Universal Warranty Corporation GAP-150-PRO-DLR-TX (10/14) 01/16/2015
Universal Warranty Corporation GCA-150 PRO UWC FT TX (01/15) 12/17/2014
Universal Warranty Corporation GCA-120 PRO TX (04/14) 06/18/2014
Universal Warranty Corporation GCA-120 PRO UWC TX (05/14) 06/18/2014
Universal Warranty Corporation GCA-150 PRO CSCI FT TX (04/14) 06/18/2014
Universal Warranty Corporation GCA-150 PRO TX (04/14) 06/18/2014
Universal Warranty Corporation GCA-150 PRO UWC FT TX (05/14) 06/18/2014
Universal Warranty Corporation GCA-150 PRO UWC TX (05/14) 06/18/2014
Universal Warranty Corporation V1-150 PRO CSCI FT TX (04/14) 06/18/2014
Universal Warranty Corporation V1-150 PRO TX (04/14) 06/18/2014
Universal Warranty Corporation V1-150 PRO UWC FT TX (05/14) 06/18/2014
Universal Warranty Corporation V1-150 PRO UWC TX (05/14) 06/18/2014
Vantage Warranty, Inc GTX_082312 08/24/2012
Vantage Warranty, Inc GTX_082312 12/12/2012
Vantage Warranty, Inc. dba RoadVantage GTX_072214 08/06/2014
Vantage Warranty, Inc. dba RoadVantage GTX120_072214 08/06/2014
Vantage Warranty, Inc. dba RoadVantage GTX125_072214 08/06/2014
Vehicle Protection Direct VPD150res-1113 09/25/2015
Vehicle Protection Direct VPD125/150res-0214 07/29/2015
Vehicle Protection Direct VPD125/150res-0214 04/03/2014
Vehicle Protection Direct VPD125/150res-0214 04/03/0214
Vehicle Protection Services vpdLegaltexas 125 9-13 10/18/2013
Vehicle Protection Services vpdLegaltexas 125 9-13 10/18/2013
Vehicle Protection Services LLC vpd 150 ndl 6-14 09/30/2014
Vehicle Protection Services LLC VPD150res-1113 12/19/2013
Vehicle Protection Services LLC VPD150res-1113 12/19/2013
Veros Credit, LLC TX Rev. 5/2014 (originally submitted as TX Rev. 3/2014) 05/13/2014
Veros Credit, LLC TX Rev. 5/2014 05/13/2014
Virginia Surety Company, Inc. GAP-91 TX (R 08/11) 11/17/2011
Virginia Surety Company, Inc. GAP-107 TX (01/12) 03/09/2012
Virginia Surety Company, Inc. GAP-107 TFS TX (01/12) 04/12/2012
Warrantech Automotive, Inc. 11MGAP0412_TX 06/10/2013
Warrantech Automotive, Inc. 11WGAP0812_TX 150 06/10/2013
Warrantech Automotive, Inc. 11WGAP0812_TX 125 06/10/2013
Warrantech Automotive, Inc. 11WGAP0812_TX 120 06/10/2013
Warrantech Automotive, Inc. 11CGAP1014_TX_FMCC-150 05/11/2015
Warrantech Automptive, Inc. 11CGAP1014_TX_-150 05/21/2015
Western Diversified Services, Inc. GAP-ADDM2429-NCF-NON TUC-TX (3/16) 11/30/2015
Page 17of 18
Debt Cancellation Agreement Forms Approved by the OCCC
under Chapter 348, Subchapter G, Texas Finance Code
Approved as of: 5/4/2016
Name Form Number Date ApprovedWestern Diversified Services, Inc. GAP-ADDM2429-NON TUC-TY-TX (3/16) 11/30/2015
Western Diversified Services, Inc. GAP-ADDM2429-TUC-TX (3/16) 11/30/2015
Western Diversified Services, Inc. GAP-ADDM2429-NCF-TUC-TX (3/16) 11/30/2015
Western Diversified Services, Inc. GAP-ADDM2429-TUC-TY-TX (3/16) 11/30/2015
Western Diversified Services, Inc. GAP-ADDM2429-NON TUC-TX (3/16) 11/30/2015
Western Funding Incorporated WFI DCA TX 1-2013 02/26/2013
Western General Insurance Company d/b/a Western General Automobile Insurance Company WGIC-816 TX (REV. 01/12) 12/21/2011
WNC Insurance Services Inc. ABCDEI-OC 10/21/2011
Zurich V4103LL (11/11) 10/13/2011
Zurich V41040LL (11/11) 10/13/2011
Zurich V41050LL (11/11) 10/13/2011
Zurich V41030LL (11/11) 10/13/2011
Zurich d/b/a Universal Underwriters Serivce Corporation V44580HQ (08/15) 08/06/2015
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