Addition of Loss Protection Form

Please complete and sign this form. If you have any questions, you may contact us.

Printable Addition of Loss Protection Form

  • In the event that the Equipment is lost, stolen or damaged in an accident, the Lessee shall pay the sum of $1,995.00 to replace the equipment or necessary repair fees and shall continue to make the monthly payments due hereunder. Lessee may obtain loss protection under the Loss Protection Plan for an additional monthly cost of $6.00. This loss protection will cover the system/device replacement cost less a $100.00 deductible fee. A police report must be filed and submitted to Lessor if the system is stolen or damaged as a result of an accident.

    The loss protection will become effective upon my next payment date after the return of this signed Addendum B.