Individuals and companies not wishing to renew their listing(s) need to complete the entire form and submit it before the 30th and include "CANCEL LISTING" next to your company name. All fields on the form are required including a valid email address.

Company Name:
Contact:
Address:
City: State: Zip:
Local Phone # Toll Free #
FAX # E-mail:
Company Web Site URL:


Cancellation Conformation provided on submission.
For personal service contact:
Diversified Insurance Services
16321 FM 344 W., Suite 6
Bullard, TX 75757
(903) 825-7758    Attn.: Dennis Rogers