Care Concept AG | Au-Pair | Verlängerungsantrag zur AuPair Versicherung Care Au-Pair

Care Concept AG
– Policy Department –
P. O. Box 33 01 51

53203 Bonn

Fax.: 0800 977 35 35 | e-Mail: info@care-concept.de

Extension of Insurance Policy	Policy number

**Policyholder**

**Insured person**
	born on:

**Contact information**
\| \| - \|

Dear Sir or Madam,

I hereby request an extension of months for the above-mentioned insurance policy. The
policy was originally to expire on ... .

Please send me a written confirmation of the policy extension.

Faithfully yours,

________________________________
Policyholder’s signature