Debt Cancellation Agreement Form Submission

Debt Cancellation Agreement Form Submission

A debt cancellation agreement (DCA) is an agreement that the holder of a retail installment contract will cancel a specified amount owed on the contract if the vehicle is stolen or totaled. Some DCAs require that the retail buyer maintain insurance on the vehicle. A DCA that requires a retail buyer to maintain insurance must be submitted to our agency for review.  The OCCC has 45 days to approve or disapprove this type of DCA form after it is submitted to the agency.   As of May 5, 2016, there is a $250 nonrefundable filing fee for each DCA.

*NOTE:   On July 1, 2017, the OCCC will begin accepting DCA submissions for retail installment transactions on Chapter 345 covered vehicles (motorcycles, recreational vehicles, recreational vehicles, all-terrain vehicles, snowmobiles, campers, boats, personal watercrafts, and personal watercraft trailers).  Retail sellers are not allowed to offer DCAs for these Chapter 345 covered vehicles until September 1, 2017.   Before selling a DCA, a retail seller must ensure that the DCA is approved by the OCCC.  The Chapter 345 DCAs will be subject to the same submission process as shown below.

Submission Procedures

Before submitting the agreement, we encourage you to read the OCCC's advisory bulletin, "Review of Debt Cancellation Agreements Requiring Insurance”.  The OCCC will deny a debt cancellation agreement that does not specify that the retail buyer is required to have insurance, does not include the provisions required by Section 354.004 of the Texas Finance Code, and that suggests it covers loans or leases. A DCA must also disclose exclusions in plain language and must not contain inconsistent or misleading provisions.

The submission process is now entirely online. Email a completed copy of the Submission Form (found below) and an Adobe Acrobat text-searchable PDF version of the DCA document to The PDF may not be locked or restricted in any way that prohibits comparison of different versions of the DCA. Request online payment in this email. We will send an email with an online payment link to the sender’s address. For a limited time, we will continue to accept payment by check. In this case, mail the completed Submission Form and your check for $250 to:

Office of Consumer Credit Commissioner
2601 N. Lamar Blvd.
Austin, TX 78705

The submission is not considered complete until both the nonrefundable filing fee and debt cancellation agreement are received by our agency.

Submission Forms (choose 1):
Debt Cancellation Submission Form (Word)
Debt Cancellation Submission Form (PDF)

Listing of Approved Debt Cancellation Agreements (as of 02/01/24)

Spreadsheet (Sortable)
PDF (Non Sortable) 

For further questions about debt cancellation agreements, please submit your inquiries to