that is not a party to the contract, will lease or furnish any labor, services, material, equipment, or machinery to, or on behalf of, the real property improvement supplier in connection with the real property improvement.
"NOTICE OF CANCELLATION
If you are notified by your insurance company that all or any part of the claim or contract is not a covered loss under the insurance policy, you may cancel the contract by mailing or delivering a signed and dated copy of this cancellation notice or any other written notice to (name of real property improvement supplier) at (address of real property improvement supplier's place of business) at any time before midnight on the third business day after you have received such notice from your insurance company.
If you cancel the contract, any payments made by you under the contract will be returned to you within ten (10) business days following receipt by (name of real property improvement supplier) of your cancellation notice, minus any amounts you may owe for work already done by (name of real property improvement supplier).
I HEREBY CANCEL THIS TRANSACTION
_______________________________
(date)
_______________________________
(insured consumer's signature)".
IC 24-5-11-10