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THIS FORM IS REQUIRED FOR CANCELLATION. PLEASE FILL OUT ALL PERTINENT INFORMATION. YOU MAY SUBMIT THE INFORMATION ELECTRONICALLY BY CLICKING THE SUBMIT BUTTON, OR ALTERNATIVELY, YOU MAY PRINT THE FORM OUT AND SUBMIT IT VIA FAX OR UNITED STATES POSTAL SERVICES. YOUR SERVICE/SERVICES WILL BE CANCELLED WITHIN 30 DAYS UPON RECEIPT OF THIS FORM.

I certify that I am the owner of this account. I understand that I will not be reimbursed for any prorated services and that this cancellation is a 30 DAY NOTICE cancellation.

I, , would like to cancel my account effective

(Note: cancellations must be dated no sooner than today's date: 5/13/2008)
   
Service: DSL
Dialup
Hosting
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First Name:
Last Name:
User Name
Email Address:
Telephone Number:
Address:
City:
State/Province:
Zip:
Reason for Cancellation:

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