Cancellation Request Form

Please complete the form below to begin Southern Web’s service cancellation process.

Company or Organization Name*
Officer's Name*
First Last
Officer's Title*
Email*
Website Address*
Please include the http://
Services to be Discontinued*
List all services to be discontinued. Services could be Web Hosting, SEO, Pay-Per-Click Managment, Domain Registration, IDX Services, Google Apps, etc.
Why are you canceling services today?
- Response times were too slow
- There was a missing feature or service
- Prices were too high
- Didn't feel the value matched the cost
- Our website is shutting down
- Other
This information helps us to improve and may allow us address any immediate concerns you may have about our services.
Do you have additional details you'd like to share with our team about why you're cancelling?
Date to Terminate Services*
Date Format: MM slash DD slash YYYY
Cancellation Agreements*
- I understand that all Services listed above, including all data, emails, reports, images and files will be deleted and unrecoverable following the “Date to Terminate Services”.
  
  With exception of the WP Site Care trial period, I understand that thirty (30) days notice is required for all Service and Product cancellations.
  
  I understand outstanding balances must be paid in order to effect this Cancellation Request.
  
  I understand that SWG does not pro-rate monthly charges.
  
  I understand that Southern Web, LLC makes no representation, warranty or guarantee regarding the use of the Product, functionality, image or software licenses with any other provider.
  
  I understand that domains registered by Southern Web on behalf of the Customer must be transferred to another registrar following the submission of this Cancellation Request Form. Southern Web will not issue domain renewal invoices or sales receipts for any domains held Southern Web or its partners following the receipt of this Cancellation Request Form. Southern Web will provide transfer authorization codes to the client upon receipt of the cancellation request. All domains not transferred away from Southern Web's domain reseller account within thirty (30) days of the submission of the Cancellation Request Form shall become the property of Southern Web, LLC.
Officer's Signature*
Phone
This field is for validation purposes and should be left unchanged.

Cancellation Request Form

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