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    Contract Service Cancellation Form F 2

    Uploaded by

    chaouch.najeh
    This document is a consumer request form for cancelling contracts and services with a telecommunications provider. It collects information such as customer details, services to be cancelled, reasons for cancellation, device returns if applicable, and terms of agreement. The customer agrees that the cancellation is limited to the services listed, indemnifies all parties, and confirms they understand the provider's terms and conditions.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Contract Service Cancellation Form F 2

    Uploaded by

    chaouch.najeh
    627 views1 page
    This document is a consumer request form for cancelling contracts and services with a telecommunications provider. It collects information such as customer details, services to be cancelled, reasons for cancellation, device returns if applicable, and terms of agreement. The customer agrees that the cancellation is limited to the services listed, indemnifies all parties, and confirms they understand the provider's terms and conditions.

    Original Description:

    42546 Contract Service Cancellation Form F 2

    Original Title

    42546 Contract Service Cancellation Form F 2

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    © © All Rights Reserved

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    PDF, TXT or read online from Scribd

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    This document is a consumer request form for cancelling contracts and services with a telecommunications provider. It collects information such as customer details, services to be cancelled, reasons for cancellation, device returns if applicable, and terms of agreement. The customer agrees that the cancellation is limited to the services listed, indemnifies all parties, and confirms they understand the provider's terms and conditions.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    627 views1 page

    Contract Service Cancellation Form F 2

    Uploaded by

    chaouch.najeh
    This document is a consumer request form for cancelling contracts and services with a telecommunications provider. It collects information such as customer details, services to be cancelled, reasons for cancellation, device returns if applicable, and terms of agreement. The customer agrees that the cancellation is limited to the services listed, indemnifies all parties, and confirms they understand the provider's terms and conditions.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
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    Consumer Request for Contract and Service Cancellation

    Agent to complete
    Agent name Account no. Order no. Case no.
    Completed form to be sent to
    Fixed Services Email address: servcancellation@telkom.co.za Contact no. 10210 Mobile Services Email address: cancellations@telkom.co.za Contact no. 081 180
    Fax no. 088 031 363 3505

    Supporting documentation
    Proof of account holders identification or duly authorised persons identification (copy of SA ID or passport)
    Copy of receipt for CPA cancellations with a device return
    Copy of death certificate (if applicable)

    1. Customer details
    Title Surname First names
    ID no./Passport no. Your Telkom account no.

    Alternative contact no.


    Final invoice Email Email address
    Post Postal address
    Suburb City Postal code

    2. Cancellation details for services/products


    Cancel all my services/products Yes No Request date of cancellation
    Service/Product to be cancelled Service no. to be cancelled Move/Port to another service provider


    3. Reason(s) for service/product cancellation


    Please select the key reason(s) for cancellation
    Customer experience Voice Broadband Customer Affordability

    Call centre service Call quality Slow internet No longer need service/product Loss of income

    Store service Cannot make or receive calls Intermittent/no service No coverage at new location Insolvency/bankruptcy
    Billing issues Dropped calls No network coverage Immigration Reduce expenses/too expensive
    Intermittent/no service Too many faults & downtime Faulty/stolen device
    Better value/deal from
    another provider
    No network coverage Deceased

    Other, details:

    4. CPA Direct marketing device return


    Device returned Yes No SIM card returned Yes No 5-day Cooling-off Yes No (If No consult with TM retentions desk)
    Device make & model Condition of device
    IMEI/Ser no. SIM ICC-ID no.
    Service no. 1 Service no. 2 Service no. 3
    Additional comments

    5. Agreement
    I, the undersigned, declare, agree and confirm that:
    1. Cancellation is limited to the above mentioned number(s)
    2. I hereby indemnify all parties that may act on the information provided and against any claims that may result from its use
    3. I have read, understand and agree to be bound by Telkoms standard terms and conditions for the Provision of Electronic Communication Services and Products, as well as Telkoms
    mobile subscriber terms and conditions (both available at http://wwwtelkom.co.za/sites/aboutus/regulatory/termsandconditions/)
    4. A customer may terminate an agreement/service at any other time (i.e. prior to expiry of the term) by giving Telkom twenty (20) business days written notice
    5. The twenty days are calculated from the day on which Telkom receives the notice
    6. In the case of services rented in terms of a contractual agreement, the rental obligations are governed by the conditions of the relevant agreement and penalties, if applicable, will apply
    7. Im duly authorised to sign on behalf of the account holder
    8. The information provided on this form is true and correct
    Full name Signature Date

    6. For office use only


    Dealer name Dealer code
    Agent name Signature Date
    (Note: All valid device returns should be captured on the Vision System as CPA returns and must comply to the Vision check list)

    V150917

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