TOTALUSA SERVICE CANCELLATION REQUEST

Please fill out the following Information if you would like to cancel your Service.

A copy of this information will be sent to your email address.
You must reply to this email to complete the cancellation request.
If you have any questions please contact us at 435-755-5877 or billing@totalusa.net
 
 
Please cancel my Internet Account on the date specified below.  I understand that I am responsible for any account balance due for services to this date, as itemized on a final statement that will be sent to me by PC's Unlimited. 
 
Name On Statement:
Totalusa.net Username:
Email Address:
Billing Address:
Daytime Phone:
Date To Cancel Service:
Service Type (dial-up, email, webhost, all):
Reason For Cancellation / Additional Inforamtion (Optional)