Cancellation of Service

Company Name:*

Service(s) to be Cancelled:*

 Data Services (Please provide connection details below, Brennan owned CPE's will need to be returned) Voice (Please provide All service numbers etc. below) Brennan IT Services (Ultimate Care, Other) Other Services

Sites & Other Details:*

Reasons for Cancellation:*

Cancellation Date: (eg DD/MM/YYYY)*

Your Email:*

Phone:*

Requested By (Name):*

Position in Company:*

• 30 days cancellation notice must be provided for all services. If the service is still within contract terms, early termination fees will apply
• Brennan IT Terms & Agreements
• CPE Return Address: Brennan IT, Level 14, 45 Clarence St, Sydney, NSW 2000 ATT: Provisioning