SERVICE CANCELLATION FORM

 

Customer authorisation form for cancellation of telecommunication service(s).
Please complete all sections in CAPITAL LETTERS, sign and return to us via email to info@v4.net.au, fax to 03 8612 4922 and 03 9826 6832 or post to PO BOX 6045, South Yarra VIC 3141.

SECTION 1 - ACCOUNT DETAILS (All fields are mandatory)


SECTION 2 - SERVICE TYPE BEING CANCELLED (Tick all that apply)


SECTION 3 - SERVICE DETAILS (Detail each number to be cancelled - only numbers listed will be cancelled)

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  • Code
  • Number
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SECTION 4 - CANCELLATION & RE-DIRECTION

V4 Telecom will disconnect the lines listed above on the date of cancellation requested. The lines in question will cease to work completely unless you re-direct the number to a new number. If you choose to redirect the number being cancelled the following charges (all charges on this form are ex-GST) will apply for redirection (the actual re-directed calls will also be charged as per our V4 Manual Plan):

* The reservation fee will be charged ($10 per month) until you advise V4 Telecom (in writing) it is no longer required.
**Duration month to month charge is $24.45 (This particular redirection will continue to each month until you advise V4 Telecom to cancel the redirection).
3 month pre paid redirect cost $30 and ceases at the end of 3 months.
6 month pre paid redirect cost $60 and ceases at the end of 6 months.
12 month pre paid redirect cost $120 and ceases at the end of 12 months.

***The Recorded Voice Announcement options are:
Option 1. Caller is advised number of the new number and call is ended
Option 2. Caller is advised number of the new number and call is re-directed
Option 3. Straight re-direction with no notification.

Option 1
Option 2
Option 3

If 'Yes' continue below. If 'No' go to section 5.


SECTION 5 - IMPORTANT THINGS TO UNDERSTAND

I declare I have read and understood the above conditions and I authorise the services listed on this form to be provisioned with V4 Telecom. I authorise you to take money due to V4 Telecom Pty Ltd out of my nominated account (if provided) on the terms shown on this form and according to the Direct Debit Request Service Agreement and pay it to V4 Telecom Pty Ltd. Person signing this form is personally liable if they are not an authorised signatory for the company listed on this form applying for the services.

To view V4’s Terms of Business please go to our website or visit www.v4.net.au/tob directly.


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