Nvision.com, Inc. Cancellation Form
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	We are sorry that you no longer wish to continue your Internet Services with Nvision.com.  If at 
any time in the future we can be of any service, please do not hesitate to contact us.

	If you wish to cancel your account with Nvision.com please fill out the form below.  After Nvision.com
has received your cancellation request you will receive a confirmation.  It is recommended that you save this 
message for future reference. All accounts will be canceled the last day of the current month since billing is
on a monthly basis.

This form may be sent by fax to 610-841-2016 (Customers outside the USA 
should fax it to (001) 610-841-2016)
or by email to billing@nvision.com or by postal mail to:

	Nvision.com, Inc.
	1636 N. Cedar Crest Blvd., PMB 320
	Allentown, PA 18104
	USA

	If you have any further questions please contact Nvision.com:

	Phone:	484-661-7664
	Fax:	610-841-2016
	Email:	support@nvision.com


Cancellation Request
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If the server is being resold please enter the reseller contact name, email address, and phone number, not the individual
server information.

Contact Name:

Contact Email Address:

Contact Phone Number:

Account Domain:

(to be cancelled)

Account Username:

Account Password:

Reason for Cancelling/Comments: