Service Cancellation Request Dear Valued Customer - We are sorry to see you leave us. If there is anything we can do to change your mind, please call us at (855) 433-6700. As a reminder, we offer a full suite of interactive services (video surveillance, video clips for home [get video clip notifications on your pet, visitors or your family], thermostat, doorbell video, interactive locks and much more!). We also install and service accounts throughout Chicago and all of its suburbs, Illinois, and parts of Indiana, Michigan and Wisconsin. In order to complete your cancellation, we require that you fill out the following cancellation notice: Name: (required) Name of Business: (if applicable) Email: (required) Your full Street Address/City/State/ZIP that you plan to cancel: (required) Phone Number: (required) Cancellation Request Date: (today's date) Termination of Service Date: (required) Please note per contract we require 30 days advance notice on cancellation; so you may be billed for current or next month depending on timing of cancellation. Alarm Password: (required) Why are you leaving us? (required) —Please choose an option—Moving to another property in IllinoisMoving out of stateI’m not using the alarmOut of businessSwitching to another alarm companyYour prices are too highHardship/cannot pay billCustomer is deceasedDissatisfied with serviceI’m a builder and have sold the property If you are moving, where to? Are you interested in having Alert Protective Services install an alarm or security system at your new home or business? (required) —Please choose an option—YesNo Is someone moving into your home or business? (required) —Please choose an option—YesNo If so, and if you make a referral, we can offer you a month of free monitoring at your new home or business. (please provide their contact information below) Please rank your level of satisfaction with Alert Protective Services on a scale of 1 – 10 (10 highest, 1 lowest) (required) 12345678910 Any other feedback for us? (required) Thank you very much for your business – we are proud to have worked with you as our customer. Regards, The Alert Protective Services Team Please type ALERT to continue