Cancellation Request Form

Cancellation
Your account will be deactivated as of the effective date you specify in your request below. Upon receipt of your request, a representative will contact you to schedule a technician to pick-up your equipment and discuss your remaining balance or refund status. Please note, if you wish to reactivate your account and services within 12 months of disconnection, you may be subject to a reconnection fee.

Cancellation Request Form

* Indicates required fields Your Full Name* First and Last

Your Community*

Address* Street, Apt #

Phone Number*

Email*

Account Number

Request Type*

Requested Effective Date*

Services to Cancel*

Equipment to Return*

Reason for Cancelling*

If Other, please specify:

Forwarding Address:

Important Information:

Unless purchased or otherwise noted, all equipment is property of BroadStar. Upon terminating services, you are responsible for returning all equipment to BroadStar. If BroadStar does not receive the equipment by the 15th of the month, you will be charged for the equipment in your next bill. If you return the equipment after the 15th of the month, please allow BroadStar up to 45 days after receipt of the equipment to finalize your bill. If there is a dispute as to whether the equipment was returned to BroadStar, please provide proof of the returned the equipment by way of a work order (if a BroadStar employee picked up the equipment or it was returned in person to one of our offices) or a shipping receipt and/or tracking number for the package that you mailed to one of our offices. If you are on autopay and we did not receive your equipment, your credit card will automatically be charged for the equipment that was not returned. If proof of return is provided after your credit card has been charged for the equipment, BroadStar has up to 45 days from the time you provide proof that you returned the equipment to finalize your final bill. Until your final bill is generated, please refrain from disputing associated charges with your credit card company or bank as this could further delay the process.

If you are currently on autopay, please allow BroadStar a period of up to 45 days after disconnection of services to finalize your last bill. BroadStar will prorate your last bill, adjust the account and refund accordingly. Please do not dispute charges with your credit card company or bank during that timeframe, as doing so could delay the process. Thank you for your cooperation.

*Indicates required fields

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Cancellation Request Form

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