MDU CANCELLATION FORM

This form is for MDU (Multi-Dwelling Units or Apartment Buildings and Complexes or other locations were ReliaNET provides services to multiple units and you occupy one of those units) only, if you are requesting the termination of Dialup, DSL, Wireless, or any other type of account, please use the appropriate form here.

For your security, the information below is required. You may print and mail the form if you prefer. If the information below is not accurate, or does not match our records, your account will not be closed and we will assume the authorized account holder did not submit this request.
*denotes required field

*First Name:
*Last Name:
*Street Address
*City, State, Zip
*Phone:
*Username: @relia.net
*Password:
*Property Name:
(Apartment Complex)
*Email Address:
Please use a valid email address and not the one you are canceling, otherwise you will not receive the confirmation email. i.e. don't use your relia.net email address if that is what you are canceling.
*Effective Date that you would like account closed:

(requests after the 10th are non-refundable for that month, cannot be prior to today's date)
*Would you like the account closed: Permanently
Temporarily, until
**Did you return your equipment?
(router, phone adapter, power supply, etc.)
No equipment provided to me

No, I purchased it, Invoice date of
*The reason for canceling:

Moving
Service problems
Price
Switching Providers
Other ...please let us know below
 other:

We appreciate your feedback! Please let us know how we could have served you better and if there is anyway to keep you as a customer i.e. if we can match prices, etc. Feel free to include positive and/or negative comments so that we can improve our service. We are driven by customer feedback.

**If you have leased or rented equipment, you must return it within 10 days of the effective date indicated above, or be charged accordingly.