Scribd
Upload
6K views1 page

Telkom Contract and Service Cancellation Form

This document is a consumer request form for contract and service cancellation with Telkom. It requests information such as customer details, services to be cancelled, reason for cancellation, device return details if applicable, and includes agreements to be signed. The customer provides their contact information, lists the services and numbers to cancel, selects a reason for cancellation from options provided, notes if any devices are being returned, and signs to agree to cancellation terms and conditions.

Uploaded by

SabzaMtimande
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
6K views1 page

Telkom Contract and Service Cancellation Form

This document is a consumer request form for contract and service cancellation with Telkom. It requests information such as customer details, services to be cancelled, reason for cancellation, device return details if applicable, and includes agreements to be signed. The customer provides their contact information, lists the services and numbers to cancel, selects a reason for cancellation from options provided, notes if any devices are being returned, and signs to agree to cancellation terms and conditions.

Uploaded by

SabzaMtimande
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 1

Consumer Request for Contract and Service Cancellation

Agent to complete:
Agent Name

Account No.

Order No.

Case No.

Complete form to be sent to


Fixed Services Email address: [email protected] Contact No. 10210

Mobile Services Email address: [email protected] Contact No. 081 180

Supporting documentation


Proof of account holders identification or duly authorised persons identification (Certified copy of SA ID or passport)
Copy of death certificate (if applicable)
Copy of receipt for CPA cancellations with a device return

1. Customer details
Title

Surname

First Names

ID No. / Passport No.


Final invoice via:

Alternative contact No.


Email

Post

Your Telkom Account No.

Email Address

Postal Address

Suburb

City

Postal Code

2. Cancellation details for services/products


Cancel all my services/products Yes

No

Request Date of Cancellation Y



Service Number to be cancelled (1)

Service/Product to be cancelled (1)

Service/Product to be cancelled (2)

Service Number to be cancelled (2)

Service/Product to be cancelled (3)

Service Number to be cancelled (3)

Y M M D D

3. Reason for service/product cancellation


Please select the key reason(s) for cancellation
Customer experience

Customer

Affordability

Call centre service

Call quality

Slow internet

No longer need service/product

Lost income

Store service

Cannot make or receive calls

Intermittent/No service

No coverage at new location

Insolvency

Billing issues

Dropped calls

Too expensive
Better value/ deal from
another provider



Other

Voice

Broadband

No network coverage

Immigration

Intermittent/No service

Poor network quality

Faulty/stolen device

No network coverage

Too many faults & downtime

Deceased

Written request:

4. CPA device return (Only if applicable & valid)


Device returned Yes

No

SIM card returned Yes

No

Device make & model


IMEI
MSIDSN

5-day Cooling-off Yes

No

(If No Consult with TM Retentions Desk)

Condition of device
ICC-ID
MSIDSN

MSIDSN

Other (returns)

5. Agreement
I, the undersigned, declare, agree and confirm that:
1. Cancellation is limited to the above mentioned number(s)
2. I hereby indemnify all parties that may act on the information provided and against any claims that may result from its use

3. I have read, understand and agree to be bound by the terms and conditions





4. In terms of Telkoms standard terms and conditions, a customer must give Telkom one calendar month notice to terminate a service
5. The one month notice period is calculated from the application date, which is the date on which Telkom receives the completed cancellation form
6. In the case of services rented in terms of a contractual agreement, the rental obligations are governed by the conditions of the relevant agreement and penalties, if applicable, will apply
7. Im duly authorised to sign on behalf of the account holder





8. The information provided on this form is true and correct
Full Name

Signature

Date Y

Y M M D D

Date Y

Y M M D D

6. For office use only


Dealer Name
Agent Name

Dealer Code
Signature

(Note: All valid device returns should be captured on the Vision System as CPA returns and must comply to the Vision check list)

You might also like