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Greenlite Cashless Transfer Owner Signup

This document is a form for Greenlite Cancellation or Transfer of Service. It collects information about a customer requesting to cancel their Greenlite service and transfer the devices to a new owner, including both parties' contact and company information, the device serial numbers, requested transfer date, and confirmation that the new owner has received the proper paperwork. The customer must pay a $30 transfer fee and the last month of service fees, and Greenlite will invoice and be in touch upon receiving the completed form.

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azzclown4u
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71 views4 pages

Greenlite Cashless Transfer Owner Signup

This document is a form for Greenlite Cancellation or Transfer of Service. It collects information about a customer requesting to cancel their Greenlite service and transfer the devices to a new owner, including both parties' contact and company information, the device serial numbers, requested transfer date, and confirmation that the new owner has received the proper paperwork. The customer must pay a $30 transfer fee and the last month of service fees, and Greenlite will invoice and be in touch upon receiving the completed form.

Uploaded by

azzclown4u
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
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Greenlite Cancellation or Transfer of Service

Need to reach us? email us at: [email protected]

1. My Business Info
Company Names (As is appears on your Greenlite Log In) *

Little Bear Food Service LLC dba Alpine Vending

Address *

125 Eid Lane

Address Line 1

Address Line 2

Kalispell
City

Montana

State Powered by Formstack Create your own form ›


59904
ZIP Code

Name *

Steve
First Name

Rains
Last Name

Phone *

(406) 260-2921

Email *

Service Change
List Device Serial Numbers currently in your account that you with to transfer or
cancel.

Cancel or Transfer? *

I wish to cancel service and transfer to another company

I wish to cancel service

If you are canceling service and transferring to another company. Please enter the
name of the company you are transferring to

Fat Dog Foods LLC dba Alpine Vending

Name of new owner *

Sarah & James


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First Name
Clark
Last Name

Address of company you are transferring to: *

p.o. box 9814

Address Line 1

Address Line 2

Kalispell
City

Montana

State

59904
ZIP Code

Email address of new Owner *

[email protected]

Date you with to have devices transferred *


Feb 06 2020

Is new owner a current Greenlite Customer? - Copy *

Yes

No

Has the new owner been sent the proper Greenlite Paperwork? *

Yes

No

Transfer Service

There will be a $30 transfer fee invoiced to you. Also, you will need to pay the last month service fee.
We will be in touch with you upon receiving this form. Please note that if you are boarded directly with
Heartland (if you signed up prior toPowered
July 2017 you may boarded
by Formstack Create yourdirectly
own formwith
› Heartland), you will need
to arrange closing your account with them (MID cancel) or you may be billed for additiona service
fees. 

Transfer Service Agreement *

I have read the above agree

ADDITIONAL QUESTIONS OR NOTES ?


Additional Notes... Is there anything else you would like to tell us or attach here?

Complete Sign-up

Form secured by Formstack

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