KNIGHTWATCH SECURITY SYSTEMS LOW VOLTAGE DATA CABLING
Office Use Only
DFEA____DATE__________BY:_____
DFB_____DATE__________BY:_____
REM RJ
OS CUST DATE______BY:___
ACCT#__________LST SIG________
KNIGHTWATCH SECURITY SYSTEMS
1216 PEQUENO LN
ST. LOUIS MO 63026
CANCELLATION REQUEST
In order for a monitoring service cancellation request to be processed, Knightwatch
Security Systems must
receive a signed, dated, written request with name and address
of the property along with a valid account
codeword. Request must be mailed (certified
with proof of mailing for your record) to Knightwatch Security Systems
1216 Pequeno,
St. Louis MO 63026
Name___________________ Address_________________________ Phone#_________
Property Insurance Agency________________ Agent_____________ Phone#_________
If moving, date phone is scheduled for disconnection ____________________________
Reason for Cancellation ____________________________________________________
________________________________________________________________________
Date Phone is Scheduled for Disconnection if applicable __________________________
I understand by signing this request form I am canceling my security system monitoring
with Knightwatch
Security Systems and I authorize Knightwatch to make programming
changes to disable my security system
from contacting my local Police, Fire, Medical
Authorities, Contact List etc. anytime after receiving this form.
I also understand
that I am required to give notice and complete any required payments in accordance
with
my Monitoring Agreement with Knightwatch Security Systems. Residential or Business
insurance rates may
increase due the termination of this monitoring service and customer
must notify insurance agency of this
change.
SIGNATURE__________________________ DATE_______________
CODEWORD__________________
(USED
TO CANCEL WITH MONITORING STATION)