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 ANTHONY ROBBINS

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file time: 2008-03-13

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> ACCOUNT TERMINATION   DOMAIN NAME Domain Name     CUSTOMER DETAILS Name   Company   Company Reg. No   Home/Company Address     State   Postal Code   Country   Mobile Phone   Home Phone (    ) Office Phone (      ) Facsimile (   ) Email   Current Username   Termination Effective Date   * Account will be terminated on the 00ermination Effective date00and all files removed from the server.          CUSTOMER ACKNOWLEDGEMENT  I understand that any errors and/or omissions in this form may cause delays in processing or even rejection. By completing and submitting this Customer Account Termination Request Form, I / my organisation # agree to accept and be bounded by all Venture Domain Hosting Policies, which will be imposed immediately upon refund approval. I / My organisation # understand that these Terms and Conditions may be subjected to changes by Venture Domain Hosting and will be notified in a manner as Venture Domain Hosting deems appropriate. I / my organisation # confirm that the information given herein is true and correct. I understand that it will take 7 working days to process this request provided that all information here is complete and in order. I hereby give Venture Domain Hosting 30 days in advance for my termination of my service(s) and understand that SGD$10 administrative fee plus any postage & bank charges is payable to Venture Domain Hosting for any refunds made out. I understand there will no be refund after the 30 Days Money Back Guarantee period.       Authorized Signature and Full NameOrganisation Stamp Date        

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For Official Use Only

Received Date : ________________          Account Termination date : ______________

Please fax completed form to (65) 6836 0278 or mail to us   Venture Domain Hosting

(Reg. No : 52975836M)

32 Maxwell Road #03-07 Whitehouse

Singapore 069115

Tel : 61008347 Fax : 68360278

URL : http://www.vdomainhost.com.sg

CUSTOMER ACCOUNT TERMINATION REQUEST FORM   

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