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ALL fields are Required. Each required field must be filled out in order for your request to be processed.
In order to process your request, we will need to verify your identification. You will find the information in the account information email that you received from us when your account was originally setup.
Client Code / Account Name
Please Choose
Cancel only Cart32 Account
Cancel only Website Account
Cancel Entire Account
Domain Name
First Name
Last Name
Billing Address
City
State
Zip Code
Phone Number
Email Addres
Last 4 digits of credit card number
Reason For Cancellation
Signature
X_______________________________________________
Date
___________
Print out and scan the form with your signature, scan and email to support@cart32.com.
We MUST have the signed copy to ensure proper cancellation and credits if any.
You can also mail this form to the following address:
McMurtrey/Whitaker & Associates, Inc.
405 N Jefferson, Ste. 1015
Springfield, MO 65806
Attn: Billing Department