Notice of vacation/seasonal disconnect must be submitted yearly in writing. Vacation/seasonal disconnect is six months maximum. Reconnect date is required. If reconnect falls on a weekend or holiday, service will be reconnected the prior business day.

First Name *

Last Name *

Service Address *

City *

State *

Zip *

Billing Street Address

City

State

Zip

Email *

Phone *

Account Number

(Please only put your account number in this field. Comments go below in the comments field.)

Comments?

Please check the service(s) you would like to disconnect

Telephone - $4.75/month plus taxes *

Disconnect

No Disconnection Needed

Telephone disconnect date requested:
Please choose the YEAR and MONTH you want service disconnected and reconnected. *

Telephone reconnect date requested: *

Cable TV - $15.00 to reactivate *

Disconnect

No Disconnection Needed

Cable TV disconnect date requested:
Please choose the YEAR and MONTH you want service disconnected and reconnected. *

Cable TV reconnect date requested: *

Internet - $15.00 to reactivate *

Disconnect

No Disconnection Needed

Internet disconnect date requested:
Please choose the YEAR and MONTH you want service disconnected and reconnected. *

Internet reconnect date requested: *

Winter Rate Internet: Internet speed 1mg down & 5mg up. Maximum 5 consecutive months from September -March $34.95/month

Yes, I will take Winter Rate Internet

No, I do not want Winter Rate Internet

Winter Rate Start Date

Winter Rate End Date

Keep crosslake.net E-mail active ($5.95/month per E-mail address)

Yes

N/A

Please read and sign below:
Phone Service:
Must be reconnected within six (6) months to keep phone number and account active.
Crosslake Long Distance and Onvoy customers will be charged an additional $3.95 per month.
Rates subject to change based on FCC Subscriber Line Charge.
During your disconnected months, you will be able to dial 911 or 611 (Crosslake Communications).

Cable Service:
Six (6) months maximum or modem/router and other equipment must be returned.

High Speed Internet Service:
Six (6) months maximum or modem/router and other equipment must be returned.

Terms of Acceptance and Signature

Please type your First and Last Name *

Date

I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance

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Crosslake Seasonal Disconnect

CrossLake Seasonal Disconnect

Terms of Acceptance and Signature