KNIGHTWATCH SECURITY SYSTEMS    LOW VOLTAGE DATA CABLING

 

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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)