Voucher Cancellation – Gigabit Vouchers

Statement

This form should be used to cancel a requested voucher. Please ensure that you have checked the information carefully and provided accurate information.

Declaration*

I confirm that I am authorised to act on behalf of my company.

Vouchers to cancel*

You can request the cancellation of up to 10 vouchers using this form. You should include the voucher number, beneficiary name and reson code from the list below.

Voucher Number	Beneficiary Name	Reason for cancellation

Your name*

By clicking submit you confirm that the information contained this change request form and any other information given in support of the request is correct to the best of my knowledge. You understand that deliberately providing false or inaccurate information may result in your removal from the Scheme.

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User data

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Date of cancellation request

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Submission IP

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User Agent

Phone

This field is for validation purposes and should be left unchanged.