Service Cancellation Request

Dear Valued Customer - Per your request we are sending this cancellation request form. Please be aware that Alert requires that we receive this completed form at least 30-days prior to your requested termination date. If this form is received in our office less than 30-days from your termination date, you may be charged for 30-days of service from the receipt of the completed form.

Upon receipt of the completed cancellation form, there will be a complete review of your account. If the terms of your contract have not been fulfilled, you will be charged 80% of the balance of your contract. The exception to this would be if you are moving to a new home and you have signed a contract with Alert for service in your new home. The account review and cancellation will be completed within 5 business days of your termination date. You will be notified by email upon receipt of your completed cancellation form and again upon the completion of the cancellation process and if there is a balance due to Alert or refund due to you.

To begin the cancellation process, please follow the link below and complete our online cancellation form which contains fields for vital account information such as your verbal password.

For the fields you do not know or have an answer for, you can put "NA", and for the referral email, you can just put your email to allow the cancellation form to submit successfully.

Please confirm that you have read the message above by checking the box.

In order to complete your cancellation, we require that you fill out the following cancellation notice:

Name: (required)

Name of Business: (if applicable)

Email: (required)

Your full Street Address/City/State/ZIP that you plan to cancel: (required)

Phone Number: (required)

Cancellation Request Date: (today's date)

Termination of Service Date: (required)
Please note per contract we require 30 days advance notice on cancellation; so you may be billed for current or next month depending on timing of cancellation.

Alarm Password: (required)

Why are you leaving us? (required)
—Please choose an option—Moving to another property in IllinoisMoving out of stateI’m not using the alarmOut of businessSwitching to another alarm companyYour prices are too highHardship/cannot pay billCustomer is deceasedDissatisfied with serviceI’m a builder and have sold the property

If you are moving, where to?

Are you interested in having Alert Protective Services install an alarm or security system at your new home or business? (required)
—Please choose an option—YesNo

Is someone moving into your home or business? (required)
—Please choose an option—YesNo
If so, and if you make a referral, we can offer you a month of free monitoring at your new home or business. (please provide their contact information below)

Please rank your level of satisfaction with Alert Protective Services
on a scale of 1 – 10 (10 highest, 1 lowest) (required)
12345678910

Any other feedback for us? (required)

Thank you very much for your business – we are proud to have worked with you as our customer.

Regards,
The Alert Protective Services Team

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