MINET - Monmouth Independence Networks

* Requests of less than 30 days notice will result in a $50.00 cancellation fee charged to your account.

* If receiver(s) is/are not returned on your disconnection date you will be charged $725.00 per receiver

* If remote(s) is/are not returned on your disconnection date you will be charged $12.00 per remote

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Name / Nombre :
Service Address / Dirección de Servicio :
Forwarding Address / Reenvío de direcciones:
Contact Number / Número Telefónico de Contacto :
Date of Disconnection / Fecha de Desconexión :
SSN Last 4 / Ultimos 4 números de SSN/TIN :
Reason for Disconnect / Razón por Desconexión :