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Customer Care Forms
Cancellation Request
Cancellation Request
Requester Full Name
(Required)
Today's Date
FBL Customer Company Name
(Required)
Enter your company name (the Fiberlight Customer's Company requesting a cancellation, not your end user company).
FBL Customer Phone
(Required)
Enter the Fiberlight Customer's Phone Number
Customer POC
(Required)
Email Address
(Required)
Enter the email address that will receive confirmation of this Cancellation request with a ticket number to reference.
Service Type
--- Select Service Type ---
Lit
Dark
Circuit ID
(Required)
Enter Lit or Dark Circuit ID Info
Order Number
(Required)
Enter the Order Number from the executed Contract
Contract Number
(Required)
Enter the contract number. If unknown, enter Unknown
Service Delivery Project Manager’s Name
(Required)
Enter the full name of the SDPM working the order to be cancelled
Account Rep’s Name
(Required)
Monthly Service Charge
(Required)
Non-Recurring Charges
(Required)
Additional Comments, Instructions or Contact Information
Description limited to 350 characters
Upload Your KMZ File (ZIP required)
Accepted file types: zip, Max. file size: 10 MB.
.ZIP REQUIRED (please compress KMZ file in .ZIP format before uploading)
Upload Additional Documents
Accepted file types: jpg, gif, png, pdf, doc, docx, xls, xlsx, Max. file size: 10 MB.
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First Name
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Last Name
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Email
(Required)
Market Location
(Required)
Please Make a Selection
Ashburn, VA
Atlanta, GA
Austin, TX
Baltimore, MD
Beaumont, TX
Boca Raton/West Palm Beach, FL
College Station, TX
Corpus Christie, TX
Culpeper, VA
Dallas/Ft, Worth, TX
Ft. Lauderdale, FL
Herndon, VA
Houston, TX
Laredo, TX
McAllen, TX
Miami, FL
San Antonio, TX
South Florida St. Petersburg, FL
Tampa, FL
Temple, TX
Waco, TX
Washington, DC
Out of Market
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