Account Cancellation Form

(For Web-host.com customers only)

Your E-mail Address (required)

Domain Name (required)

Primary User ID (required)

Password (required)

Last 4 digits of credit card used (required)

Reason for canceling account (required)

Special Instructions (If any)

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NOTE: Your site will be deleted within 1-5 business days upon receipt of this request.  If you wish to receive a formal confirmation of this request, please note this in the special instructions.  Special confirmations via mail or formal receipt is an additional $10.   Otherwise the moment you hit submit, consider your account canceled.