Cancellation Authorization form

The completion of this form is being requested to safeguard the legal rights of all 212website.com Partners and Customers, in addition to other businesses utilizing the Internet. 212website.com is committed to doing everything possible to meet and safeguard the individual requirements of your website and your Internet promotions campaign. Your assistance in this effort is appreciated.

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This information is to be used on my new web provided by iGenii.com.

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Reason for Cancellation: