Cancellation of Billing Request Form

Cancellation of your Netscape Internet Service Membership

Important Note: To ensure proper processing of your request, please complete all numbered fields. By completing and returning this form you will no longer be billed by Netscape Communications Corporation for your Internet access service. You can continue to enjoy your paid service for the remainder of your current bill cycle. To find out more about how to cancel your Netscape Internet Service membership, sign in to your account and access “My Account” or go to this Internet URL: http:// c h a n ne l s . i s p. n et sc a p e. c o m / m e m be r c ente r /p u b lic / t m p l . js p? i d = m c _ c an c e l p a ge

1. Billing Contact’s Name:

2. Billing Address:

3. Evening Telephone Number:

4. Netscape Internet Service Email Address:

5. For your account security please provide one of the following: a) The LAST four digits of the payment method on file b) The answer to the account security question of the master screen name

6. Signature: Date: (enter full name)

Please return your completed form to one of the following:

a) USPS Mail: Netscape Internet Service, Dept. 5100, PO Box 65101, Sterling, VA 20165-8801 b) Fax: 1-703-466-9583 c) Send this document (filled out) via email to: Can c e l A ss i s t @ net sc a pe. c om Important Note: To ensure proper processing of your request, please complete all numbered fields.