[Your Name]

[Street Address]

[City, ST ZIP Code]

[Date]

[Recipient Name]

[Title]

[Company Name]

[Street Address]

[City, ST ZIP Code]

Dear [Recipient Name]:

Please discontinue [type of service] service at [Street Address], [City, ST ZIP Code] effective [click to select date]. The account number for this service is [number]. If you have any questions, please call me at [phone number].

Sincerely,

[Your Name]