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1. Sender Details: Full name, address, and contact information of the person/entity canceling the service
2. Recipient Details: Full name and address of the service provider, including any specific department or contact person
3. Date: Current date formatted according to Belgian standards
4. Contract Reference: Specific identification of the service contract being cancelled (contract number, customer ID, account number)
5. Clear Statement of Cancellation: Explicit declaration of intent to cancel the service contract
6. Service Identification: Clear description of the service(s) being cancelled
7. Requested End Date: Specific date when the service should be terminated, taking into account contractual notice periods
8. Signature Block: Space for signature, printed name, and date of signing
1. Reason for Cancellation: Include when required by contract terms or when strengthening the cancellation request
2. Payment Status Declaration: Include when there are outstanding payments or when confirming all payments are up to date
3. Equipment Return Details: Include when the service involves equipment that needs to be returned
4. Special Instructions: Include when there are specific requirements for service disconnection or account closure
5. Request for Confirmation: Include when written confirmation of the cancellation is desired
6. Legal Reference: Include when invoking specific legal rights or consumer protection provisions
1. Proof of Contract: Copy of original service contract or recent bill (as attachment)
2. Authorization Document: If the cancellation is being made by a representative, proof of authority to act
3. Service History: Summary of service history and payment record, if relevant to the cancellation
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