Cancel Membership or Subscription Notice
Date: ________________
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________________________
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[name and address of publication or organization; include name of department if available]

Re: _______________________ [subscription or membership number]
This letter is to notify you that I would like to cancel my ________________________ [specify what you are canceling, such as a subscription to publication or membership in organization] effective ____________. [date of cancellation]
The reason for this cancellation is _____________________________. [specify reason for cancellation]
Thank you for your prompt assistance.

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Signature

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Address

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Subscription or Account Number