Customer Request Form
Contact Type
Account Holder
Authorised Contact
Unknown Contact
First Name
Last Name
Maxo Account Number
Must be exactly 8 digits
Email Address
Mobile Phone (AU)
Must start with 04 and be 10 digits
Keep VoIP Numbers?
Yes
No
Additional Notes
I give consent to close the Maxo account
Please type
"I AGREE"
to confirm:
Submit