Disconnect Information
PRIOR TO SUBMISSION, PLEASE NOTE:
ONLY USE THIS SERVICE NAME SUBMISSION FORM FOR LOCAL SERVICE - ENTERPRISE (LNS ONLY) IF YOUR ACCOUNT NUMBER FORMAT IS SIMILAR TO THIS: ABCD-ABCD01 (ALPHA NUMERIC, 4 DIGITS SEPARATED BY A DASH, THEN 5 DIGITS). OR IF IT BILLS ON AN ABN ACCOUNT IDENTIFIED AS LOCAL LNS SERVICE.
IF YOUR SERVICE IS CONSIDERED LOCAL PHONE SERVICE AND THE ACCOUNT NUMBER IS IN THE FORMAT OF A BILLING TELEPHONE NUMBER (I.E. 214-111-1111, 214-111-1111-111, 214-M11-1111, ETC) OR IS A UVERSE DSL ACCOUNT WITH A 9 DIGIT NUMERIC ACCOUNT NUMBER, THEN YOU SHOULD UTILIZE THIS SUBMISSION WEBSITE TO PROCESS YOUR REQUEST. THEN SELECT "To Place a Business Local Access Service or DSL Order click here"
IF YOUR ACCOUNT NUMBER FORMAT BEGINS WITH 020 OR 030, CALL THE NUMBER ON YOUR BILL FOR ASSISTANCE.
FOR ALL OTHER ACCOUNT NUMBERS, CONTACT YOUR ACCOUNT TEAM FOR DISCONNECT SUBMISSION ASSISTANCE USING THE PROPER FORM AND PROCESS TO AVOID POTENTIAL REJECTION OF YOUR REQUEST.
*Bundle:
BVOIP must be removed before submitting a VVB-E service disconnect. Please contact your Sales Team for assistance.
For Internet Security Services - Internet Protect, Premises-Based Firewall, Intrusion Detection or Network Gateway, etc.
Use to disconnect all components (PNC, SOHO Device, and DSL).
ANIRA is a bundle billed service combining DSL, ATT VPN Gateway, and Private Network Connection (PNC).
Please contact your account team to request a disconnect for non-U.S. sites and sites with AT&T managed router/CSU.
Note: Please complete a form for each separate physical location.
Former IBM Service Only, not applicable for MIS - Managed Internet Service.
*Wholesale Customer:
Yes No
If you are a Wholesale customer then set the Wholesale indicator to “Yes”.
*Sub Service:
Remote access and all related components will be disconnected including AT&T Virtual Tunneling Services or ATT VPN Gateway.
*Sub Service:
*Specific Service:
*SNG Service:
Your date has been adjusted to the next available day.
IMPORTANT!!! Please select the option that best fits your disconnect scenario. If you select Migration or one of the Move/Add/Change options, be sure to provide the New Service Circuit Id #, New Order # and New Account #. This information will help determine if the following apply:
- Early Termination Fees
- Move Fees
IMPORTANT!!! You selected "Migration…" or "Move/Add/Change..." as the Disconnect Reason. Please be sure your new AT&T service is turned up and fully operational before submitting this Disconnect Request Form. Otherwise, you risk an outage at your service location.
ALSO, be sure to provide the New Service Circuit Id #, New Order # and New Account #. This information will help determine if the following apply:
- Early Termination Fees
- Move Fees
New Service Circuit #:
New Order #:
Please enter information in one or more of the above fields:
- New Service Circuit Number
- New Order Number
*New Contract Id:
Select all AVTS Services to be disconnected:
AVTS High End Site to Site
AVTS ATT VPN Gateway (with or without DSL)
Other:
Disconnected Service Detail
Please enter a Router Id and/or the Circuit Type and Number.
*Circuit Street Number:
*Circuit Street Name:
Circuit Street Number 2:
Circuit Street 2:
*Circuit City/Town:
*Circuit State:
*Circuit ZIP Code:
*Circuit Street Number:
*Circuit Street Name:
Circuit Street Number 2:
Circuit Street 2:
*Circuit City/Town:
*Circuit State:
*Circuit ZIP Code:
*Circuit Street Number:
*Circuit Street Name:
Circuit Street Number 2:
Circuit Street 2:
*Circuit City/Town:
*Circuit State:
*Circuit ZIP Code:
*Circuit Street Number:
*Circuit Street Name:
Circuit Street Number 2:
Circuit Street 2:
*Circuit City/Town:
*Circuit State:
*Circuit ZIP Code:
*Circuit Street Number:
*Circuit Street Name:
Circuit Street Number 2:
Circuit Street 2:
*Circuit City/Town:
*Circuit State:
*Circuit ZIP Code:
*Circuit Street Number:
*Circuit Street Name:
Circuit Street Number 2:
Circuit Street 2:
*Circuit City/Town:
*Circuit State:
*Circuit ZIP Code:
*Circuit Street Number:
*Circuit Street Name:
Circuit Street Number 2:
Circuit Street 2:
*Circuit City/Town:
*Circuit State:
*Circuit ZIP Code:
*Circuit Street Number:
*Circuit Street Name:
Circuit Street Number 2:
Circuit Street 2:
*Circuit City/Town:
*Circuit State:
*Circuit ZIP Code:
*Circuit Street Number:
*Circuit Street Name:
Circuit Street Number 2:
Circuit Street 2:
*Circuit City/Town:
*Circuit State:
*Circuit ZIP Code:
*Circuit Street Number:
*Circuit Street Name:
Circuit Street Number 2:
Circuit Street 2:
*Circuit City/Town:
*Circuit State:
*Circuit ZIP Code:
*Circuit Street Number:
*Circuit Street Name:
Circuit Street Number 2:
Circuit Street 2:
*Circuit City/Town:
*Circuit State:
*Circuit ZIP Code:
*Circuit Street Number:
*Circuit Street Name:
Circuit Street Number 2:
Circuit Street 2:
*Circuit City/Town:
*Circuit State:
*Circuit ZIP Code:
*Circuit Street Number:
*Circuit Street Name:
Circuit Street Number 2:
Circuit Street 2:
*Circuit City/Town:
*Circuit State:
*Circuit ZIP Code:
*Circuit Street Number:
*Circuit Street Name:
Circuit Street Number 2:
Circuit Street 2:
*Circuit City/Town:
*Circuit State:
*Circuit ZIP Code:
*Circuit Street Number:
*Circuit Street Name:
Circuit Street Number 2:
Circuit Street 2:
*Circuit City/Town:
*Circuit State:
*Circuit ZIP Code:
*Circuit Street Number:
*Circuit Street Name:
Circuit Street Number 2:
Circuit Street 2:
*Circuit City/Town:
*Circuit State:
*Circuit ZIP Code:
*Circuit Street Number:
*Circuit Street Name:
Circuit Street Number 2:
Circuit Street 2:
*Circuit City/Town:
*Circuit State:
*Circuit ZIP Code:
*Circuit Street Number:
*Circuit Street Name:
Circuit Street Number 2:
Circuit Street 2:
*Circuit City/Town:
*Circuit State:
*Circuit ZIP Code:
If you have the International Circuit number, please include below in the order description field.
Only Lead Circuit ID is required for IMA and MLPPP.
Only circuits at same location should be included on this request.
If you have additional circuit(s) for the same service selection, check the box below, complete this form, and select "Submit". Your current request will be processed, entered business information will be retained, and you will have the opportunity to enter additional circuit information.
I have additional circuits.
Please include your MAC Address in the Order Description field above if you are disconnecting ATT VPN Gateway/SOHO.
Company Information
*Company Name:
Service Location Information
*Address 1:
Address 2:
*City/Town:
*Country:
*State:
*ZIP Code:
Service Location Information
Location Type 1:
Location Type 2:
Location Type 3:
*Circuit Street Number:
*Circuit Street Name:
Circuit Street Number 2:
Circuit Street 2:
*Circuit City/Town:
*Circuit State:
*Circuit ZIP Code:
