Home Services Modification/Cancel Form
Existing Marketing Materials Information
Company Name (please input EXACT Company Name)
Website
Phone Number
Street
City
State
Zip Code
Order ID Number (Same as the number submitted with the original Order
Campaign Information
Please Select
Modify Existing Campaign
Cancel Existing Campaign
Please fill the date in MM/DD/YYYY format
Are you increasing or decreasing the Sales Record Count?
Increasing
Decreasing
Effective Date for Mod/Cancellation
Please fill the date in MM/DD/YYYY format
Select new TOTAL number of Sales Records
Please select...
Sales Data Records 5k
Sales Data Records 7,500k
Sales Data Records 10k
Sales Data Records 15k
Sales Data Records 20k
Sales Data Records 22.5k
Sales Data Records 25k
Sales Data Records 30k
Sales Data Records 35k
Sales Data Records 40k
Sales Data Records 45k
Sales Data Records 50k
Sales Data Records 55k + (input the number of records in the appropriate field)
Please enter the number of
Sales Data Records
needed if over 55k
Will these records be used in a Direct Mail campaign?
Yes
No
Is this a One Time or Ongoing Email Deployment?
One Time
Ongoing
LocaliQ Info
First & Last Name
Email
Phone Number
Account Executive
Sales Manager
Client Success Manager
LocaliQ Internal Information
Adpoint ID Number
If you have additional Contacts, please email
LocaliQCCChanges@clientcommand.com
with the same fields listed above
If you receive an error message from a field that requires an email address, please make sure to remove any spaces before or after the email address.
Contact Information