Follow the steps to successfully complete the Clipper Card Cancellation Form online.

1. Press the 'Get Form' button to obtain the Clipper Card Cancellation Form and open it in the editor for completion.
2. Enter the 10-digit serial number, including zeros, found on the back of your Clipper card in the designated field.
3. Provide your cardholder contact information. Ensure this information aligns with your registered card details. Fill in your first name, middle initial, last name, billing address, and, if different, your mailing address. Additionally, include your day phone, evening phone, and email address.
4. Indicate your reason for cancellation by checking all applicable options to help process your request efficiently.
5. Complete the payment details section by selecting your credit card type, entering the credit card number, and expiration date, noting that a $5 processing fee applies, which will be charged to your credit card. Ensure the billing address matches your provided details.
6. Sign and date the form to indicate your agreement with the terms and conditions outlined. This authorizes the processing of the payment for the cancellation.
7. Finally, mail the completed form along with your Clipper card to the designated Clipper Customer Service address provided. For any inquiries, contact Clipper Customer Service.

Act now to complete your Clipper Card Cancellation Form online and ensure a smooth cancellation process.