Please use this form to give your 30 days' notice of your intention to move to a new services provider. First name* Last name* Street* Town County Telephone number, including dial code [e.g. 01 for Dublin etc.]* Universal Account Number [UAN, you will find this on your eircom bill]* Service to be terminated [if you have more than 1 service and do not specify which service is to be switched we will take your instruction to mean that all services are to be switched]