COMCAST
AFFIDAVIT FOR DECEASED CUSTOMER
(not required if death certificate is supplied)
I _______________________________, being duly sworn according to law, declare that I am the
Spouse Next of kin Executor or administrator of the estate (Check one)
of___________________________________ (“Decedent”) who died on or about the day of
(Date)
, 20__.
(Month) (Year)
Fill In One Option Below
[I request that Comcast disconnect Comcast account #_____________________for service at
_______________________ (Address) ________________ (City), ________________ (State)
_____________ (Zip Code). The final bill should be sent to _______________________ (Address)
________________ (City), ________________ (State) _____________ (Zip Code).]
OR
[I request that Comcast transfer Comcast account #__________________ for service at
_______________________________(Address) ________________(City), ________________
(State)_____________(Zip Code) to my name.
If applicable, I certify that I am authorized to view or hear any messages left in the Decedent’s Xfinity
Digital Voice voicemail box, receive call detail records or view emails left in the Decedent’s Xfinity Internet
email account.
I am accepting assignment and assumption of all Comcast equipment and/or any Xfinity minimum term
agreements on the Xfinity account which may be up to 24 months in length and include early termination
fees up to $460, including agreements for Xfinity Home and Xfinity Mobile devices and services.
I agree to be bound by the Comcast Agreement for Residential Services
(https://www.xfinity.com/Corporate/Customers/Policies/SubscriberAgreement) and by the Xfinity Mobile
Customer Agreement (https://www.xfinity.com/mobile/policies/customer-agreement) and Xfinity Home
Agreement, if Xfinity Home services are active (https://www.xfinity.com/secureagreement).
I am aware of account elections made by the account holder including, but not limited to, paperless billing,
notifications and marketing elections. It is my responsibility upon transfer of the account to change
passwords as necessary to prevent unauthorized access to the account or equipment used for the
services, such as wireless routers.
I have reviewed the Comcast Customer Privacy Notice
(https://www.xfinity.com/Corporate/Customers/Policies/CustomerPrivacy)
If I have Xfinity Voice. I understand and acknowledge that in order for 911 calls to be properly directed to
emergency services, Comcast must have my correct service address. If I move my Xfinity Voice
equipment to a different address without Comcast’s approval, 911 calls may be directed to the incorrect
emergency authority with the incorrect address, and my phone service, including 911, may fail. If there is
an electrical power outage in my home, calling, including calls to 911, may be unavailable. Calls to 911
may not be completed if there is a technical or other problem with Comcast’s network or other network
facilities or databases used to complete 911 calls.
I agree to RELEASE, INDEMNIFY, AND HOLD HARMLESS Comcast, its subsidiaries, affiliates, their
respective parents, officers, employees, agents, successors and assigns from and against any claims,
demands, actions, liens, rights, subrogated or contribution interests, debts, liabilities, judgments, costs,
and attorney’s fees, arising out of the this change of account status.
The foregoing is the truth to the best of my knowledge, information and belief.
Dated at , this day of , 20 .
(City) (State) (Date) (Month) (Year)
Signature
Print Name
_______________________
Address Telephone
_______________________
Current Account Holder Name Account Number
---------------------------------------------------------------------------------------------------------------------------------------------
Sworn and subscribed before me, on _____________________.
(Date)
Notary Public
My commission expires on .
(Date)
(Please print and sign)
(Please print and sign)
