Please complete and submit this form when deactivation of Quadrate Data Workbench is not possible using online methods. The Quadrate licensing team will process this within one business day of receipt. If no response is received after one full business day, or other license related problems are encountered, please open a support ticket at https://support.quadrate.com (initial self-registration required).

I,  *, acting in full capacity as *  of *  (Customer), hereby declare that the software with the License Key: *  is no longer accessible by the Customer.

The foregoing license key is no longer accesssible by the customer because:*  State your Knowledge of the Facts

This Affidavit is to attest that the license key will no longer be used, and to request that the license key be deactivated by Quadrate licensing within one business day of receipt of this Affidavit.

Signed and sworn by