Streaming Service Account Holder Death Notification
Please complete this form to notify us about the passing of a streaming service account holder. Your information will help us process your request efficiently.
Full Name of Deceased Account Holder
*
First Name
Last Name
Email Address Associated with the Account
*
example@example.com
Streaming Service Name
*
Please Select
Netflix
Hulu
Amazon Prime Video
Disney+
HBO Max
Apple TV+
Other
Account Username (if known)
The Last 4 Digits of the Payment Card (if available)
Date of Death
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Your Full Name (Person Notifying)
*
First Name
Last Name
Your Relationship to the Deceased
*
Family member
Executor of estate
Legal representative
Friend
Other
Your Email Address
*
example@example.com
Your Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Action for the Account
*
Close the account
Transfer ownership (if eligible)
Other (please specify below)
Upload Supporting Documentation (e.g., death certificate, proof of relationship)
*
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Additional Information or Comments
Signature
*
Submit Notification
Submit Notification
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