SurePay Cancellation Form

The Online Cancellation Form must be received by Hawaiiana on or before the 15th of a month to terminate SurePay service for the following month.

Owner Details

First Name

Last Name

Property Name

Unit Number

Hawaiiana Account Number

Need help locating your account number?

Phone Number

Email Address

Type your name in the *Signature Block*. By typing in your name, you are signing this form electronically and you agree your electronic signature is the legal equivalent of your manual signature on this form and that you are authorizing the changes you have made on this form.