Pattern withdrawal form

pattern withdrawal form

 

If you want to cancel the contract, please fill out this form and send it back to us 

An


Company:

Address:

E-Mail:

Fax:   

 

I/we (*) hereby cancel the contract concluded by me/us (*) for the purchase of the following goods (*):

 

Ordered on (*)/received on (*)

 

Name of the consumer(s):

 

Address of the consumer(s):

 

   

Signature of the consumer(s) (only for paper communication)

 

Date

   

(*) Delete as applicable.

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