Standard withdrawal form
This is a translation of the original German document and for convenience purposes only.
Model withdrawal form
(If you want to cancel the contract, please fill in this form and send it back.)
Frau Faiza Lemoine
Tel: +49 (0) 7367 92494 10
Fax: +49 (0) 7367 92494 12
I / we (*) hereby revoke the contract concluded by me / us (*) for the purchase of the following goods (*) / the provision of the following service (*)
Ordered on ___________________ (*) / received on _______________________ (*)
Name of the consumer (s) ______________________________________
Address of the consumer (s)
Date Signature of the consumer(s) (only when notified on paper)
(*) Please cross off what is not applicable.
You agree that the translation is provided for convenience only and that the German language version will govern your use of the Site and your purchase of products.