If you want to revoke the contract, please fill out this form and send it back.
Zum Schienerberg 25a
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 consumer(s)
Address of consumer(s)
Signature of consumer(s) (only if notified on paper)
(*) Strike out where not applicable.