Specimen - revocation form
(If you wish to revoke the contract, please fill up this form and send it back to us.)
- To Klaus Kolodziej, Netterdensche Str. 127, 46446 Emmerich, Email address: info@kk-versandhandel.de :
- I/we (*) herewith revoke the contract concluded by me/ us (*) regarding the purchase of the following products (*)/
the provision of the following service (*)
- Ordered on (*)/ received on (*)
- Name of the consumer(s)
- Address of the consumer(s)
- Signature of the consumer(s) (only in case of a notification on paper)
- Date
(*) Cross out the incorrect option.
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