(If You want to revoke the contract, please fill out this form and send it back.) – An:
Kiefernweg 19, 90513 Zirndorf
• hereby give notice(n) I, we (*) the by me / us (*) concluded contract the purchase of the following products, (*)/ provision of the following service (*)
• Ordered on (*)/received at (*)
• of / Name of consumer(s)
• Address of / consumer(s)
• of / consumer Signature(s) (only message on paper)
(*) delete as applicable.