Cancellation form

If you would like to cancel your contract, please fill out this form and click on Send cancellation.

Cancellation

* (indicates the required input field)

Your Email-Address*

Your cancellation

I/We hereby revoke the contract signed by me/us for the purchase of the following product/for the provision of the following service *:

Ordered on:

Received on:

Consumer name:

Consumer address:

Date:

Your message

Security check (Required field) (please enter the text)

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