Return form

Example cancellation form
(If you want to cancel the contract, please fill out this form and send it back.)

• To: [to be inserted by the entrepreneur here is the name, address and, if applicable, the fax number and email address of the entrepreneur]
• I/we* hereby revoke the contract concluded by me/us* for the purchase of the        following goods or the provision of the following service.
• Ordered on * / received on * [date] Name of the consumer(s):
• Address of the consumer(s):
• [Signature of the consumer(s)] (only for paper notification)
• [Date]

*Delete what does not apply