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