Revocation form

If you wish to revoke the contract, please print out this form and send it by fax to: +49 3212 1465182

I / we hereby revoke


From me / us


Concluded agreement to purchase the following


Ordered on


received at


Name of consumer (s)

Address of the consumer (s)

Signature of the consumer (s) (only in the case of a communication on paper)


(*) Delete as appropriate.