Specimen - revocation form
(If you wish to revoke the contract, please fill up this form and send it back to us.)
- To Klaus Lemmermeier, Dompfaffweg 3, 90455 Nürnberg, Fax number: 0911 880276, Email address: email@example.com :
- I/we (*) herewith revoke the contract concluded by me/ us (*) regarding the purchase of the following products (*)/ the provision of the following service (*)
- Ordered on (*)/ received on (*)
- Name of the consumer(s)
- Address of the consumer(s) - Signature of the consumer(s) (only in case of a notification on paper) - Date
(*) Cross out the incorrect option.