If you wish to cancel this contract, please complete and submit this form.
The form can also be found here as a download. To open the offered PDF file, you need the additional program Adobe Acrobat Reader, which you can download free of charge from the Internet.
Obernburger Strasse 125
63811 Stockstadt am Main
Fax: +49 / (0) 6027 / 3772
I/We (*) hereby give notice that I/We (*) cancel my/our (*) contract of sale of the following goods (*) /for the supply of the following service (*),
Ordered on (*) ____________ / received on (*) __________________
Name of consumer(s)
Address of consumer(s)
Signature of consumer(s) (only if this form is notified on paper)
(*) Delete as appropriate