Model form for cancellation

 

(only fill in this form and return it when you want to cancel the contract)

 

- To: [name of entrepreneur]

[geographic address entrepreneur]

[facsimile number entrepreneur, if available]

[e-mail address or electronic address of entrepreneur]

 

- I / We * share / share * hereby inform you that I / we * are in agreement

the sale of the following products: [product designation] *

the delivery of the following digital content: [indication of digital content] *

the performance of the following service: [service designation] *,

revoke / revoke *

 

- Ordered on * / received on * [date of ordering with services or receipt of products]

 

- [Consumer name (s)]

 

- [Consumer address (s)]

 

- [Signature consumer (s)] (only when this form is submitted on paper)

 

 

* Delete what is not applicable or fill in what is applicable.