Revocation form

If you wish to cancel the contract, please complete and return this form.

 

To

Adrian Kittner

Luther Stra├če 61

09126 Chemnitz

 

I/we (*) hereby cancel the contract concluded by me/us (*) for the purchase of the following goods (*)/ the provision of the following service (*):

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Ordered on (*)/received on (*)

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Name of the consumer(s)

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Address of the consumer(s)
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Signature of the consumer(s) (only if communicated on paper), place, date

 

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(*)Delete as applicable