Model cancellation form

Template for consumers

Where your contract is subject to a right of cancellation, this form may be used to declare the cancellation.

Form

To: —, —, email apruss78@googlemail.com

I/We hereby cancel the contract concluded by me/us for the purchase of the following goods / provision of the following service: ______________________________

Ordered on / received on: ______________________________

Name of consumer(s): ______________________________

Address: ______________________________

Date: ______________________________

Signature (only if submitted on paper): ______________________________