Model Withdrawal Form

APPENDIX 1: MODEL WITHDRAWAL FORM

(If you wish to withdraw from the contract, please complete this form and return it.)

To:
Kleberli Namensaufkleber GmbH
Greifswalder Straße 226
10405 Berlin
Germany
Email: [email protected]

I/We (*) hereby give notice that I/we (*) withdraw from my/our (*) contract for the purchase of the following goods (*):

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Ordered on (*) / received on (*):

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Name of consumer(s):

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Address of consumer(s):

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Signature of consumer(s) (only if this form is submitted on paper):

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Date:

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(*) Delete as appropriate.