Sample Revocation Form
(If you intend to revoke the contract, then please fill out this form and send it back to us. You can also combine your withdrawal in your own words – what matters is that all the necessary information are included )
- Jeff Brenner blob.cards, Schweidnitzer Str. 27, 51069 Köln
- Hereby revoke(s) I/ we () from my/ our () contract of sale of the following Goods (*)/
- the provision of the following service (*)
- Ordered on ()/ received on ()
- Name of the consumer(s)
- Address of the consumer(s)
- Signature of the consumer(s) (only for notification on paper)
- Date
- (*) Delete as appropriate.