Model withdrawal form
If you want to cancel the contract, please fill out this form and send it back.
Joel Charlie Passow
I / we (*) hereby revoke the contract concluded by me / us (*) for the purchase 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 when notified on paper):
* please delete where applicable
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