Sample Cancellation Form

Sample Cancellation Form

If you wish to cancel the contract, please fill out this form and return it.

To:
404MEDIA,
Owner: Stefan Pingel,
Töpferstraße 18
19336 Bad Wilsnack
Germany
Phone: 038791 80926; Email: info@catama-software.de

I/we, ___________ (*), hereby cancel the contract entered into 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 for paper notifications): ___________

Date: ___________

(*) Delete as appropriate