Sample cancellation form

Sample cancellation form

If you want to revoke the contract, please fill out this form and send it back.

To:
404MEDIA,
Owner: Stefan Pingel,
Töpferstraße 18,
19336 Bad Wilsnack,
Germany,
Tel.: +49 38791 80926; E-Mail: info@catama-software.de

I/we ___________ (*) ​​hereby revoke the contract I/us (*) made regarding the purchase of the following goods ___________ (*) ​​/ the provision of the following service ___________ (*)

ordered on _________ (*) ​​/received on ___________ (*)

Name of consumer(s): ___________

Address of consumer(s): ___________

Signature of the consumer(s) (only if notified on paper): ___________

Date: ___________

(*) Delete where not applicable