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.: 038791 80926; Email: 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