Cancellation form

Sample cancellation form

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

it back)

- To Refurmed, Miningstr. 56, 12359 Berlin:

- Herewith I/we (*) revoke the contract concluded by me/us (*) for the purchase of the

the following goods (*)/the provision of the following service (*)

- Ordered on (*)/received on (*)

- Name of the consumer(s)

- Address of consumer(s)

- Signature of consumer(s) (only in case of paper communication)

- Date(s)

(*) Delete where inapplicable.