Cancellation form


(If you wish to revoke the contract, please fill up this form and send it back to us.) - To Tijen G├╝rses-Sefil, Heinrich-Welken-Str. 1, 59069 Hamm, Fax number: 02385 / 942 94 43, Email address: info@vimoda.de : - I/we (*) herewith revoke the contract concluded by me/ us (*) regarding the purchase of the following products (*)/ 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 in case of a notification on paper) - Date (*) Cross out the incorrect option.