Model withdrawal form
(If you want to withdrawl the contract, please fill out this form and send it back)
To
ax-lightness composites GmbH
Breiter Anger 1
37115 Duderstadt
Fax: 05527 9965996
info@ax-lightness.de
I/We (*) hereby give notice that I/We (*) withdraw from my/our (*) contract of sale of the following goods (*)/for the provision of the following service (*),
______________________________________________________________________________________________
Ordered on ___________________ (*)/received on _______________________(*)
Name of consumer(s) ______________________________________
Address of consumer(s)
_________________________________
_________________________________
_________________________________
_______________________________________________________________
Date and Signature of consumer(s) (only if this form is notified on paper)
(*) Delete as appropriate