Withdrawal form

MODEL WITHDRAWAL FORM

(to copy and fill in)

 

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

 

To

Norbert Stein Pata Music

Humboldtstr. 26

50676 Koeln

mail@patamusic.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)

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_________________________________

_________________________________

 

 

 

 

 

 

 

 

 

 

_____________________

 

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Date

 

Signature of consumer(s) (only if this form is notified on paper

 

(*) Delete as appropriate