Sample cancellation form

(If you wish to cancel the contract, please fill out this form and return it to us.)

To

Kaiser Bekleidungs GmbH

Am Hundsrück 4

63924 Kleinheubach

customerservice@kaiser-fashion.de

I/we (*) hereby withdraw from the contract concluded by me/us (*) for the purchase of the following goods (*) / the provision of the following service (*)

_______________________________________________

_______________________________________________

Ordered on ___________________ (*)/received on _______________________(*)

Name of consumer(s) ______________________________________

Address of consumer(s)

_________________________________

_________________________________

_________________________________

Date:________________

Signature of consumer(s):___________________________________________

(only for paper notifications)

(*) Delete as applicable