(Should you wish to revoke the contract, please fill in this form and return it to us.)
To
J.F. Kennedystraße 154
39055 Leifers (BZ)
Italien
Tel. +39 0471 954207
I/we (*) hereby revoke the contract concerning the pruchase of the following goods (*) / the provision of the following services concluded by me/us (*)
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Ordered on ___________________ (*)/received on _______________________(*)
Name of the conusumer(s) ______________________________________
Address of the consumer(s)
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_________ _____________________________________________________
Date Signature of the consumer(s) (only in case of paper notification)
(*) Delete as appropriate.