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Declaration of revocation

 
If you want to withdraw your contract, please fill out this form and send it back to:
 
An die meconet e.K.,
Seelbacher Weg 7,
57072 Siegen,
Fax 0271/703087 99,
 
Hereby i withdraw our enclosed contract over the purchase of the following goods (*)/ provision of the following services (*):
 
 
___________________________________________________________________
 
 
Date ordered (*)/date delivered (*)
 
 
___________________________________________________________________
 
 
Consumer's name
 
 
___________________________________________________________________
 
 
Consumer's address
 
 
___________________________________________________________________
 
 
___________________________________________________________________
 
 
 
 
___________________________________________________________________
Consumer's signature (required in a written communication only)
 
Date
 
 
___________________________________________________________________
 
(*) Delete as applicable.
 

 

Declaration of revocation as PDF

 


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© meconet e.K. 1996-2019 | Seelbacher Weg 7 | D-57072 Siegen | Tel.: +49 (0)271 703087 0 | Fax: +49 (0)271 703087 99 | info@meconet.de
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