MODEL WITHDRAWAL FORM

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

To
Horns24 Inh. Marcus Leidiger Barbarastr. 64
50735 Köln
Telefax: +49-221-1699815 info@horns24.sw

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:________________
Signature of consumer(s) :___________________________________________

(only if this form is notified on paper)

(*) Delete as appropriate

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