[translated from German using Google Translate®]
If you want to revoke the contract, please fill out this form and send it back (email, fax or post) service@fensterwischer.info / Fax: +49 (0) 9088 920 09 03
At
Company Karl Göttler
Castle Street
86754 Hohenaltheim, Germany
[translated from German using Google Translate®]
I hereby / / hereby revoke the contract concluded by me / us about the purchase of the following goods / provision of the following service:
.................................................. .................................................. .................................................. .......................
.................................................. .................................................. .................................................. .......................
.................................................. .................................................. .................................................. .......................
(Name (s) of the product (s), possibly order number and price)
Ordered on: ................................... / Received on: ........ ..................... (Date - Day, Month, Year)
Name and complete address of the consumer
(First name + last name) ............................................. As shown in Fig. .....................
(Street + no) ............................................. .................................................. As shown in Fig.
(Postcode + town) .................................... ......... .................................................. ...........................................
(Country) ............................................... .................................................. .................................................. ,
.................................................. ....................................., the ........... .................................................. ..
.................................................. .. Signature Customer (only with written cancellation)