Cancellation form (sample)

Cancellation form

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

To:
Perla d'Oro – Jewelry Shop
Bürgermeister-Kuner-Straße 16
78136 Schonach in the Black Forest
Germany

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Declaration of revocation

I/We ( ) hereby revoke the contract concluded by me/us ( ) for the purchase of the following goods ( ) / the provision of the following service ( ):

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Ordered on (_________________ ) / received on (____________________ )

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Consumer name(s): __________________________________

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Address of the consumer(s):

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Place , date ____________________

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Signature of consumer(s)
(only required for notifications on paper)

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(*) Please delete as appropriate.