Withdrawal form
(If you want to withdraw from the contract, please fill out this form and send it back.)
At:
Skotasmus Gothic Shop Christian Haupt
Ahauser-Str. 44
48599 Gronau
or by e-mail to: info(at)skotasmus.de
Hereby give notice (s) I / We (*) withdraw from my / our (*) contract entered into for the purchase of the following goods (*) / provision of the following service (*)
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Appointed on ___________________ (*) / received on _______________________ (*)
Name / consumer (s) ______________________________________ / order number (if available): ________________
Address of / consumer (s)
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Date Signature / consumer (s) (only for message on paper)
Underline (*) Delete