Sample revocation form

Here you can find the Sample revocation form. (PDF-Download, ca. 65 KB)

Sample revocation form

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

To Leptoon | Stefan Enge | Krummackerweg 6a | 47495 Rheinberg | E-Mail  
I/we (*) hereby revoke the contract concluded by me/us (*) for the purchase of the following goods (*) #
Ordered on (*)/received on (*) #
Name of the consumer(s) #
Address of the consumer(s) #
Signature of the consumer(s) (only for paper notification) #
Date #

(*) Delete as applicable.

Online Revocation Form

If you want to cancel the contract online, please fill out this form and click on send.

To: Leptoon | Stefan Enge | Krummackerweg 6a | 47495 Rheinberg | E-Mail