Revocation Form

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Revocation form

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

Invoice number*

Invoice date*

Article number*

Designation*

Price*

Ordered on*

Received on*

First and Last Name*

Street and house number*

Postcode*

Place of residence*

e-mail address*

Country*

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