Sample revocation form

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

To:

H&D shoes and more instyle GmbH
North-Carolina-Avenue 10
66953 Pirmasens
Germany
E-Mail: info@hdinstyle.de
Tel.: 063312165517

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

Ordered on (*)/ received on (*): _____________________________

Name of the consumer(s): ______________________________

Address of the consumer(s): ________________________________

_________________________________________________
Signature of the consumer(s) (only for communication on paper)

Date

___________________________________

(*) Delete where inapplicable