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Sample Withdrawal Form

(If you want to withdraw from the contract, please fill out this form and return it.)

To
WLAN-Shop24.de
DAJB Hamburg GmbH
Von-Bargen-Straße 34
22041 Hamburg
Fax: +49-40-605902419
Email: hello@wlan-shop24.de

I/we () hereby withdraw from the contract concluded by 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 as appropriate

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