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Revocation form

Model withdrawal form
 
(If you want to withdraw from the contract, please fill out this form and send it back.)
At
Patriotic Store Tobias Reinhardt
Breitscheidstr. 31
98559 Oberhof
Germany
Phone: +49 (0) 173-4689686
Email: info@patriotic-store.de
Hereby give notice (s) I / We (*) withdraw from my / our (*) contract entered into for the purchase
of the following products:
Ordered on (*) / received on (*):
Name / consumer (s):
Address of / consumer (s):
Signature / consumer (s) (only for message on paper):
date:
(*) Delete where inapplicable.
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