Cancellation form | Lecksteine Shop

Cancellation form


Sample withdrawal form

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

imima GmbH, Managing Director: Mr. Marvin Thoma, Schwarzäckerstr. 41, 82178 Puchheim, Phone: +49(0)89 54662292, E-Mail: info@imima.de 

  • I/we (*) hereby revoke 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 consumer(s) (only in case of paper communication)
  • Date(s)

 

(*) Delete where not applicable.