Cancellation form

In the event of a revocation, please fill out the form below and send it at:

Philahandel GmbH
Vorster Str. 9
47906 Kempen

Tel. 02152-53085
Fax 02152-893837
E-Mail info@philahandel.de.

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

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Ordered on (*)/ ___________________________

received at (*): __________________________


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Name of consumer(s) :


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Address of the consumer(s)

 

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Signature of the consumer(s) (only for paper notification):

Date : ________________________________________(*)