Revocation form template

Baumann, Heydeck & Wegner 24-7-Shop GbR
Heidestraße 50
10557 Berlin

by Fax to: 
or by E-Mail to:

Hereby I / we* give notice that I / we* withdraw from the contract for the purchase of the following goods*/ provision of the following service*


Ordered on*/ received on*

Name of customer(s)

Address of customer(s)

Signature of customer(s)(only when sent on paper)


*Delete as appropriate.