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Withdrawal form

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

On

HOM Home of Malts GmbH
Hosegstieg 11
22880 Wedel

Fax: +49 4103-965969-6
E-mail: info@homeofmalts.com
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 the consumer (s) (only when notified on paper)


date


(*) Delete as appropriate

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