Model cancellation form

- To
Tzamouranis & Schmidt & Artale Internationale Handels GmbH & Co. KG
Weinbergsweg 20
10119 Berlin
Deutschland 

- I / we [*] hereby give notice that I / we [*] cancel my / our [*] contract of sale of the following goods [*] / for the supply of the following service [*],
- Ordered on [*] / received on [*]

- Name of consumer(s)

- Address of consumer(s)

- Signature of consumer(s) (only if this form is notified on paper)

- Date

[*] Delete as appropriate