Signature: ______________________________ (only required if sending on paper)
Delete as appropriate.
withdrawal form If you want to revoke the contract, Then please fill out this form and send it back. On: SEI DESIGN home textiles Inh. Irina Richter service department Sachsenhausen Str. 6D 16515 Oranienburg e-mail: amazon@techniktrade.de Fax: 03301 / 83926-26 Hereby I / we * revoke this from me / us * concluded contract for the purchase of following goods * / providing the following services * Ordered on * ____________________ / received on * ______________ Surname ________________________________________________
Order - or customer number ________________________________________________
address ________________________________________________ ________________________________________________ date _____________________________ signature ______________________________ (only required on paper) * Please delete as appropriate.