Sample cancellation form

(If you wish to cancel the contract, please fill out this form and send it back to us)

TO
ax-lightness composites GmbH
Breiter Anger 1
37115 Duderstadt
Germany
Telefax: +49 5527 9965998
info[at]ax-lightness.de

I/we (*) hereby cancel 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)
_________________________________
_________________________________
_________________________________

________________________________________________________________________________
Date and signature of the consumer(s) (only for notification on paper)

(*) Delete as appropriate