Main page » Model withdrawal form

Withdrawal

Complete and return this form only if you wish to withdraw from the contract.

Keune Wiederladen&Schießsportzubehör
Thomas Keune
Jülicherstr. 7
53919 Weilerswist
Germany

Fax: 02254 837314
E-Mail: Bestellung@Keune-Wiederladen.de

Withdrawal

Note: Delete as appropriate.

Ordered on

Received on

Name of consumer(s)

Salutation

Mr Miss/Ms/Mrs None

Firstname

Lastname

Address of consumer(s)

No./Street

Postcode / Town

Country

Your e-mail address, to immediately confirm the receipt of the withdrawal

Your e-mail

Withdrawal date

Privacy I have read the privacy notice.

* required