Withdrawal Form

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

- To
Desiree Kosel und Khanh Pham GbR
Emminghaus str.47A
61250 Usingen

- I/We (*) hereby give notice that I/We (*) withdraw from my/our (*) contract of sale of the following goods (*)/for the provision 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.