Model withdrawal form
To Andreas Katikos, Im Rosenpark 18/2, 74366 Kirchheim am Neckar, Germany
Email: Andreas.katikos@googlemail.com

I/We (*) hereby give notice that I/we (*) withdraw from my/our (*) contract for the sale of the following goods (*) / provision of the following service (*):
Product or service:
Ordered on (*) / received on (*):
Name of consumer(s):
Address of consumer(s):
Date:
Signature of consumer(s) (only if submitted on paper):
(*) Delete as appropriate.