Cancellation form


 

Sample withdrawal form


(If you wish to withdraw the contract, please fill in this form and send it back to us.)


to:


MEDIAdorado Ltd.
Alteburger Str. 212
D - 50968 Köln


Fax: 0221 / 27907249


email: info@afrika-shop24.de


I/We (*) hereby withdraw the contract entered into for the sale of the following goods (*) / the provision of the following services (*):


 


Ordered on (*) / Received on (*)


Name of the consumer(s)


Address of the consumer(s)


Signature of the consumer(s) (only for communication on paper)


Date


 


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(*) delete where inapplicable