Revocation form

Sample revocation form

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



To

Becopa

Bruno-Bürgel-Weg 18

12439 Berlin



Email: info@becopa.de



I/we (*) hereby revoke the contract concluded by me/us (*) for the purchase of the following goods (*)/the provision of the following service (*)



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Ordered on (*)/ received on (*)

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Name of the consumer(s)

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Address of the consumer(s)

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



Date.........................................................................................................................



(*) Delete as appropriate