Model Withdrawal Form


 


 

(complete and return this form only if you wish to withdraw from the contract)


 


 

To:

Asia-Tec Motorradzubehör

Jochen Lehnert

Adelholzener Str. 20a

D- 83313 Siegsdorf

 

Fax: 08662/663819

Mail: Anfrage@Asia-Tec.com

 

 

 

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.