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.