Withdrawal

To
PauSat Lutz Paul
Hornstrasse 12
D 09599 Freiberg

service@pausat.de

I/We hereby give notice that I/We withdraw my/our contract of sale of following goods/for the supply of the following service:

(name of the product, if applicable order number and price)

Ordered on:
Received on:


name and address of the consumer(s):
Name of consumer(s):
Address of consumer(s):


_____________________________________________________
date and signature of the consumer(s) (only if this form is notified on paper)

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