Formular zur Widerrufsbelehrung

REVOCATION FORM

(If you want to revoke the contract, please fill out this form and return it by mail or email.)

 

To


PERMETEX GmbH
Müllerstr. 10
14482 Potsdam


or via E-Mail: service@permetex.de

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

 

 

 

 

Ordered*/ Received*


Name of customer


Adress of customer


Signature of customer (only if in written form)


Date


* Delete if inapplicable.