Withdrawal

To
STORE_DATAshop@rheinleder.de
Rheinleder - Sonja Amrhein
Waldstr. 21
65329 Hohenstein

Germany

Email: shop@rheinleder.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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