Withdrawal

To
STORE_DATAshop@rheinleder.de
Rheinleder - Sonja Amrhein
Joseph-Haydn-Str. 14
654812 Bad Soden

Germany

Email: schop@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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