(If you want to cancel the contract, please fill out this form and send it back.)

At
company
Meine Kette
Am Markt 14
44575 Castrop-Rauxel

Email address: support@meinekette.de

- I/we (*) hereby revoke the contract concluded by me/us (*) for the purchase of the following goods (*)
- Ordered on (*)/received on (*)
- Name of the consumer(s)
- Address of the consumer(s)
- Signature of the consumer(s) (only for paper notification)
- Date
-------------------------------------- (*) Strike out what is not applicable.

Source: Plutte law firm