Cancellation form
If you wish to cancel this contract, please complete and submit this form.
CONVAR EUROPE GmbHCONVAR BUSINESS PARK
Massachusetts Avenue 4600
66953 Pirmasens
Fax: +49 6331 268 299
E-Mail: info@conserva.de
I/We (*) hereby give notice that I/We (*) cancel my/our (*) contract of sale of the following goods (*) /for the supply of the following service (*),
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Ordered on (*) ____________ / received on (*) __________________
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Name of consumer(s)
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Address of consumer(s)
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Signature of consumer(s) (only if this form is notified on paper)
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Date
(*) Delete as appropriate