Sample withdrawal form

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

At :

Kurth Classics UG (limited liability)

Norman Kurth

Römerstr. 13

50996 Cologne

Email info@kurth-classics.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 on (*)/received on (*)

__________________

Name of consumer(s)

_____________________________________________________

Address of consumer(s)

_____________________________________________________

Signature of consumer(s) (only if notification is on paper)

__________________

date

__________________

(*) Delete where not applicable.