Revocation form

Specimen - revocation form

(If you wish to revoke the contract, please fill up this form and send it back to us.)

To :
ADCS GmbH & Co. KG
Hutmacherring 5
23556 Lübeck
email: info@adcs-germany.com

I/we (*) herewith revoke the contract concluded by me/ us (*) regarding the purchase of the following products (*)/ the provision of the following service (*)

_____________________________________________________

Ordered on (*)/ received on (*)

__________________

Name of the consumer(s)

_____________________________________________________

Address of the consumer(s)

_____________________________________________________

Signature of the consumer(s) (only in case of a notification on paper)

__________________

Date

__________________

(*) Cross out the incorrect option.