Cancellation form
Specimen - revocation form
(If you wish to revoke the contract, please fill up this form and send it back to us.)
- To dynamic SHIELD GmbH, Bessemerstraße 38-42, 12103 Berlin, Fax number: +4930577088259, Email address: support@artwizzcare.de :
- 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.