Revocation Form

MODEL WITHDRAWAL FORM

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

haustierkost.de®
VISIONISTAS GmbH
Werftstr. 26
40549 Düsseldorf

by Fax: +49 211 99446744
by E-Mail: [email protected]

I/we (*) hereby give notice that I/we (*) withdraw from my/our (*) contract of sale of the following goods (*)/for the provision of the following service (*),

Ordered on^* / received on ^*

Name of consumer(s)

Address of consumer(s)

^* Delete as appropriate