Revocation form

Model withdrawal form

complete and return this form if you wish to withdraw from the contract

An

KUNBUS GmbH
Heerweg 15C
73770 Denkendorf
Germany
Fax: +49 (0) 711 400 91 501
Email: info@kunbus.com

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 (*),

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Article No./ article description and quantity

Ordered on (*) ____________ / received on (*) __________________

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Order number

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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