Model Cancellation Form
Klivatec B.V
Pelgrimsweg 14 5018 EN Tilburg,
info@klivago.com
+31 684 817 783)
- I / we [1] hereby give notice that I / we [2] cancel my / our [3] contract of sale of the following goods [4] / for the supply of the following service
- ______________________________________
- ______________________________________
- ______________________________________
- ______________________________________
- Ordered on _______________ received on __________________
- Name of consumer(s)___________________
- Address of consumer(s)______________________
- Signature of consumer(s) (only if this form is notified on paper)__________________
- Date_____________________________