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

1. ______________________________________
2. ______________________________________
3. ______________________________________
4. ______________________________________

- 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_____________________________