Cancellation Form

Sample Cancellation Form for Consumers

>(If you want to cancel the contract, please fill out this form and send it back.)

To:
Micony GmbH, Inh. Frederic Horsch
Sitzenhof 1
92421 Schwandorf

Telefon: +49 162 5715510
E-Mail: hey@ag-parts.de

I/We (*) hereby revoke the contract concluded by me/us (*) for the purchase of the following goods (*)/the provision of the following service (*)!

Ordered on (*)/received on (*):
Order Number:
Shipping Note Number:
Name of the consumer(s):
Address of the consumer(s):

Signature of the consumer(s) (only if notified on paper):
________________________

Date:
________________________

(*) Delete as applicable.

Please return your parcel, which must include the completed returns form (see attachment), to the following address:

HORSCH Maschinen SE & Co. KG
Sitzenhof 1