Revocation Form

Revocation form

(Complete and return this form only if you wish to withdraw from the contract.)

To
KEC GmbH
Poststraße 2
35794 Mengerskirchen
Germany

Tel: +49 6476 419401
Fax: +49 6476 419402
Mail: info@boxxerparts.de


I/We* hereby give notice that I/We (*) withdraw from my/our (*) contract of sale of the following goods (*) / provision of the following service (*)
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Ordered on ___________________ (*)/received on _______________________(*)

Name of the consumer(s) ______________________________________
Address of the consumer(s)
_________________________________
_________________________________
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_________      _____________________________________________________
Date                signature of the consumer(s) (only with message on paper)

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(*) delete as applicable